Thoracolumbar Spine III- LBP Flashcards
With LBP, it is ____-_______ and has an unidentified ________ source
non-specific; nociceptive
Which area is the smallest amount of related pathology?
thoracic
With LBP, it is the leading cause of …
worldwide _______
________ limitation and _____ absence
disability
activity
work
What percentage of people will experience LBP in their life?
80%
LBP is common in
Biological ______
Older or younger?
_______ educational status
________ physical work demands
women
older (half > 65 yrs.)
lower
higher
Imaging with MRI:
_______ of asymptomatic individuals had “abnormal” findings
1/3
What are some examples of abnormal findings on imaging with MRI?
IDD
Age-related disc changes
N. compression
Facet Hypertrophy
With Imaging w/ MRI:
______ of symptomatic individuals had an abnormality
1/2
With imaging with CT and MRI:
_____ of asymptomatic 30-80 yr. old individuals had disc changes
1/3
With imaging w/ CT and MRI:
Normal asymptomatic age-related changes MUCH ____ symptomatic structural changes
A. <
B. >
B.
Imaging changes significantly increase with ____
age
Who should get imaging with LBP?
> ____ years of age with a
hx of _____
_______ paresthesias
_______ and ______ dysfunction
Specific _______ deficits
Progressive/_______symptoms
NO improvement after ____ weeks of Rx
50; cancer
saddle
bowel; bladder
neurological
disabling
6
Imaging _____ ______ improve outcomes and guidelines; consistently recommended against routine imaging
does NOT
With LBP nearly all cases have an _________ _________ source
unidentified; nociceptive
With PT Rx, there is a SUBSTANTIAL gap between ______ and ________
evidence; practice
With PT Rx, there is ___________ of unsupported and ineffective Rx
overutilization
What are some examples of unsupported and ineffective Rx?
______ avoidance behaviors promoted with _______ interventions like modalities AND even some manual therapies
Leads to _____ costs
Contributes to greater _______ addiction
Greater imaging and _______ exposure
MORE likely to have ______ procedures, side effects and missed work
Fear; PASSIVE
higher
opioid
radiation
invasive
With PT Rx and prevention, it is:
_______ research
______ promoted preventions lack evidence
Exercise is ________ effective in adults
Inadequate
MOST
Largely
With PT Rx and prevention involving children, it is:
________ furniture effective
_______ is NOT evaluated
Ergonomic; Exercise
With PT Rx and early PT:
Only ___% developed persistent LBP
Significant reductions in lost ____ time
________ by numerous studies
2
work
Supported
With LBP involving education and advice: it is the _____ line of Rx with moderate to strong evidence
First
With LBP, PT Rx is AGAINST what two things?
Bed rest
In-depth explanations
With LBP, PT Rx is FOR what?
Spinal _______ and _______ strength
Overall ________ prognosis
Active P! ________ mechanisms that decrease fear catastrophizing
Stay _______ with early resumption of ADLs
__________ contributors and basics of nociplastic P!
Emphasis on _______ with back protetion techniques
structural; anatomical
favorable
coping
active
Biopsychosocial
function
Dry needling with LBP has what kind of evidence and benefit?
weak; short-term
Modalities with LBP is generally ________ and ____ recommended
ineffective; NOT
Modalities with LBP have what results?
short-term at best
With LBP, soft tissue mobilization/massage have what kind of evidence and benefit?
moderate; short-term
With PT Rx, what overcoming barriers are BEST to practice?
_________ consultation time and follow up
Better ______ to return to work
Reward _______ and NOT volume with reimbursement
________ service announcements
_________ provider knowledge of evidence and guidelines for use in clinical reasoning and decision making
Increase
incentives
quality
Public
Increased
LBP Rx Classifications:
There is ______ evidence with acute LBP
moderate
LBP Rx Classifications:
There is ______ evidence with chronic LBP
weaker
What are the 4 subgroups of LBP Rx Classifications?
Mechanical Traction
Directional Preference
Mobilization/Manipulation
Stabilization