learning Lumbar library

Teaching threads

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Lumbar

D1 Disc pain

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1: Has there been a fall/RTA/trauma? No = go 2


2: Has there been sudden onset of low back pain following an action of lifting/ twisting? Yes = go to 3


3: Bending forwards, is it painful? Yes = go to 6


6: Is the patient standing with a lateral pelvic shift? Yes = go to 7


7: Palpate Lumbar segments, is it painful? Yes = go to 8


8: Sitting slouched, straighten patient’s leg, lift toes, and bend head forward.
Is it painful or is altered sensation felt? Yes = go to 9


9: Therapist lifts painful leg straight up into the air. Is it painful or is altered sensation felt?
Patient may lift head to test further. Yes = go to 10


10: Test reflexes, myotomes, and dermatomes. Are some positive? Yes = D1

D1 treatment
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Lumbar

D2 Lumbar stenosis

1: Has there been a fall/RTA/trauma? No = go 2


2: Has there been sudden onset of low back pain following an action of lifting/ twisting? No = go 11


11: Palpate Lx segments, is it painful? Yes = go 12


12: Is patient over 50yrs old? Yes = go 13


13: When walking up hill or bent forward, is it less painful? No = D2


D2 treatment
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Lumbar

D3 Facet joint pain

test

1: Has there been a fall/RTA/trauma? No = go 2


test

2: Has there been sudden onset of low back pain following an action of lifting/ twisting? Yes = go 3


test

3: Bending forwards, is it painful? No = go 4


test

4: Bending backwards, is it painful? Yes = go 11


test

11: Palpate Lx segments, is it painful? Yes = go 12


test

12: Is patient over 50yrs old? Yes =D3

D3 treatment
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Lumbar

D4 Muscle spasm/ strain

test

1: Has there been a fall/RTA/trauma? No = go 2


test

2: Has there been sudden onset of low back pain following an action of lifting/ twisting? Yes = go 3


test

3: Bending forwards, is it painful? No = go 4


test

4: Bending backwards, is it painful? No = go 5


test

5: Bending to the right and left, is it painful? Yes = go 14


test

14: Is increased muscle tension evident in muscles along back? Yes = go 15


test

15: Feel the muscle bellies along the lower spine and above the pelvis is it painful to touch? Yes = D4

D4 treatment
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Lumbar

D5 Arthritis

test

1: Has there been a fall/RTA/trauma? No = go 2


test

2: Has there been sudden onset of low back pain following an action of lifting/ twisting? No = go 11


test

11: Palpate Lx segments, is it painful? Yes = go 12


test

12: Is patient over 50yrs old? Yes = go 13


test

13: When walking up hill or bent forward, is it less painful? No = D5

D5 treatment
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Lumbar

D6 Myofascial tightness

test

1: Has there been a fall/RTA/trauma? No = go to 2


test

2: Has there been sudden onset of low back pain following an action of lifting/ twisting? No = go to11


test

11: Palpate Lx segments, is it painful? No = go to 15


test

15: Feel the muscle bellies along the lower spine and above the pelvis is it painful to touch? No = go to 17


test

17: Pick up skin, and roll it between fingers. Does it feel painful and tight? Yes = D6

D6 treatment
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Lumbar

D7 Fracture

test

1: Has there been a fall/RTA/trauma? Yes = go to 16


test

16: Is the lumbar segment painful to tap locally? Yes = D7

D7 treatment
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