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OPP Lect 30
OPP Lect 30 LBP III
Question | Answer |
---|---|
Effective treatment for chronic LBP | 1.Manipulation (more so than acute). 2.Exercise therapy. 3.Back to school (intensive multidisciplinary biopsychosocial intervention) |
What is a Lumbar Step-off a sign of? | Spondylolithesis |
What is the cause of a UNIlateral Iliolumbar ligament syndrome? | Short leg (anatomical or functional). **Treat the Short leg. |
What are the causes of BIlateral Iliolumbar ligament syndrome? | 1.Hyperlordosis. 2.Overuse strain. 3.Postureal weakness (from lack of activity w/ aging). 4.Spondylolysis (degeneration from OA). 5.Spondylolisthesis (Ant shift of vertebrae). 6.Sacroiliitis. |
Where will pain present with Iliolumbar ligament syndrome? | 1.Lateral Hip. 2.Inner thigh. |
What are the 4 main causes of Chromic LBP? | 1.Coccydynia. 2.Iliolumbar Ligament Syndrome. 3.Pelvic Pain. 4.Sacroiliitis. |
How would you start treating a patient with Iliolumbar ligament syndrome? | 1.Back stretching. 2.Abdominal strengthening. **Can tolerate back strengthening only once pain is gone and abdomen is strong. |
Causes of Sacroiliitis | 1.Ankylosing Spondulitis. 2.Psoriatic Arthritis. 3.Reactive Arthritis. 4.Gouty Arthritis. 5.Vit A/ Retinoid toxicity. 6.DISH syndrome. **Will have Sacral pain with an ASIS compression test. |
OMT for Acute Arthritis | 1.Indirect tech to relieve pain. 2.Lymphatic tech to reduce swelling. 3.Direct tech w/ traction to improve motion & avoid stressing joint (adding the traction will make it effective if it doesn't produce pain) |
Is pelvic pain common? | YES |
Are radiologic and laparoscopic evaluation usually negative with Pelvic pain? | YES |
Pelvic pain is much more common in men or women? | WOMEN, after several births. |
What should you treat to help with pelvic pain? | 1.Pelvic Diaphragm. 2.Sacrum. 3.Hips (retraining iliopsoas function: hip extensor stretch, supine lef lift) |
SDs associated with Chronic Pelvic Pain | 1.Pubic Shear or compression. 2.Innominate shear. 3.Psoas Syndrome. 4.Pelvic Diaphragm weakness. 5.Coccydynia (Coccyx pain, often from fall/fracture). |
Somatic Dysfunctions associated with Coccydynia | 1.Glut max strain. 2.Sacrotuberous ligament sprain. 3.Pelvic floor muscle strain (Birth). 4.Coccyx flexion. |
Key Indicator of Iliolumbar ligament syndrome | Bilateral Upper pole L5 tennderpoints OR iliolumbar lig tenderness. |
Key Indicator of Sacroiliitis | 1.Diffuse tenderness in the joints, 2.ASIS compression reproduces the pain, 3.FABER test/Patrick maneuver (Ant hip pain). |
Key Indicators of Pelvic Pain | 1.Anterior Pelvic tenderpoints. |
Key Indicators Coccydynia | Sacrococcygeal tenderness, Palpation of coccyx is anterior is reproduces pain. |