Week 8- Lx Flashcards
What causes lumbar spine fractures
lumbar spine fractures occur when forces of compression, distraction and rotation exceed the strength of the spinal column
Common injuries resulting in fractures of the lumbar spine
fall from height
motor vehicle and pedestrian accidents,
high velocity sports
Microtrauma affect on the lumbar spine
Microtrauma can cause low level inflammation that cannot be seen or felt
arise in muscle, ligament, vertebrae, and discs, either singly or in combination
Repetitive microtrauma not allowed time to heal can result in more serious conditions
LBP Risk factors (11)
Being middle aged (risk drops after age 65)
Being male
having family history of back pain
heavy manual occupation
Having had a previous back injury
Psychosocial factors, anxiety, depression
Being overweight, smoking, unfit, poor posture
Having had trauma to the spine
Having had previous back surgery
Having spine problems since birth (congenital)
Being pregnant
What makes LBP difficult
85% of sufferers cannot be given a definitive diagnosis with radiological investigations
Therefore careful attention to clinical signs and symptoms
Lumbar movement disorders
Hypomobility disorders 0 restricted ROM
Hypermobility Syndrome - ROM in excess of acceptable
There are a number of different classification systems employed in low back pain
What factors are used to diagnose LBP
Age
current history and behaviour of symptoms
examination findings
response to treatment
What happens to the spine as we age
the disc dehydrates and undergoes fibroses
Alters spinal loads in the body
facet joints undergoes OA changes
ligament/ capsules and muscles also age
Two basic components of the vertebral disc
Annulus fibrosis (outer part) Nucleus pulposus (inner part)
What is Lumbar spondylosis
degenerative changes such as osteoarthritis
What is spinal stenosis
structural changes narrowed spinal canal
- congenital or development bony anomaly in elderly population >60
- degenerative changes Z joint and disc bulges
What is a intervertebral disc prolapse
Bulge - herniation - prolapse
Peak age 20-45 yrs
more common in males
herniation
Signs of disc prolapse
LBP + Sciatica
Quality of pain = severe. sharp and aggravated with flexion activities
Possibly neurological signs
Often a shift or deviation of the spine
Yellow flags
psychosocial factors that increase the risk of developing or perpetual long term disability
Fear avoidance
low mood and social withdrawal
Belief that back pain is harmful/disabling
Monitor for red flags
Cauda equina compression
Persistent or progressive neurological deficit
intractable pain
serious spinal pathology
tumour / cancer
inflammatory disorders (ankylosing spondylitis & related disorders)
