Low Back Pain LECT Flashcards Preview

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Flashcards in Low Back Pain LECT Deck (25)
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1
Q

Aching pain in gluteal region increasing after sitting longer than 15-20 minutes, with “wallet” sign is indicative of what syndrome?

A

Piriformis syndrome

2
Q

How is the sacrum affected by a tight piriformis?

A

Sacrum rotates anterior toward ipsilateral side on a contralateral oblique axis

(R piriformis syndrome causes L on L sacral torsion with compensatory rotation of lower lumbar vertebrae to the right)

Leads to ipsilateral physiologic short leg and ipsilateral hip external rotation

3
Q

How are L1 and L2 commonly affected by psoas syndrome?

A

Flexed and rotated toward side of affected psoas

4
Q

How is L5 commonly affected by psoas syndrome?

A

Extended

5
Q

Where are the tenderpoints for psoas syndrome commonly found?

A

Ipsilateral iliacus

Contralateral piriformis

6
Q

Short leg syndrome is commonly due to dysfunctions where?

A

Sacroiliac, lumbosacral joints

7
Q

Pt with scoliosis c/o dull, midline lumbosacral aching. Pt c/o that pain gets worse as the day progresses. What syndrome might this be?

A

Short leg syndrome

8
Q

In short leg syndrome, what structure is the first to react to added stress in the lumbosacral area?

A

Iliolumbar ligament

TTP at attachment on iliac crest or L4/L5 TP

9
Q

What is the somatic dysfunction associated with short leg syndrome?

A

Lumbar spine sidebent away and rotated toward side of lower sacral base

Innominate rotated anterior on side of short leg

Foot on longer leg pronated with internal rotation

10
Q

What is the indication for heel lift therapy in short leg syndrome?

A

Typically only tx if leg length discrepancy is >5mm

11
Q

If there is an acute change in leg length in short leg syndrome, how quickly must you replace the discrepancy?

A

Replace the full discrepancy immediately

12
Q

What is the postural fault most implicated in spondylolysis/spondylolisthesis?

A

Hyperlordosis

13
Q

35 yo female athlete c/o pain in the buttock and posterior thigh after a motor vehicle accident. + Thomas test. On radiograph, pt appears to have a sliding vertebra at the lumbosacral joint. What is this presentation?

A

Spondylolisthesis

14
Q

Spondylolysis is a stress fracture in the ________

A

Pars Interarticularis

15
Q

Common somatic dysfunctions in spondylolysis/spondylolisthesis

A

Psoas spasm

Iliacus dysfunction

Flexed upper lumbar dysfunction

Sacroiliac/sacral torsion

Innominate dysfunction

16
Q

What type of spinal disc herniation is most common?

A

Posterolateral herniation

17
Q

Pt c/o sudden onset LBP with bending/lifting and numbness and tingling down the front and sides of the thigh after a motor vehicle accident 2 days ago (sudden or compressive force). Pt has a + Straight Leg Raise. What pathology is this?

A

Spinal disc herniation

18
Q

Discs most commonly affected by spinal disc herniation?

A

L4-L5

L5-S1

19
Q

Clinical test of choice for confirmation of herniation

A

MRI

20
Q

Pt presents with bowel and bladder incontinence after motor vehicle accident yesterday which resulted in a lumbar spinal fracture. Upon examination, pt appears to have numbness and tingling in the perineal area. What pathology does this pt most likely have?

A

Cauda Equina syndrome

Requires urgent surgical referral - do not tx with OMT

21
Q

What part of the spine is most affected by degenerative disc disease?

A

Lumbar spine

Due to mobility and weight-bearing responsibilities

22
Q

60 yo female w/ PMH of osteoarthritis c/o low back pain exacerbated by standing and walking, relieved by sitting or lying down. Pt also complaints of numbness and tingling radiating down her thighs. What disease process is this?

A

Spinal stenosis

23
Q

Diagnosis of spinal stenosis is made with what test?

A

MRI

24
Q

What OMT is most contraindicated for low back pain in pts with back pain-related comorbidities (vertebral tumor, CA, osteoporosis, acute lumbar disc herniation, compression fx, Rheumatoid arthritis)?

A

HVLA

25
Q
A