OMM- Low Back Pain question perfectly elaborated 2023/2024.

Lumbar strain/sprain or somatic dysfunction - AnswersMechanical low back pain may be caused by: Degenerative disc disease, lumbar facet arthritis, spondylolisthesis - AnswersDegenerative low back pain may be caused by: Disc herniation with radiculopathy or spinal stenosis - AnswersNeurologic low back pain may be caused by: Ankylosing spondylitis - AnswersInflammatory low back pain may be caused by: Prostate cancer, abdominal aortic aneurysm, urolithiasis - AnswersReferred low back pain may be caused by: Mechanical, no "medical" reason - AnswersThe majority of low back pain cases fall under the __________ category and are caused by _________, which is why they are considered lumbar strain/sprains Significant trauma, prolonged glucocorticoid use, age >50 - AnswersWhat are the red flag symptoms for a spinal fracture? PMH of cancer, unexplained weight loss, immunosuppression, injection drug use, nocturnal pain, age >50 - AnswersWhat are the red flag symptoms for infection or cancer? Urinary retention, incontinence, bilateral motor deficit, saddle anesthesia - AnswersWhat are the red flag symptoms for cauda equina syndrome? Severe morning stiffness, pain improves with exercise, alternating buttock pain, age <40 - AnswersWhat are the red flag symptoms for spondyloarthritis? Hip and sacroiliac dysfunction - AnswersWhat does the Patrick Test (aka FABER test) look for? Femoroacetabular impingement or hip arthritis - AnswersA patient has limited ROM on Patrick testing. What should you be thinking of? Hip conditions - AnswersA patient has groin pain on Patrick testing. What should you be thinking of? SI joint conditions - AnswersA patient has lower back pain on Patrick testing. What should you be thinking of? Radiculopathy from sciatic nerve - AnswersWhat does the Straight Leg Raise test for? Psoas muscle tightness - AnswersWhat does the Thomas test test for? L4 - AnswersA patient is unable to dorsiflex her foot, has diminished sensation to the medial foot, and has absent patellar reflex. Which nerve root is likely involved? L5 - AnswersA patient is unable to dorsiflex her great toe, has diminished sensation to the dorsal foot, and has normal reflexes. Which nerve root is likely involved? S1 - AnswersA patient is unable to plantarflex her foot, has diminished sensation to the lateral foot, and has absent Achilles reflex. Which nerve root is likely involved? Spondylolisthesis of L4 on L5 - AnswersIdentify the problem seen on this x-ray. Disc degeneration - AnswersThe first step in degeneration of the spine is: Dehydration - Answers______________ of the disc causes a decreased ability to handle mechanical load Increased facet joint stress - AnswersFacet joint degeneration, hypertrophy, and osteophyte formation all come from: Medial branch of dorsal primary rami - AnswersWhat are the vertebral facets innervated by? Backwards, Upwards, Medial (BUM) - AnswersIn both the cervical and lumbar spine, the superior facets face: Sagittal - AnswersWhat plane are the lumbar superior facets? Backwards, Upwards, Lateral (BUL) - AnswersIn the thoracic spine, the superior facets face: Lumbar spondylosis (arthritis) - AnswersDisk/joint space narrowing, subchondral sclerosis, osteophytes, and degeneration of both the discovertebral joints and facet joints are characteristic of: Spondylolisthesis, spondylolysis - Answers__________ is the anterior "slippage" of a superior vertebra on the one beneath it ________ is a fatigue fracture in the pars interarticularis (commonly @ L5, as seen in image!!) Spondylolisthesis, lateral lumbar x-ray - AnswersA patient presents with low back pain that is significantly worsened by extension, slightly worse in flexion. There is lumbar tenderness, lumbar hyperlordosis, and tightness in the hamstrings. What diagnosis do you suspect? What would you order to confirm that diagnosis? Facet syndrome - AnswersA patient presents with low back pain that radiates into the leg. The pain is worse with extension. They were previously diagnosed with "some degenerative issues" in their spine. What diagnosis do you suspect? Right psoas spasm - AnswersA patient presents with low back pain, worse on the right side, that radiates partly down the back of his left leg. Pain is worse when standing after prolonged sitting. On exam, straight leg raise is painful on the left and the patient is slightly hunched over/leaning towards the right. What diagnosis do you suspect? Positive Thomas test on right Type II L1 or L2 dysfunction, SrRr Pelvic shift left Left piriformis dysfunction Sacral torsion Positive Left straight leg raise (piriformis compresses sciatic n.) - AnswersA patient has a Right sided Psoas Spasm. List the associated findings you would expect. Piriformis tenderness, externally rotated hip, positive SLR - AnswersWhat findings would you expect associated with Piriformis Syndrome? 1) Type II Lumbar 2) Pubic shear 3) Posterior sacral base 4) Innominate shear 5) Short leg/pelvic tilt 6) Muscular imbalance (includes psoas syndrome) - AnswersWhat 6 somatic dysfunctions are associated with back pain from the "Dirty Half Dozen" or Failed Back Syndrome? False (may be facet, sacroiliac, piriformis syndrome, etc) - AnswersTrue/False: Referred pain is always from a nerve injury Within the disk, facet joint, or lumbar paraspinals - AnswersSclerotomal pain refers to pain arising from: Sclerotomal pain (not sciatica!!) - AnswersDull, nondermatomal pain that radiates down the leg (but usually not past the knee) without any associated numbness is likely: Ankylosing spondylitis - AnswersDull lower back pain in younger people (<40) that is worse in the morning and improves with activity is likely: