Sophisticated testing/ flags

Question 1

What is the indication for reeval/ referal

Answer 1

If a patient w acute pain does not improve after 2-3w of care

Question 2

what 3 questions does dr deyo suggest to ask in every case of LBP

Answer 2

1. are there any red flags
2. Are there any yellow
3. Is there any neurological comprimise

Question 3

what are red flags

Answer 3

• pot serious pathology
• risk factors of delayed recovery
• contraindications to manual therapy

Question 4

what are the major red flags (5)

Answer 4

1. Cancer (past hx, night pain)
2. Spine infection (tendernesss, urinary inf)
3. compression fracture
4. Ankylosing spondylitis (reduced chest expansion)
5. cauda equina

Question 5

what are the abdominal red flags

Answer 5

1. peptic ulcer
2. Hiatus hernia
3. Cholecystis
4. Inflammatory bowel disease
5. colon cancer
6. abdominal aortic aneurysm

Question 6

What are the pelvis red flags

Answer 6

1. Uterine
2. Overian cyst
3. Pelvic inflammatory disease

Question 7

What are the genitourinary red flags

Answer 7

1. UTI
2. Pyelonephritis
3. kiney stones
4. Prostatis
5. Prostatic carcinoma

Question 8

what is waddels test for pain behaviour

Answer 8

1. pain on axial loading
2. distraction SLR
3. superficial tenderness
4. region disturbance
5. overreaction

if 3/5 are positive then there is a psychological component to pain

Question 9

Hysteria

Answer 9

those who unconsiosly fakes diseases ilness for personal gain

Question 10

somatizization

Answer 10

conversion of mental or emotional distresss to bodily symptoms

Question 11

non physical factors that suggest better indicators of return to work (3)

Answer 11

1. lack of hs education
2. long term length of injury
3. presence of pain behaviours/ attorney

Question 12

what is abnormal illness behaviour

Answer 12

maladaptive way of seeing ones own state of health, despite having solutions or a managemnet plan from doc

Question 13

what are some clinical features of malingering

Answer 13

1. marked discrepency between the persons claimed stess and objective findings
2. lack of cooperation
3. if there is financial comp

Question 14

what are some early indicators of chronic non organic pain

Answer 14

1. wadells test
2. inappropriate pain beviour
3. pain amplification
4. discrepancy bw subjective pain and tests
5. lack of cooperation

Question 15

what do u do with patients that u suspect are exagerating

Answer 15

1. treat msk issue

2. refer to psychologist for fear avoidence behaviour

Question 16

what are the 4 yellow flags that indicate a delayed recoovery

Answer 16

1. Ideas (belif that pain is harmful)
2. Concerns (fear avoidence behaviour)
3. Psych hx (depression etc)
4. Expectations (expectations that passive treatment will help them )