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21 Cards in this Set
- Front
- Back
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Where does low back pain typically occur anatomically?
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Midline at the L4 or L5 level
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Where does low back pain typically radiate?
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Radiation to the sacroiliac joint area or even the buttocks
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How do you perform the straight leg raise test?
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Patient supine, cradle foot in your hand and elevate the leg until knee bends or patient complain of severe pain in the butt or back. Dorsiflex the ankle to see if this motion increases pain. Dorsiflexion increases sciatic tension and increases sciatic pain. Plantar flexion relieves sciatic tension, thus increased pain in the back is probably nonorganic.
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How do you perform the flip sign?
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Patient seated, lift the foot and extend the knee; patients with sciatic tension will immediately flip backwards in acute pain and may hit the wall. The flip sign correlates with straight leg raising pain under 45 degrees.
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What is a low back sprain?
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Episode of low back pain that impairs functions from a few days to as long as 4 weeks.
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What are the causes of low back sprain?
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Risk factors include lifting heavy objects and repeated twisting or sitting for prolonged periods of time.
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What is the prognosis of a low back sprain?
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85% of patients improve within 1 month
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What is chronic low back pain?
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Axial lumbar spine pain where symptoms have lasted longer than 3 months
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What is a common cause of chronic low back pain?
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Degeneration of the intervertebral disk
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What is the clinical presentation of lumbar degenerative disk disease?
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Lumbar pain that may radiate to one or both buttocks is the hallmark symptom.
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What is sciatica?
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Sciatica is most commonly an irritation of the 5th lumbar or 1st sacral nerve roots
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What is the most common cause of sciatica?
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Result of a herniated nucleus pulposus causing direct mechanical compression of the root leading to root pain
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What is the clinical presentation of sciatica?
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Onset of symptoms is abrupt and accompanied by low back pain. Pain is severe and exaggerated by coughing/sneezing.
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Where does sciatica pain radiate?
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Buttock down to the posterior/posterolateral leg to the ankle or foot
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How do you examine a patient with sciatica?
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Flip sign is highly reliable for a herniated disk especially when coupled with back pain produced with the straight leg raising test.
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What is spinal stenosis?
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It is a narrowing of the spinal canal, usually worsening with age.
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What is the clinical presentation of spinal stenosis?
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Low back pain and leg symptoms are worsened by extension of the spine (as when walking, standing); may also include leg symptoms
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How can patients with spinal stenosis experience relief on their own?
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Flexion or bending forward, patients with spinal stenosis walk well with the lumbar spine flexed forward.
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How do you examine a patient with spinal stenosis?
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Have the patient stand with the spine extended (leaning backward); pain reproduction indicates spinal stenosis
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How does a patient with a metastatic tumor to the spine present?
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Unrelenting night pain and weight loss
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What is ankylosing spondylitis?
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Chronic, inflammatory arthritis that affect the joints of the spine and sacroilium in the pelvis, causing eventual fusion of the spine
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