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24 Cards in this Set

  • Front
  • Back
what are the 5 categories that Saunders divides back disorders into
1) muscle disorders
2) joint disorders
3) disc disorders
4) neural disorders
5) miscellaneous disorders
What is the main difference between muscle disorders in the upper spine vs. lower spine
in the lumbar spine only a small percentage of back problems have the primary disorder of muscle dysfunction, rather it is often a secondary response to an underlying pathology
what is a muscle spasm
increased muscle tone
what causes muscle spasm
almost always secondary to trauma or to an injury to another structure
what are the S and S of muscle spasm
1) tenderness to palpation
2) increased muscle tone (BIG ONE)
3) no indication of joint involvement (i.e. PA pressure on spinous process is negative)
how is treatment affected by muscle spasm if it is deemed a secondary pathology
must treat the muscle spasm before treatming the primary pathology
what is the treatment for an acute muscle spasm
1) ice
2) modalities
3) relative rest with gentle painfree AROM/PROM
4) exercises on regular basis especially if work environment requires the use of prolonged static posture
what is the treatment for a chronic muscle spasm
1) moist heat
2) modalities
3) soft tissue massage
4) restore flexibility
5) strength
6) functional tasks
7) regular rest periods
what is the process by which an acute muscle spasm/guarding may become chronic
process of circulatory stasis, retention of metabolites, and pain
what is a muscle strain or contusion
a muscle injury/tear
what causes a muscle strain/contusion
1) direct tauma
2) excessive muscular effort
3) hx of minor strain followed by aggravation with multpile repititions
what are the S and S of a muscle strain/contusion
1) hx of trauma or significant muscular effort
2) pain with palpation of injured muscle (BIG ONE!)
3) rest decreases pain
4) activities/movements increase pain
5) stiffness after rest
6) feeling of "loosening up" with light activities
7) joint testing is negative
why could resisted motion for the lumbar spine be misleading
there are a lot of other things being stressed so by itself pain with resisted ROM is not always a strong indicator/diagnosis of muscle strain
what is the treatment for a muscle streain/contusion
treat as anoy other muscle strain depending on the stage of injury.... restoration of full function and normal posture should be most important!
what is myositis
inflammation of the muscle (typically insidiuous onset)
why is it "weird' that myositis is considered an "inflammation"
because there is usually no real marker of inflammation, rather a global dysfunction of the system
what is the cause of myositis
chronic microtrauma or repetitive stress or could be secondary to an initial trauma
what are the S and S for myositis
1) same as muscle strain but INSIDIOUS CAUSE
2) pain with palpation (over large area)
3) rest decreases pain
4) activities/movements increase pain
5) stiffness after resting
6) feeling of loosening up with light activities
7) pain is diffused not well localized (vs. muscle strin where its localized)
8) joint testing is negative
what is the treatment for myositis
1) same as for muscle strain/contusion
- heat as opposed to ice
- rest
- modalities
- progressive rehab
2) restore full function
- ROM
- strength
- endurance
3) MOST IMPORTANTLY
- Identify and correct the cause of chronic irritation (posture or work activities for example)
what is a quadratus lumborum strain
strain of the quadratus lumborum (DUH!)
what is the cause of a quadratus lumborum strain
1) pulling or lifting in a position combining FB and reaching to one side
2) direct trauma/car accident
3) falling
what are the S and S for a quadratus lumborum strain
- localized deep aching pain (sharp with mov't)
- referred pain in the iliac crest area (possibly to lower quad of abdomen, groin, greater troch, buttock, SIJ)
- lumbar spine concavity to the side of the injury
- pain with FB, contralateral SB and possibly extension with ipsilateral rotation
- denderness to deep palpation of the muscle
why could a patient with a quadratus lumborum strain present with a Lspine concavity
the muscle shortens for protection on the side of the injury
what is the treatment for a quadratus lumborum strain
treat as any muscle strain depending on the stage of the injury..... restoration of full function an dnormal posture should be the most important aspects of tx