LBP

Question 1

What is LBP?

Answer 1

Pain in the lumbar spine or sacral areas

Question 2

Pain lasting less than how long is considered acute?

Answer 2

six weeks

Question 3

Pain lasting between what lengths of time is classified as sub-acute pain?

Answer 3

6 weeks to 3 months

Question 4

Chronic pain is defined as pain lasting longer than how long?

Answer 4

3 months

Question 5

True or false: spinal manipulations is one of the few procedures that demonstrably improves outcomes for acute LBP without radiculopathy

Answer 5

True

Question 6

What is the best preventative measure to take against LBP?

Answer 6

Exercise

Question 7

90% of cases of LBP resolve within what time frame?

Answer 7

six weeks

Question 8

50% of patients with radiation pain, symptoms resolve within what time frame?

Answer 8

one month

Question 9

What percent of pts with LBP will have recurrent episodes within two years?

Answer 9

60-80%

Question 10

The highest prevalence of LBP are in what age group?

Answer 10

45-64

Question 11

What percent of LBP cases have an unknown etiology?

Answer 11

85%

Question 12

What type of lumber SDs usually cause pain?

Answer 12

type II

Question 13

What type of sacral SD typically produces pain?

Answer 13

BSTs or unilateral sacral flexions/extensions

Question 14

What hip problems typically cause pain?

Answer 14

Innominate up-slips/down-slips

Question 15

Situations where L5 and sacrum rotate in the (same/opposite) directions usually cause pain.

Answer 15

Same

Question 16

True or false: bilateral extensions of the sacrum causes pain, but not usually flexions

Answer 16

False–both cause pain

Question 17

True or false: short leg/pelvic tilt syndrome commonly cause pain

Answer 17

True

Question 18

What are the three most common sacral causes of LBP?

Answer 18

BSTs
Unilateral sacral flexions
Innominate upslip

Question 19

True or false: bilateral extensions/flexions of the sacrum are common causes of LBP

Answer 19

True

Question 20

What are the three main reasons LBP may become chronic?

Answer 20

1. Lack of specific diagnosis
2. Lack of treatment for a specific SD
3. Failure to recognize and treat strain patterns

Question 21

What is the diagnostic process? (5)

Answer 21

1. H&P
2. rapid, then specific structural exam
3. Red flags
4. labs/radiology
5. OMM

Question 22

True or false: you only need one element of TART to diagnose a SD, but the more there are, the more significant the SD

Answer 22

True

Question 23

When are you done treating LBP? (3)

Answer 23

• Pain is gone
• SDs are gone
• Pt has been in CCP for two visits, and you have treated them for it

Question 24

Long standing SDs in the low back may lead to what?

Answer 24

Disc pathology
Facet arthritis
Stenosis

Question 25

What is the most common SDs of the back in patient 20 yo and younger?

Answer 25

SDs of the L-spine, sacrum, and pelvis

Question 26

What is the most common SDs of the back in patients 21-45?

Answer 26

SDs of the L-spine, sacrum, and pelvis

Question 27

What is the most common SDs of the back in patients 46-65?

Answer 27

SDs of the L-spine, sacrum, and pelvis

Question 28

What is the most common SDs of the back in patients 65+?

Answer 28

SDs of the L-spine, sacrum, and pelvis

Question 29

What is the most common mechanical disorder of the spine?

Answer 29

Muscle strains

Question 30

What is the more common type of BST: right on left, or left on Right?

Answer 30

Right on left

Question 31

Which is the more common, right unilateral sacral flexion, or left unilateral sacral flexion?

Answer 31

Right unilateral

Question 32

Which is more common: right up-slip or a left up-slip?

Answer 32

Right

Question 33

Which is more common: right on right FST, or a left on left RST?

Answer 33

Right on right

Question 34

How common are unilateral sacral extension? How painful are they?

Answer 34

really uncommon, but very painful

Question 35

Running on an uneven surface = what SD?

Answer 35

Innominate up/down-slips

Question 36

Sleep cycle disturbance d/t LBP is usually associated with what SD?

Answer 36

Type II

Question 37

True or false: most of the SDs that cause pain are CCP

Answer 37

True

Question 38

Pain preceded by fast extension of the spine = what SD?

Answer 38

Type II SD of the lumbar spine

Question 39

How long does it take for an upslip to present with pain?

Answer 39

Few days

Question 40

What is the problem with short leg/pelvic tilt syndrome?

Answer 40

Is not a SD, but leads to them

Question 41

What muscles should be strengthened to prevent SDs of the spine?

Answer 41

Core

Question 42

What are the steps of the diagnostic treatment process for SDs?

Answer 42

1. History 2. PE 3. Rapid structural screen 4. Structural exam 5. Red flags 6. Order stuff 7. OMM

Question 43

True or false: the more elements of TART you have, the worse the SD

Answer 43

True

Question 44

What are the 10 steps of the rapid structural screen?

Answer 44

1. Gait 2. St flexion 3. Seated flexion 4. Spinal sweep 5. Vertebral TTP 6. Paraspinal musculature 7. Rib sweep 8. Respiratory rib motion 9. Rib TTP 10. Supine body asymmetry

Question 45

When do you know that you no longer need to treat the patient with OMM, besides loss of pain and lack of SD that cause pain.

Answer 45

The patient has been in CCP for two visits in a row, and you have treated them for it.

Question 46

What are the objective findings that indicate that a patient has resolved their SD? (5)

Answer 46

- Standing/seated flexion is negative - Sphinx test is negative - normal spinal curves - Paraspinal muscles with normal tone - Supine body in neutral