Week 3 - LBP Triage

Question 1

Ankylosing Spondylitis

Answer 1

Prevalence - 2% in Australia
M:F = 3:1
- deep ache in buttocks
- pain in front of chest/between scaps

Question 2

CES

Answer 2

Compression of Lx/Sacral roots

• bowel/bladder dysfunction
• saddle anesthesia
• bilateral motor weakness

Question 3

Spinal Canal Stenosis

Answer 3

• older people >65
• due to impingment of spinal canal due to various factors
• osteophytic changes
• lig. flavum hypertrophy
• disc bulge
• degenerative spondylolisthesis

PRESENTATION:

• worse with extension
• better with extension
• may be relieved with rest
• neurogenic claudication?
• burning pain

Question 4

Vascular Claudication

Answer 4

• affected by activity (relieved promptly by rest)
• throbbing pain
• absent pulses?

Question 5

Osteoporosis - risk factors

Answer 5

• female post meno
• corticosteroid use
• medical conditions (affecting kidney, thyroid, parathyroid)
• FMHx

Question 6

Spondylolisthesis

Answer 6

• agg by extension
• usually unilateral
• presents as LBP (45% of athletic adolescents)
• early dx to prevent progression!

Question 7

Red flags in kids with LBP (besides the usual red flags)

Answer 7

• development of SCOLIOSIS
• severe constipation
• reduction in mobility + abnormalities of gait

Question 8

Management of NSLBP

Answer 8

1. Patient education (self management)
2. Active PA encouraged
3. Simple analgesic meds

Address IMPAIRMENT
DON’T USE: US/TENS/IFC/ACUPUNCTURE/TRACTION/ORTHOTICS