Lumbopelvic Differential Diagnosis Flashcards
(60 cards)
1
Q
What are the common pain patterns for internal disc disruption?
A
- Gluteal pain
- Possible mid-line pain
- Pain worst in the morning
2
Q
What are the risk factors for internal disc disruption?
A
- Age > 50 years
- Repetitive trauma/motion
- Awkward/repetitive work
- Vibration and seated positions
- Prior low back pain
3
Q
What are common examination findings for internal disc disruption?
A
- Pain early & 2D ROM
- Pain with segmental mobilization
- (+) Positive pain over spinous processes
4
Q
What manual therapy techniques are used for internal disc disruption?
A
- Traction
- Joint mobilization (thoracic and lumbar)
- STM/MFR of glutes, paraspinals, QL
5
Q
What therapeutic exercises are recommended for internal disc disruption?
A
- Directional preference exercises
- Progressive loading exercises
- Motor control retraining
6
Q
What are the classifications of disc herniation?
A
- Protrusion
- Prolapse
- Extrusion/sequestration
7
Q
What is the typical pain pattern for disc herniation?
A
- Nerve root level pain
- Discogenic pain
- Pain worst in the morning and at night
8
Q
What are the risk factors for disc herniation?
A
- Age 30-50 years
- Male > female
- Work-related twisting
- Smoking
- Multiple pregnancies
- Obesity
- Mental stress
- Prior history of LBP
9
Q
What are common examination findings for disc herniation?
A
- guarded posturing
- pain early/mid 2D ROM (flexion)
- (+) positive Valsalva/sneeze/cough
- (+) positive STLR and slump test
- sensory changes
- weakness
- decreased sensation or DTR
10
Q
What manual therapy techniques are used for disc herniation?
A
- Traction
- Joint mobilization (thoracic and pelvis),
- STM/MFR of glutes, paraspinals, QL
11
Q
What therapeutic exercises are recommended for disc herniation?
A
- Neural flossing
- Directional preference extension-based exercises
- Piriformis stretching
- Progressive loading for deep core
- Endurance strengthening
- Body mechanics education
12
Q
What are the classifications of foraminal stenosis?
A
- lumbar radiculopathy/itis
- lumbar spondylosis
- chronic sciatica syndrome
- degenerative disc diseases
- secondary disc disease
13
Q
What is the typical pain pattern for foraminal stenosis?
A
- bilateral buttock or leg pain
- pain worst in the evening
14
Q
What are the risk factors for foraminal stenosis?
A
- age > 65 years
- activity outside of norm
- previous lumbar surgeries
15
Q
What are common examination findings for foraminal stenosis?
A
- forward lean/decreased lordosis
- wide-based gait
- Possible weakness
- sensation loss
- decreased DTR
16
Q
What manual therapy techniques are used for foraminal stenosis?
A
- Joint mobilization (thoracic and pelvis)
- STM/MFR in flexion paraspinals, glutes, QL
17
Q
What therapeutic exercises are recommended for foraminal stenosis?
A
- neural flossing
- postural education
- flexion-based exercises
- flexibility preservation
- thoracic mobility
- balance activities
- gait retraining
18
Q
What is the classification of piriformis syndrome?
A
- deep gluteal syndrome,
- sciatica caused by extra pelvic entrapment
- hip/buttock pain
- leg pain without LBP
19
Q
What is the typical pain pattern for piriformis syndrome?
A
- Pain in buttock that shoots/burns or aches down the back of the leg.
- Worse in the morning, inactivity worsens.
20
Q
What are the risk factors for piriformis syndrome?
A
- Trauma to the buttock
- Prolonged sitting
- Hypertrophy of hip ER
- Anatomical variations where the sciatic nerve passes through the muscle belly of piriformis.
21
Q
What are common examination findings for piriformis syndrome?
A
- (+) Positive pain with resisted ER or passive IR (FAIR position)
- (+) Positive SLR
- Negative hip testing other than hip derotation test and FAIR
- (+) Positive palpation of the piriformis
22
Q
What manual therapy techniques are used for piriformis syndrome?
A
- Mobilizations/manipulations to the lumbar spine, pelvis, and hip joint
- STM/MFR of piriformis and glutes
- Dry needling to piriformis
23
Q
What therapeutic exercises are recommended for piriformis syndrome?
A
- Stretching/inhibiting the piriformis muscle
- Nerve glides to sciatic
- Hip strengthening to glut med and max
- Lumbar stabilization/motor control exercises
24
Q
What is the classification of lumbar spondylosis/facet syndrome?
A
- Lumbar spondylosis
- Facet syndrome
- Local lumbar syndrome
- Lumbago
- Spinal arthritis
- Degenerative joint
25
What is the **typical pain pattern** for lumbar spondylosis/facet syndrome?
* Facet pain referral pattern
* Well-localized LBP with any LE pain located above the knee
* Absence of neuro deficits/nerve tension
* Lateral pain non-midline
26
What are the **risk factors** for lumbar spondylosis/facet syndrome?
* Age > 50 years
* History of DDD
27
What are **common examination findings** for lumbar spondylosis/facet syndrome?
* Possible hyperlordosis
* Hypomobility in spring test
* Pain late & 3D ROM, ext+rot (ipsi) +SB (ipsi)
* (**+**) Positive hypomobility and spring test
28
What **manual therapy techniques** are used for lumbar spondylosis/facet syndrome?
* Joint-specific traction
* joint mobilization (lumbar, pelvis, and thoracic)
* STM/MFR of paraspinals, glutes, piriformis
29
What **therapeutic exercises** are recommended for lumbar spondylosis/facet syndrome?
* postural retraining
* mobility focus
* facet distraction in flexion or rotation
* thoracic postural muscles
* **directional preference for flexion**
30
What is the classification of spondylolisthesis?
* Lumbago
* Spondylosis
* Anterolisthesis
* **Flexion** preference
31
What is the **typical pain pattern** for spondylolisthesis?
* history of trauma
* repeated unprovoked episodes of low back feeling unstable
* aberrant motions
* Gowers sign
32
What are the **risk factors** for spondylolisthesis?
* Age < 20 years
* males > females
* hyperextension activities
* impact-related activities
* repetitive posturing
33
What are **common examination findings** for spondylolisthesis?
* excessive lumbar lordosis
* restricted ROM
* (**+**) positive PIT test
* (**+**) positive stork test
34
What **manual therapy techniques** are used for spondylolisthesis?
* Sacral counternutation
* STM/MFR of paraspinals, glutes, QL
35
What **therapeutic exercises** are recommended for spondylolisthesis?
* flexion-based exercises, reduce hyperlordosis
* squat retraining
* deep core stabilization, activation & endurance
* thoracic postural muscles
* sensory awareness of positioning
36
What is the classification of lumbar spine instability?
* Lumbar laminectomy
* lumbar hypermobility syndromes
* anteriolisthesis
* spondylolisthesis
37
What is the typical pain pattern for lumbar spine instability?
* Varies, with subjective complaints of popping and clunking, end ranges of motion cause pain.
38
What are the **risk factors** for lumbar spine instability?
* trauma
* ligamentous laxity
39
What are **common examination** findings for lumbar spine instability?
* Gowers sign
* choppy movements
* guarded movements
* high levels of muscle guarding
* (**+**) positive PIT
* (**+**) positive hip abduction test
* (**+**) positive bilateral leg lowering test
40
What **therapeutic exercises** are recommended for lumbar spine instability?
* progressive loading
* stabilization exercises
* address fear avoidance behaviors
* utilize directional preferences
* address impairments
* sensory angle reproduction
* laser neutral/tracing
* add secondary task
* add reflex reactivation
41
What is the classification of lumbar sprain/strain?
* Sprain strain
* SI joint dysfunction
* myositis
42
What is the typical **pain pattern** for lumbar sprain/strain?
* localized low back pain with no leg pain
* guarding and pain posturing
43
What are the **risk factors** for lumbar sprain/strain?
* lifting
* trauma (MVA)
* women > men
* anxiety or depression
* older age
44
What is the typical **pain pattern** for lumbar Sacroiliac Joint Dysfunction (SIJD)?
* Worse when standing from seated position
* End range pain
* Running worse than walking
* Buttock pain
* Tender to Palpation
45
What is the typical **manual therapy** for lumbar Sacroiliac Joint Dysfunction (SIJD)?
Joint Mobilization:
* SI joint manipulation
* SI joint Muscle Energy
46
SIJD vs Lumbar
47
What is the typical **pain pattern** for Pelvic Floor Dysfunction?
* Pelvic/abdominal/hip Myofascial pain
* **Dyspareunia**: pain with intercourse
* Vaginismus = spasms
* **Vulvodynia**: Chronic vulva pain
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