Pain Flashcards
(65 cards)
Name six mechanical theories of joint dysfunction and etiology of low back pain
- SI joints
- Facet joints and meniscoid entrapment
- Internal disc disruption and the intradiscal lesions (contained)
- Disc herniation with radiculopathy (non-contained)
- Trauma (micro included)
- Muscle imbalance
According to research, the prevalence of pain generators in LBP are:
39% ___
15% ___
10% ___ (younger)
>30% ___ (older)
39% disc
15% SI joint
10% Z-joints (younger)
>30% Z-joints (older)
Given that numbers vary, what is recognized as the predominant pain generator in the low back?
Disc
Where is low back pain perceived?
Region between T12 spinous and S1 and between S1 and sacrococcygeal joint, medial to PSISs
(lumbar and sacral are both low back)
What is somatic pain?
Arising from stimulation of nerve endings in a bone, joint, ligament, or muscle/fascia
What is referred pain?
Perceived in a region innervated by nerves other than those that innervate the actual source of pain
What is the physiologic basis of referred pain?
Convergence: sensory neurons from different peripheral sites converge in the spinal cord and thalamus, then are relayed to higher centers
What is radiculopathy?
Neurological condition (disease process) in which conduction is blocked in the axons of a spinal nerve or its roots
radiculopathy
Conduction block in sensory axons results in ___ and in motor axons result in ___
Sensory axons= numbness
Motor axons= weakness
Does radiculopathy lead to pain?
Not necessarily
What is the cause of radiculopathy?
Compression or ischemia
ie. from disc herniation, foraminal stenosis, infection, or other intraspinal disorder (cysts, tumors)
What is radicular pain?
A symptom: pain arising from irritation of a spinal nerve or its roots
radicular pain
In order to cause pain at a nerve root, there must be ___ and not simply compression.
Why is this?
there must be irritation because healthy nerves when compressed are not painful
What is the most common cause of radicular pain?
What is the likely source of irritation in this case?
Disc herniation
Source of irritation is likely chemical (non-compressive) from nuclear material which has escaped the annulus
Any symptoms down an extremity due to an abnormal environment around the spinal nerve root is usually referred to as…
radiculopathy (because radiculopathy is frequently accompanied by radicular pain symptoms)
What is the clinical presentation of somatic referred pain?
Constant, deep ache that is diffuse or poorly localized
What is the clinical presentation of radiculopathy?
(This is a condition/disorder)
Sensory and/or motor neurological loss (numbness or weakness) with corresponding neurological exam or electro diagnostic test findings
What is the clinical presentation of radicular pain?
(This is a symptom)
Sharp, shooting pain travelling along a band usually no more than 2 inches wide, in a somewhat dermatomal pattern
What is LMNOPQRST?
History taking… idk what it stands for lol
The SI joint has a dual function of:
- Stability and stiffness (to transmit forces)
- Flexibility (to relieve torsional stress on bony pelvic ring)
SI excursion is on order of ___ degrees on average
2 (small but important especially in symmetry)
In the SI joints, asymmetrical motion may provoke pain in…
the more mobile of the 2 joints (due to ligamentous and articular irritation from excess torsional strain)
With SI pain, you do not just adjust…
where the pain presents
Treatment of SI pain may include:
- Manipulation of the stiffer/restricted SI
- SI support belt to help with pain
- Stabilizing exercises
