Treatments for Non-Specific Lower Back Pain

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Questions and Answers

What is the primary treatment method mentioned for spinal stenosis?

Mulligans mobilisations (correct)

Corticosteroid injections

Regular aerobic exercise

Surgical intervention

Which movement pattern is preferred by individuals with spinal stenosis?

Swimming and cycling

Leaning over a trolley (correct)

Walking and standing

Running and jumping

What is emphasized in core training related to spinal health?

Pilates and motor control (correct)

Strengthening hip flexors only

Reducing movement variability

Maximal weight lifting

Which demographic is most prone to spinal stenosis according to the content?

Individuals aged 75 and older Signup and view all the answers

Which exercise is specifically mentioned as a part of functional testing?

Lift heavy objects Signup and view all the answers

What is a characteristic of stenosis in relation to pain distribution?

Affects the whole leg rather than following a nerve root Signup and view all the answers

Which assessment technique is indicated for evaluating lumbar spine radicular pain?

Straight leg raise (SLR) Signup and view all the answers

What symptom distinguishes radiculopathy from radicular pain?

Reduced reflexes and sensation Signup and view all the answers

What is the prognosis for lumbar spine radicular pain?

Most cases show favorable recovery over time Signup and view all the answers

Which exercise is recommended for maintaining conditioning in patients with knee pain?

Stationary cycling Signup and view all the answers

Which assessment technique is used to evaluate the range of motion of the lower back?

ROM assessments Signup and view all the answers

What is considered the best treatment option for patients with low back pain?

Exercise Signup and view all the answers

Which technique is used to treat localized, diffuse pain with a focus on improving range of motion?

Mulligan techniques Signup and view all the answers

Which type of education is important in the management of non-specific lower back pain?

Pain neuroscience education Signup and view all the answers

What does the acronym PAIVMs stand for in the context of lower back pain assessment?

Passive Accessory Intervertebral Movements Signup and view all the answers

Which of the following methods is NOT typically used for managing non-specific lower back pain?

Activity restriction Signup and view all the answers

During a neuro assessment for lower back pain, which test primarily evaluates nerve root tensions?

Slump test Signup and view all the answers

In addressing lower back pain, what is a primary goal of exercise programs?

To strengthen core muscles Signup and view all the answers

What is a characteristic of nerve sensitivity to mechanical stimuli?

Aggravation of symptoms may occur under tension or stress. Signup and view all the answers

What does the prognosis for nerve sensitivity indicate?

Most patients should see improvement within a few weeks. Signup and view all the answers

What is the incidence of Cauda Equina syndrome?

0.002-0.4% Signup and view all the answers

Which symptom is commonly associated with cancer in the context provided?

Unexplained weight loss Signup and view all the answers

Which of the following could be a secondary condition affecting nerve sensitivity?

Diabetes mellitus Signup and view all the answers

Which symptom is least likely to indicate a condition related to lumbar pain?

Frequent headaches Signup and view all the answers

What is the purpose of sliders in neurodynamic treatment?

To induce sliding of the peripheral nerves with minimal nerve strain Signup and view all the answers

Which of the following tests is specifically a neurodynamic assessment?

Slump test Signup and view all the answers

What does the Bell test assess?

Nerve strain and mobility between specific lumbar vertebrae Signup and view all the answers

Which statement about myotome testing is incorrect?

It does not provide information about reflex actions. Signup and view all the answers

What is the primary goal of traction in manual therapy?

To increase spinal mobility and reduce compression Signup and view all the answers

Which therapeutic exercise is specifically associated with the McKenzie method?

Cobra pose Signup and view all the answers

Decreased reflexes in the Achilles and patellar tendon suggest which of the following?

Potential nerve root compression at the lumbar level Signup and view all the answers

Study Notes

Non-specific Lower Back Pain Treatments

Pain neuroscience education emphasizes understanding natural history, maintaining activity, and realistic expectations.
Mobilizations consider derangement, dysfunction, and posture.
PAIVMs (Passive Accessory Intervertebral Movements):
- Central PA and Transverse glide techniques help assess and treat vertebral segments.
PPIVMs (Passive Physiological Intervertebral Movements):
- Mulligan’s techniques address localized pain and restricted range of motion (ROM).
Manipulation techniques like lumbar distraction aid in treating osteoarthritis (OA) and radiculopathies.
Exercise is the most effective treatment; options include:
- Core strengthening, Pilates, functional restoration, and McKenzie method.
- Specific exercises: prone cobra, cat/cow, bird dog, pelvic neutral, plank, superman, double leg bridge.
Assessments include:
- ROM evaluations: flexion, extension, lateral flexion, rotation.
- Neuro assessments: straight leg raise (SLR), slump test, sensory, and reflex checks.
- Functional tests for endurance and movement tasks.

Spinal Stenosis Treatments

Spinal stenosis involves degenerative changes causing spinal canal narrowing, common in individuals over 75.
Characteristics include preference for flexion and sitting, exacerbated by standing or walking, and bilateral thigh pain.
The Cook clinical decision rule indicates likelihood with age > 48 years, bilateral symptoms, and specific pain patterns.
Assessments involve ROM evaluation, neuro assessments, and locating L4 for PAIVMS checks.

Lumbar Spine Radicular Pain and Radiculopathy Treatments

Radicular pain is sharp and shooting, while radiculopathy includes signs of nerve compromise, like decreased sensation and reflexes.
Ensure imaging for the complete absence of myotomes indicates a potential orthopedic review.
Education about prognosis shows 85% recovery within 12 months; significant weakness warrants further evaluation.
Treatment options:
- Short-term relief can include massage, heat therapy, and manual therapy techniques like traction.
- Effective exercise regimes are vital, including motor control and McKenzie exercises.

Neuromechanical Sensitivity and Lower Limb Treatment

Neuromechanical sensitivity pertains to how lower limbs and nerves respond to mechanical stimuli during movement.
Assessment includes nerve palpation, myotome, and neurodynamic tests.
Treatment techniques include:
- Sliders for nerve bed sliding with minimal strain.
- Tensioners for prolonged nerve bed elongation.
Education is crucial to help patients understand their condition's nature and protective nerve responses.

Red Flag Conditions

Red flags, indicating serious underlying conditions include:
- Cauda Equina syndrome: Low back pain, urinary changes, loss of bowel control.
- Cancer: Symptoms such as unexplained weight loss and persistent pain warrant immediate concern.

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Description

This quiz explores various treatments for non-specific lower back pain. It includes information on pain neuroscience education, natural history, the importance of staying active, and managing patient expectations. Ideal for those studying pain management and rehabilitation.