diagnosis Flashcards
(16 cards)
Facet subjective and objective
S: localized LBP, aggravated with prolonged sitting and combined movements (ex: reaching behind back or reaching down and at an angle). Might state that they feel a “nip” into extension
O:
- arom either painful in a closing pattern (ex, ipsi Sb and contra rotation) or open position (flex, contra SB and ipsi Rotation)
- Positive quadrant
- deceased or painful unilateral PAs
Facet treatment
Manual:
- SNAGS for opening
- MET in opening for multifidi
- joint mobs grade 1and 2 for pain relief for acute and 3 and 4 for chronic mobility
Ther ex/HEP: core or correct postural imbalances
EDU: avoid quick motions in the saggital plane and postural correct
HNP - protrusion with out NR involvement subjective and objective
S:
LBP only “radiating” to gluteal fold
pain with prolonged sitting
better with standing
age 30-50 usually men
O:
-Hypolordosis and slumped posture
-decrease ROM in extension
-tender PA glides
-positive repeated motions with increased in LBP in flexion and decrease LBP in extension
-positive crossed SLR
-positive milgrams
HNP - protrusion with out NR involvement treatment
manual
-PA for extension mobility
ther ex
- prone on elbows (hold 13 to 30 seconds repeat 5-10 times every 2 hours)
- prone press ups (10x with 1-2 second hold) - press up with OP can be preformed in clinic to improve extension PROM in needed
HEP
- prone press ups
- pt education on the importance of staying in flexion
- show patient how to move (ex: bend over to pick objects up or tie a shoe)
HNP protrusion with nerve root involement subjective and objective
S:
LBP with radiating pain
pain with prolonged sitting
better with standing
age 30-50 usually men
O:
-Hypolordosis and slumped posture
-decrease ROM in extension
-tender PA glides
-possible frontal shift
-positive repeated motions with peripheralization in flexion and centralization in extension
-positive crossed SLR
-positive milgrams
- positive neuro screen
HNP with nerve root involvement treatment
manual
- traction
- grades 1 and 2 joint mobs for pain reduction
- fixing shift if present
ther ex
-tummy time (5 minutes)
-prone on elbows 15-30 second hold repeat 5-10 times
-prone press ups 10x with 1-2 second hold
HEP- prone press ups, self correction of lateral shift
EDUcation: postural education! towel roll activity modification
Adverse lower limb tissue tension subjective and objective
S: can be after a surgery, pain going down the leg, might have a history of HNP
O: decreased flexion in standing but normal flexion in sitting. positive LLTT, positive SLR with DF, positive slump, might have pain when palpating the sciatic nerve
treatment for lower limb tissue
manual therapy
- PNF based on postural screen
- STM to muscles that are tight around the static nerve if palpated by the sciatic
ther ex
- nerve tension or glides
HEP:
nerve glides or tension at the wall, stretch for muscles that are tight
PT EDU: show then how to move (aka bend your knee to sit down or tie to tie your shoe)
Spinal stenosis S and O
S: LBP with pain in one or both legs, N/T in feet, muscle weakness, aggrivated in extension, relieved in flexion
age 60+
O:
-positive neuro screen in a lot of patterns
-decreased ROM in extension
-weak core
-tight hip flexors
-postive stroop test
-are we doing PAs?
spinal stenosis treatment
are we referring out if no B&B?
manual
-supine traction- can bias extension
-PNF hip flexors
ther ex
-core stab
HEP
-mobility: stretch tight muscle
instability subjective and objective
S:
young
gradual onset with pain tracing back to childhood
pain with prolonged standing
may or may not have a positive neuro screen
O:
-hyperlordosis
-hypermobility
- step off with central PA
- decreased core stabilization
- weak hamstrings
treatment for instability
refer out for imaging if have not seen primary
manual
-PNF of the core
- PNF strengthening of the hamstrings
-stm of erector but do not deminish pretective sensation
ther ex
-PNF of core or core stabilization
-HS strenghening
HEP: maybe talk about bracing avoid hyperextension
QL strain S and O
S: usually trauma, pain with leaning to the side
O: Prom contra SB, AROM ipsi SB pain with palpation
treatment for QL strain
manual
-STM QL
treatment
-contract relax QL
HEP
-QL stretch
erector spine stain S and O
s:
trauma
pain with saggital plane movement
O:
PROM flexion
AROM extension
pain with palpation
treatment for erector spine
manual: STM strumming
ther ex: prone supermans
HEP: yoga ball roll out streach or 3 way childs pose
