System - II. Limb Pain, Lower back pain
|
|
- Linette Nelson
- 5 years ago
- Views:
Transcription
1 Common Problem of the Musculoskeletal System - II Limb Pain, Lower back pain 本講義表格資料取自 Dains, J.E., Baumann, L.C., & Scheibel, P. (2007). Advanced assessment and clinical diagnosis in primary care. (3rd ed). St. Louis: Mosby. 1 圖片取自 Seidel HM, Ball JW, Dains JE, Benedict GW. (1999). Mosby s guide to physical examination. St. Louis, MO: Mosby.
2 Acute Low Back Pain 2
3 Acute lower back pain Actively intolerance producing lower back or back-related leg symptoms of fless than 3 months duration Most common cause Musculoskeletal injuries Age-related degenerative process 90% resolved within 4 weeks without serious sequelae 3
4 AHRQ s causes of ALBP Potentially serious conditions Spinal fracture, tumor or infection, cauda equina syndrom Nerve root compression Sciatic or leg pain and numbness of the lateral thigh, leg, and foot (nerve root compression) Nonspecific back problems Musculoskeletal strain, dickogenic pain, bony deformity 2ndary to inflammatory disease Nonspinal causes secondary to abdominal involvement Psychological causes (Agency for Healthcare Research and Quality) 4
5 Testing for lumber nerve root compromise 5
6 DIFFERENTIAL DIAGNOSIS OF Common Causes of Acute Low Back Pain CONDITION HISTORY PHYSICAL FINDINGS DIAGNOSTIC STUDIES Potentially Seriou Causes Spinal fracture Trauma to spine or back; pain is felt near site of injury Palpable tenderness over site of fracture Considered an emergency; immobilize patient and transport for radiographs Tumor History of cancer; Weight loss, fever, ESR; bone scan progressive pain is unremitting; occurs at night and at rest tenderness near tumor Osteoblastoma Neck or back pain not Localized tenderness; Plain film shows an relieved by aspirin; occurs in older adolescents and young adults may have scoliosis with muscle pain expansive osteolytic lesion surrounded by thin peripheral rim of bone; bone scan; CT scan Osteoid osteoma Occurs primarily in adolescents; rare in patients over age 40; well localized pain that may be more severe at night and relieved by aspirin or other prostaglandin inhibitors Painful, welllocalized scoliosis may be present Bone scan 6
7 DIFFERENTIAL DIAGNOSIS OF Common Causes of Acute Low Back Pain CONDITION HISTORY PHYSICAL FINDINGS DIAGNOSTIC STUDIES Potentially Seriou Causes Infection (vertebral osteomyelitis) Diskitis History of infection, invasive i procedure; continuous, dull back pain; chronic back pain Pain aggravated by movement; more common in children Acute onset presents with fever, diaphoresis; i tenderness over affected disk; positive SLR(straight leg raising) Tenderness overaffected disk ESR; blood culture; bone biopsy; CT scan; MRI ESR Cauda equina syndrome Constant pain in a saddle distribution; urinary retention, fecal incontinence, radiculopathy Positive SLR, abnormal DTRs, motor weakness Surgical emergency Sciatica Problems Sciatica Acute back pain with Paravertebral EMG if chronic radiculopathy; history of tenderness and spasm; strain or trauma, relief positive SLR; sitting with sitting knee extension < 60 produce radicular pain below the knee, sensory findings 7
8 DIFFERENTIAL DIAGNOSIS OF Common Causes of Acute Low Back Pain-cont d CONDITION HISTORY PHYSICAL FINDINGS DIAGNOSTIC STUDIES Nonspecific Back Problems Musculoskeletal strain Spondylolisthesis ( 脊椎炎 ) Ankylosing ( 關節粘連 )spondylitis Spinal stenosis Scheuermann s disease Osteoporosis Pain in back, buttocks; history of new activity or exertion; relief of pain with sitting Young person in a sport that demands rapid movement between hyperflexion and hyperextension or requires excess loading in hyperextension Persons under age 40: insidious onset; progressive morning back pain relieved with exercise Pain worse throughout day; aggravated by standing, relieved by rest; pseudoclaudication Affects mostly adolescent males; mild to moderately severe pain, worse at end of day, relieved by rest Chronic, poorly localized back pain; postmenopausal; slight build; history of inactivity or endocrine disorder Paravertebral tenderness, scoliosis, or loss of lumbar lordosis; no neurological signs No neurological signs; pain localized to low back, just below level of iliac crest; tight hamstrings Painful sacroiliac joints, reduced spine mobility; may have uveitis Signs of osteoarthritis of joints; may have neurological signs Normal examination; may show an exaggerated thoracic kyphosis that is fixed in attempted hyperextension Palpable tenderness over area of compression fracture; kyphosis or lordosis; loss of height None Lumbar spine radiographs ESR; spinal radiographs Spinal radiographs Thoracic spine radiographs Bone densiometry; spinal radiograph to assess fracture 8
9 DIFFERENTIAL DIAGNOSIS OF Common Causes of Acute Low Back Pain-cont d CONDITION HISTORY PHYSICAL FINDINGS DIAGNOSTIC STUDIES Nonspinal Causes Aortic aneurysm Severe, acute-onset pain not related to activity or movement; increase risk in persons over age 30; pallor, diaphoresis, anxiety, confusion Intact aneurysm will be a visible pulsatile midline upper quadrant abdominal mass; in a dissected aneurysm, upper extremity pulse and pulse pressures are asymmetrical; posterior thoracic pain may be felt Emergency surgical referral Gallstones Increased incidence with age; steady, intense pain in RUQ with radiation to right scapula or shoulder; belching, bloating, fatty food intolerance Normal physical examination or positive Murphy s sign on palpation of abdomen Surgical referral Pyelonephritis Ill-appearing; sweating, nausea, back or flank pain, headache Fever: cloudy, malodorous urine; CVA tenderness on percussion Urinalysis; urine culture Pleuritis History of recent URI; pleuritic pain Normal examination or crackles and bronchial breath sounds PPD; chest radiograph Psychological back pain Psychological back pain History of psychosocial stressors, depression, exaggerated expressions of pain Exaggerated or inconsistent reactions to testing; normal examination None 9
10 Focused History Is This a Potentially Serious Cause of ALBP? Do you have a fever? Have you experienced any trauma to the spine or back? Do you have any other health problems? Have you been treated for cancer?? What is your age? Have you had loss of control of your bowels or bladder? Are you taking any medications? Fever indicating i inflammatory condition i Injury to the back usually cause contusions and abrasions but also can cause spinal fracture Loss of urinary or stool continence indicates cauda equina or S1-S2 nerve compromise secondary to herniated disk. 10
11 Focused History What Does the Location of Pain Tell Me? Where does it hurt? Siatic pain is a sharp, burning pain that radiates down the posterior and lateral leg to the foot or ankle. Back pain with neck stiffness can indicate cervical osteomyelitis. Rheumatoid arthritis produced pain in the upper back and neck Localized pain is seen with spondylolysis and tumors. Flank pain in adults may indicate a kidney infection. Pain of gallbladder disease radiates to the subcapular area. Compression fracture of vetebrae associated with osteoporosis or malignancy may produce pain over midthoracic area 11
12 Focused History What Does the Pattern of Pain Tell Me? When did the pain start? How long have you had this pain? What does the pain feel like? Does it interfere with sleep? Have you had this pain before? The onset of ALBP is sudden, and more than half of patients with this symptom do not associate it with a specific precipitating event or injury. Subacute back pain is 6~12 week duration. Chronic back pain is pain more than 3 months duration Night pain is a worrisome symptom that often signals a serious such as tumor, infection, or inflammation. M i tiff th t i th d t k l i Morning stiffness that improves as the day progresses suggests ankylosing spondylitis. 12
13 Focused History What Does the Pain in Relation to Activity Tell Me? What makes the pain worse?? What makes the pain better? Pain that t is aggravated by activity it and alleviates by rest is usually muscuoskeletal in origin. Spinal stenosis is associated with increased pain with standing, sneezing, or coughing, and is relieved on flexion of the spine.. Pain experienced in the lumber area occurring after strenuous sporting activities is usually the result of trauma to muscles and tendons, causing contusion and sprain. Suspect spondylolisthesis, or forward slippage of one vetebra over another, if the onset of pain is during hyperextension. Back pain not associated a with any activity and not relieved eved by rest may indicate tumor. 13
14 Focused History What Does Rediation of Pain Tell Me? Does the pain travel? Show me Where the pain travel? Pain from the upper lumber spine usually radiates to the anterior aspect of the thigh and leg. Pain from the lower lumber spine usually radiates to the gluteal region, posterior thigh, and calves. Pain from visceral disease is usually felt within the abdomen and flank. Gallbladder pain radiates around the trunk to right scapula. Person with spondylolysis complain of hamstring tightness and buttack discomfort as well as low back pain. Siatic pain: sharp, burning radiates down to the lateral or posterior aspect of the leg to the lateral ankle or foot 14
15 Focused History Are There Signs of Neurological Damage? Have you been stumbling?? Have you noticed any change in your balance or coordination? Does the child frequently stumble or fall? Do you have numbness or tingling g in your extremities?? Is There a Family History of Back Pain? Does anyone in your family have scoliosis or a crooked spine? Could This Pain Be Caused by a Systemic Disease?: Have you been ill? eg, PID, URI, 15
16 Focused PE Observe the Patient,s General Appearance Observe Gait Assess Vital Sign Examine Skin Examine Eyes, Ears, Nose, and mouth Inspect the Back and Extremities Percuss and Palpate Back and Spine Perform Range of Motion of the Spine Perform Straight Leg Raising Check Hip Mobility Examine Feet Evaluate Muscle Strength Measure Muscle Circumference Test Sensory function Assess Deep Tendon Reflexes Palpate the Abdomen Check Rectal Sphincter Tone 16
17 Lab and diagnostic studies Plain Radiographs Standing Anteroposterior and Lateral Views of the Spine Oblique and Flexion Views of the Spine Spine Radiograph Bone Scan Electromyography Diagnostic Imaging Urinalysis Erythrocyte Sedimentation Rate Complete Blood Cell Count 17
18 18
Epidemiology of Low back pain
Low Back Pain Definition Pain felt in your lower back may come from the spine, muscles, nerves, or other structures in that region. It may also radiate from other areas like the mid or upper back, a inguinal
More informationNumb bum means cauda equina Per rectal examination is indicated to assess anal tone
SPINE Age and occupation Pain: Where: Low back or leg Which is worse? Where about in the leg? Describe the radiation How long? More than 6 wks need warrant evaluation How the pain is now compared to the
More informationCommon Orthopedic Conditions of the Spine
Common Orthopedic Conditions of the Spine Learning Objective Given a scenario describing a patient with symptoms suggestive of an orthopedic or musculoskeletal condition, formulate a treatment plan after
More information외래에서흔히접하는 요통환자의진단과치료 울산의대서울아산병원가정의학과 R3 전승엽
외래에서흔히접하는 요통환자의진단과치료 울산의대서울아산병원가정의학과 R3 전승엽 Index Introduction Etiology & Type Assessment History taking & Physical examination Red flag sign Imaging Common disorder Management Reference Introduction Pain
More informationDifferential Diagnosis: Visceral Conditions Ruled Out
Regional Review of Musculoskeletal System: Presented by Michael L. Fink, PT, DSc, SCS, OCS Chapter 2: Thoracic Spine Differential Diagnosis: Visceral Conditions Ruled Out Ruled Out Early in the Examination
More informationPaul Allan Regional Clinical Lead - South. Lumbar Spine. Assessment & Differential Diagnosis
Paul Allan Regional Clinical Lead - South Lumbar Spine Assessment & Differential Diagnosis Aims Refresh lumbar spine anatomy Red flags Discuss common pathologies seen in general practice Subjective and
More informationChiropractic Health Plan - Diagnosis of Low Back Pain
Chiropractic Health Plan - Diagnosis of Low Back Pain 1 Adult Patient with ot for major Trauma Low back pain 2 Intake Evaluation (Inset 1) Recommendation 1 3 Potentially Serious Condition Strongly Suspected
More informationHIGH LEVEL - Science
Learning Outcomes HIGH LEVEL - Science Describe the structure and function of the back and spine (8a) Outline the functional anatomy and physiology of the spinal cord and peripheral nerves (8a) Describe
More informationThe Spine.
The Spine www.fisiokinesiterapia.biz Characteristics of Vertebrae Cervical Spine 1 and 2 Sacrum and Coccyx Curves Lordotic in the Spine Kyphotic Lordotic Ligamentous Support Muscles of the Spine Spinal
More informationCervical Plating BACK PAIN
BACK PAIN Back Pain Back pain is frequent complaint. It is the commonest cause of work-related absence in the world. Although back pain may be painful and uncomfortable, it is not usually serious. Even
More informationChapter 35 Back Pain. Episode overview: Wisecracks: Crack Cast Show Notes Back Pain July 2016
Chapter 35 Back Pain Episode overview: 1) List 10 historical red flags for back pain 2) List 6 Emergent Diagnosis for back pain Wisecracks: 1) Describe the most common sites of disc protrusion with their
More informationObjectives. Comprehension of the common spine disorder
Objectives Comprehension of the common spine disorder Disc degeneration/hernia Spinal stenosis Common spinal deformity (Spondylolisthesis, Scoliosis) Osteoporotic fracture Destructive spinal lesions Anatomy
More informationGary Rea MD PhD Medical Director OSU Comprehensive Spine Center
Gary Rea MD PhD Medical Director OSU Comprehensive Spine Center 1. The less specific the patient is about symptoms and pain, the less likely a specific diagnosis will be made and the less likely the patient
More informationCase Studies, Impairment of the Spine in Washington State
Case Studies, Impairment of the Spine in Washington State NAOEM at Skamania, 2015 25 Sep, 2015 Tim Gilmore, MD Several Slides from this Presentation Borrowed with permission from the Washington State Department
More informationBACK PAIN. Disclaimer. Integrated web marketing. Multimedia Health Education
BACK PAIN Disclaimer This movie is an educational resource only and should not be used to make a decision on. All decisions about surgery must be made in conjunction with your surgeon or a licensed healthcare
More informationExamination of the lumbosacral spine. Dr Lucy Holtzhausen Rotorua GP CME June 2015
Examination of the lumbosacral spine Dr Lucy Holtzhausen Rotorua GP CME June 2015 Diagnostic Algorithm Presenting symptoms Diagnostic decisions Diagnostic triage LOW BACK PAIN Mechanical NON-SPECIFIC LBP
More informationA Syndrome (Pattern) Approach to Low Back Pain. History
A Syndrome (Pattern) Approach to Low Back Pain Hamilton Hall MD FRCSC Professor, Department of Surgery, University of Toronto Medical Director, CBI Health Group Executive Director, Canadian Spine Society
More informationModule Eight. Application of Health Assessment NUR 225. Physical examination of Musculoskeletal System. King Saud University. Collage of Nursing
King Saud University Collage of Nursing Medical Surgical Nursing depart Application of Health Assessment NUR 225 Module Eight Physical examination of Musculoskeletal System Obtaining a health history Ask
More informationBack pain and bladder problems
Back pain and bladder problems Search Learn the causes and symptoms of chronic back pain, as well as safe techniques that provide back pain relief better than prescriptions drugs. If back pain is reducing
More informationPediatric Spinal Evaluation for Scoliosis and Back Pain
Pediatric Spinal Evaluation for Scoliosis and Back Pain Jill E. Larson, MD September 29, 2018 Ann & Robert H. Lurie Children s Hospital of Chicago Division of Pediatric Orthopedic Surgery and Sports Medicine
More informationCLINICAL GUIDELINES. Primary Care Guideline Summary Lumbar Spine Thomas J. Gilbert M.D., M.P.P. 3/17/15 revision
CLINICAL GUIDELINES Primary Care Guideline Summary Lumbar Spine Thomas J. Gilbert M.D., M.P.P. 3/17/15 revision TRIAGE At the initial visit, a focused history and physical examination is performed to assign
More informationCommon Conditions. Visit our homepage for more info >> TABLE OF CONTENTS. Bulging/Herniated Disc... PAGE 2. Cervical (Neck) Pain...
Common Conditions TABLE OF CONTENTS Bulging/Herniated Disc... PAGE 2 Cervical (Neck) Pain... PAGE 3 Degenerative Disc Disease... PAGE 4 Sciatica...PAGE 5 Spinal Stenosis... PAGE 6 Spondylolisthesis...
More informationSciatica. 43 Thames Street, St Albans, Christchurch 8013 Phone: (03) Website: philip-bayliss.com
43 Thames Street, St Albans, Christchurch 8013 Phone: (03) 356 1353. Website: philip-bayliss.com Sciatica Nagging, burning pain radiating down the back of the leg, or dull throbbing pain in the buttocks
More informationRN(EC) ENC(C) GNC(C) MN ACNP *** MECHANISM OF INJURY.. MOST IMPORTANT ***
HISTORY *** MECHANISM OF INJURY.. MOST IMPORTANT *** Age of patient - Certain conditions are more prevalent in particular age groups (Hip pain in children may refer to the knee from Legg-Calve-Perthes
More informationLOW BACK PAIN EPIDEMIOLOGY:
LOW BACK PAIN OBJECTIVES: Discuss epidemiology of low back pain Summarize diagnosis/ special tests Review Red Flags Discuss treatment and referral guidelines Discuss light duty guidelines EPIDEMIOLOGY:
More informationPAIN. Headache. enstrual Pain. Low Back Pain. Osteoarthritis. Carpal Tunnel Syndrome. Sprains and Strains. Taking Care of. Pain of
Low Back Pain Sprains and Strains Taking Care of PAIN TIPS FOR UNDERSTANDING, AVOIDING, AND CARING FOR COMMON TYPES OF PAIN Carpal Tunnel Syndrome Pain of Osteoarthritis enstrual Pain Headache BROUGHT
More informationPediatric Spinal Evaluation for Scoliosis and Back Pain
Pediatric Spinal Evaluation for Scoliosis and Back Pain Jill E. Larson, MD September 29, 2018 Ann & Robert H. Lurie Children s Hospital of Chicago Division of Pediatric Orthopedic Surgery and Sports Medicine
More informationSpondylolisthesis DESCRIPTION EXPECTED OUTCOME POSSIBLE COMPLICATIONS COMMON SIGNS AND SYMPTOMS GENERAL TREATMENT CONSIDERATIONS CAUSES
DESCRIPTION is the slippage of one or more vertebrae, the bones of the spine. Many causes of slippage of the vertebra are possible; these include stress fracture (spondylolysis), which is often seen in
More informationCommon Thoraco- Lumbar Problems in the Mature Athlete
Common Thoraco- Lumbar Problems in the Mature Athlete Diana Heiman, MD Associate Professor, Family Medicine Residency Director East Tennessee State University Objectives Review the pathophysiology of the
More information405 Firemans Ave LaVale, Maryland 21502
Dec 19, 2016 CHIEF COMPLAINT: Iris presents with a chief complaint involving her lower lumbar and sacral region, left sacroiliac region and left anterior hip and groin. ONSET OF SYMPTOMS Iris states this
More informationSpineFAQs. Lumbar Spondylolisthesis
SpineFAQs Lumbar Spondylolisthesis Normally, the bones of the spine (the vertebrae) stand neatly stacked on top of one another. The ligaments and joints support the spine. Spondylolisthesis alters the
More informationLumbar disc prolapse. Done by : Areej Al-Hadidi
Lumbar disc prolapse Done by : Areej Al-Hadidi Anatomy of IVD IVD is composed of two components: 1. anulus fibrosus : it is the outer fibrous layer (fibrocartilage ) **It is comressible &tough 2. nucleus
More informationChapter 20: The Spine The McGraw-Hill Companies, Inc. All rights reserved.
Chapter 20: The Spine Anatomy of the Spine Prevention of Injuries to the Spine Cervical Spine Muscle Strengthening Muscles of the neck resist hyperflexion, hyperextension and rotational forces Prior
More informationA Patient s Guide to Back Pain in Children
A Patient s Guide to Back Pain in Children 2350 Royal Boulevard Suite 200 Elgin, IL 60123 Phone: 847.931.5300 Fax: 847.931.9072 DISCLAIMER: The information in this booklet is compiled from a variety of
More informationThe Complex/Challenging Spine Patient Steve Wisniewski, M.D. Department of PM&R
The Complex/Challenging Spine Patient Steve Wisniewski, M.D. Department of PM&R 2011 MFMER slide-1 Disclosures None 2011 MFMER slide-2 Learning Objectives Review indications for obtaining imaging studies
More informationHISTORY OF PRESENT ILLNESS A. TELL US ABOUT YOUR PAIN PROBLEM
1 UT Health Austin Comprehensive Pain Management New Patient Questionnaire Thank you for scheduling a visit with the Comprehensive Pain Management Care Team. The responses you provide to these questions
More informationWHAT IS SCIATICA? Apart from the compression of one of the nerves, there are other known causes of sciatica which include:
WHAT IS SCIATICA? If you suffer from Sciatica, or you re close to someone who does, you already know that it is one of those conditions that can be quite overwhelming and incapacitating while causing a
More informationPrimary care referral criteria for musculoskeletal MRI scans
Appendix 1 Primary care referral criteria for musculoskeletal MRI scans Accepted Criteria for Direct Access MRI Body Part Symptoms Imaging indicated Lumbar Spine Low Back Pain with adverse symptoms or
More informationSymptom Review (page 1) Name Date
v2.4, 2/13 JonathanTreasure.com Botanical Medicine & Cancer Herb Drug Interactions Herbalism 3.0 Symptom Review (page 1) Name Date INSTRUCTIONS Please read each section below carefully and, after each
More informationLower back pain radiating to buttocks
Lower back pain radiating to buttocks 22-1-2018 Get information on causes of mild to severe lower back pain (arthritis, pregnancy, herniated disc, sciatica, ovarian cysts). Read about low back pain. Back
More informationAlan H Daniels, MD. Spine Division, Department of Orthopaedics Warren Alpert School of Medicine of Brown University
Spinal and Orthopaedic Surgery in the Elderly Alan H Daniels, MD Spine Division, Department of Orthopaedics Warren Alpert School of Medicine of Brown University As the population ages, and patients remain
More informationSpine Conditions and Treatments. Your Guide to Common
Your Guide to Common Spine Conditions and Treatments The spine is made up of your neck and backbone. It allows your body to bend and move freely. As you get older, it is normal to have aches and pains.
More informationComprehension of the common spine disorder.
Objectives Comprehension of the common spine disorder. Disc degeneration/hernia. Spinal stenosis. Common spinal deformity (Spondylolisthesis, Scoliosis). Osteoporotic fracture. Anatomy Anatomy Anatomy
More informationRADICULOPATHY AN INTRODUCTION TO
AN INTRODUCTION TO RADICULOPATHY This booklet provides general information on radiculopathy. It is not meant to replace any personal conversations that you might wish to have with your physician or other
More informationCERVICAL STRAIN AND SPRAIN (Whiplash)
CERVICAL STRAIN AND SPRAIN (Whiplash) Description time and using proper technique decrease the frequency of Whiplash is an injury to the neck caused when it is forcefully whipped or forced backward or
More informationBACK AND LEG PAIN ASSESSMENT (Prior Surgery)
ANSWER EVERY QUESTION! SPINE SURGERY LTD. (IMPORTANT PATIENT INFORMATION FORM) BACK AND LEG PAIN ASSESSMENT (Prior Surgery) 1. NAME: DATE TODAY: 2. AGE: SEX: 3. PRESENTLY EMPLOYED? NO YES, How long there?
More informationCERVICAL STRAIN AND SPRAIN
CERVICAL STRAIN AND SPRAIN Description Cervical strain/sprain is an injury to the neck caused when it is forcefully whipped or forced backward or forward. The structures involved are the muscles, ligaments,
More informationSuspecting Tumors, or Could it be cancer?
Suspecting Tumors, or Could it be cancer? Donna E. Reece, M.D. Princess Margaret Cancer Centre University Health Network Toronto, ON CANADA 07 February 2018 Background Low back pain is common However,
More informationWhat Is Back Pain? Fast Facts: An Easy-to-Read Series of Publications for the Public. Who Gets Back Pain? What Are the Causes of Back Pain?
Back pain can range from a dull, constant ache to a sudden, sharp pain that makes it hard to move. It can start quickly if you fall or lift something too heavy, or it can get worse slowly. Who Gets Back
More informationLumbar Stenosis Rehabilitation Using the Resistance Chair
PRODUCTS HELPING PEOPLE HELP THEMSELVES! Lumbar Stenosis Rehabilitation Using the Resistance Chair a. Description Lumbar spinal stenosis is a term used to describe a narrowing of the spinal canal. The
More informationTOP RYDE CHIROPRACTIC
1. Ankle Pain Conditions Helped by Chiropractic The ankle joint is made up of ligaments, tendons, nerves, and a disc to cushion motion. Distortions of motion of the ankle can strain the ligaments and muscles
More informationCase Studies: Low Back Pain in the Athlete. Jim Messerly DO
Case Studies: Low Back Pain in the Athlete Jim Messerly DO Nothing to disclose Case #1 History 15 y/o male presents for evaluation of his low back pain. His pain has been present for several months. The
More informationUpper back pain and blood in urine
Upper back pain and blood in urine The Borg System is 100 % Upper back pain and blood in urine Bloody Urine and Back Pain are both symptoms.. She did a urinalysis which came back with blood in the urine
More informationHailee Gibson, CCPA Neurosurgery Physician Assistant. Windsor Neurosurgery & Spine Associates. Windsor Regional Hospital Ouellette Campus
Hailee Gibson, CCPA Neurosurgery Physician Assistant Windsor Neurosurgery & Spine Associates Windsor Regional Hospital Ouellette Campus Disclosures I have no disclosures Learning Objectives Provide information
More informationCERVICAL SPINE TIPS A
CERVICAL SPINE TIPS A Musculoskeletal Approach to managing Neck Pain An ALGORITHM, as a management guide Rick Bernau & Ian Wallbridge June 2010 THE PROCESS An interactive approach to the management of
More informationMedicare Regulations for Chiropractors. Presented by Clinic Pro Software Inc. Marilyn K. Gard. CEO, MBA
Medicare Regulations for Chiropractors Presented by Clinic Pro Software Inc. Marilyn K. Gard. CEO, MBA Use AT modifier which means active treatment. Claims submitted for Chiropractic manipulative treatment
More informationFrancine M. Pulver, MD, Clinical Assistant Professor Department of Physical Medicine & Rehabilitation Ohio State University Medical Center
Oh My Aching Back! Francine M. Pulver, MD, Clinical Assistant Professor Department of Physical Medicine & Rehabilitation Ohio State University Medical Center Epidemiology 90% of episodes of LBP resolves
More informationSurgery. Conus medullaris and Cauda Equina Syndromes. Anatomy. See online here
Surgery Conus medullaris and Cauda Equina Syndromes See online here Conus medullaris and cauda equina syndromes are spinal cord injuries that involve injury to the lumbosacral segment of the spinal cord.
More informationPlease take the time to answer all questions that apply to your problem as completely as possible. Thank You.
USC Center for Spinal Surgery New Patient History Form Please take the time to answer all questions that apply to your problem as completely as possible. Thank You. Date Referring Doctor/Primary Doctor
More informationB a c k p a t h a t r a d i a t e s h i p
B a c k p a t h a t r a d i a t e s h i p 12-3-2018 I have pain in lower back on left side, left hip pain, left pelvic pain and pain down the left leg at times. It comes and goes. Gets real bad,(when I
More informationPatient Chart Quotes. Spine Mythology and Evidence- Based Management of Back Pain. Patient Chart Quotes. Patient Chart Quotes
Spine Mythology and Evidence- Based Management of Back Pain John Engstrom, MD Professor of Neurology August 11, 2009 Patient Chart Quotes The patient was in his usual state of good health until his airplane
More informationObjectives. Identify and differentiate appropriate surgical cases. Good Surgical Outcomes
ECHO February 5 th, 2015 Surgical Selection for Low Back Pain Objectives Identify and differentiate appropriate surgical cases Disclosures Medical director for UHN Rehabilitations Solution Back and Neck
More informationSPINAL PAIN. Mr. Yagnesh Vellore FRACS Neurosurgeon and Spine Surgeon
SPINAL PAIN Mr. Yagnesh Vellore FRACS Neurosurgeon and Spine Surgeon PAIN GENERATORS IN THE SPINE Ligaments: ALL,PLL Muscle Periosteum bone Outer 1/3 annulus disc Facet joints Sacro-iliac joint sinuvertebral
More informationHerniated Disk in the Lower Back
Herniated Disk in the Lower Back This article is also available in Spanish: Hernia de disco en la columna lumbar (topic.cfm?topic=a00730). Sometimes called a slipped or ruptured disk, a herniated disk
More informationLumbar Disc Prolapse. Dr. Ahmed Salah Eldin Hassan. Professor of Neurosurgery & Consultant spinal surgeon
Lumbar Disc Prolapse By Dr. Ahmed Salah Eldin Hassan Professor of Neurosurgery & Consultant spinal surgeon 1-What are the Functions of the Spine Structural support for upright posture Protection of Spinal
More informationPremier Orthopedic Spine Center
Premier Orthopedic Spine Center Atrium Medical Center Professional Buliding 200 Medical Center Dr., Ste. 375 Middletown, Ohio 45005 Neck Questionnaire Patient Date Family Physician The onset of my neck
More informationMusculoskeletal Examination of the Pain Patient
Musculoskeletal Examination of the Pain Patient Joseph F. Audette, M.A., M.D Assistant Clinical Professor, Harvard Medical School Chief, Department of Pain Medicine Harvard Vanguard Medical Associates
More informationSpinal Trauma. General Rehabilitation of Patient with Spinal Trauma. Common Spinal Injuries. Important Anatomical Structures at each Vertebral Level
Asian Association for Dynamic Osteosynthesis Workshop on Management of Spinal Trauma 22 April 2007 (Sunday) Orthopaedic Learning Centre, PWH, Shatin, Hong Kong General Rehabilitation of Patient with Spinal
More informationOrthopadic cors. Topic : -Cervical spondylitis. -Development disorders(spondylolysis and Spodylolsithesis)
Orthopadic cors Topic : -Cervical spondylitis. -Development disorders(spondylolysis and Spodylolsithesis) Cervical spondylitis. Definition : - a painful condition of the cervical spine resulting from the
More informationHow to Overcome Lower Back Pain The Lumbar Spine Explained
How to Overcome Lower Back Pain The Lumbar Spine Explained Devi Gajendran Disorders Lower back pain is one of most common disorders among adults which affects around 40% of the total population. It is
More informationRegional Pain Syndromes: Neck and Low Back
Regional Pain Syndromes: Neck and Low Back Srinivas Nalamachu, MD Disclosures Consultant/Independent Contractor/Honoraria: Ferring 1 Learning Objectives Identify the most common painful conditions in the
More informationDiagnosing a Herniated Disc
Diagnosing a Herniated Disc Sciatica is a condition where the sciatic nerve is being irritated or pinched by a herniated disc in the low back. In order to do the correct exercises, you first have to self
More informationRecommended reading Christopher M Norris Back Stability edition two
1 2 CHERRY BAKER 2017 3 Recommended reading http://www.physology.co.uk/james-tyrell-nestor/ james@physology.co.uk Christopher M Norris Back Stability edition two 4 Welcome Anatomy of the spine Vertebra
More informationBACK AND NECK PAIN QUESTIONNAIRE
Neurological Surgery and Spine Surgery, S.C. 1 Westbrook Corporate Center, Suite 800 Westchester, Illinois 60154 BACK AND NECK PAIN QUESTIONNAIRE Please PRINT all information CLEARLY and answer all questions
More informationSpondylolysis DESCRIPTION EXPECTED OUTCOME POSSIBLE COMPLICATIONS COMMON SIGNS AND SYMPTOMS GENERAL TREATMENT CONSIDERATIONS CAUSES
DESCRIPTION is a stress or fatigue fracture of the bones of the spine (vertebrae) that does not involve the main weight-bearing part of those bones, the body of the vertebra. Instead, it involves an area
More informationLOTHIAN LUMBAR SPINE PATHWAYS
LOTHIAN LUMBAR SPINE PATHWAYS Patient Completes STarT Back form Assess patient and screen for Red Flags. If present refer to Appendix 1 Establish if Neurogenic. If so refer to Appendix 2 Children under
More informationRiver North Pain Management Consultants, S.C., Axel Vargas, M.D., Regional Anesthesiology and Interventional Pain Management.
River North Pain Management Consultants, S.C., Axel Vargas, M.D., Regional Anesthesiology and Interventional Pain Management. Chicago, Illinois, 60611 Phone: (888) 951-6471 Fax: (888) 961-6471 Clinical
More informationNumbness: o o o o o. Grade your overall pain. Pain Rating Scale Mosby. Worst Possible Pain. No Pain HURTS LITTLE MORE HURTS EVEN MORE
Patient Name: Original Referring Physician: Current PCP: PAIN DIAGRAM Is your condition the result of a: Work injury? YES NO Auto accident? YES NO Date of Injury: / / Please mark the areas of discomfort
More informationCox Technic Case Report #169 published at (sent 5/9/17) 1
Cox Technic Case Report #169 published at www.coxtechnic.com (sent 5/9/17) 1 Management of Lumbar Radiculopathy Associated with an Extruded L4 L5 disc and concurrent L5 S1 Spondylolytic Spondylolisthesis
More informationQuestionnaire for Lipedema Patients
Questionnaire for Lipedema Patients Name Date of diagnosis Date Name of physician making diagnosis Do you also have lymphedema? What areas of the body are affected? Outside of thighs Inner thighs Knees
More informationCopyright 2017 Dr. David Hendrickson Discover Life Chiroprac c 5015 Tacoma Mall Blvd Ste E102 Tacoma, WA Phone #: (253)
Copyright 2017 Dr. David Hendrickson Discover Life Chiroprac c 5015 Tacoma Mall Blvd Ste E102 Tacoma, WA 98409 Phone #: (253) 472 4400 www.discoverlifechiro.com Chiropractic and Sciatica Sciatica is a
More informationHome Address. City Postal Code Home Telephone # Business Telephone # Address. Emergency Contact Name, Address, Phone#
Date Name / / last first middle initial Personal Health # - Male Female Home Address City Postal Code Home Telephone # Business Telephone # Cell # E-Mail Address Best way to contact you: Home # Work #
More informationDIAGNOSIS CODING ESSENTIALS FOR LONG-TERM CARE: CHAPTER 13, M CODES MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE
DIAGNOSIS CODING ESSENTIALS FOR LONG-TERM CARE: CHAPTER 13, M CODES MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE Preferred Clinical Services for Leading Age Florida August 26-27, 2015 MUSCULOSKELETAL FUNCTIONS
More informationThoracolumbar Spine Conditions: Treatment and Return to Play
Thoracolumbar Spine Conditions: Treatment and Return to Play C H R I S T O P H E R B U R K S, MD B I E N V I L L E O R T H O P A E D I C S P E C I A L I S T S O C E A N S P R I N G S, MS Thoracolumbar
More informationUpper back pain that radiates down arm
Upper back pain that radiates down arm Deep upper back pain particularly if it is associated with tingling in arms and hands is often an irritated nerve and not primarily a muscular condition. Explanation
More informationCox Technic Case Report #126 published at (sent December 2013 ) 1
Cox Technic Case Report #126 published at www.coxtechnic.com (sent December 2013 ) 1 Cox Technic Decompression Spinal Manipulation Resolves Symptoms Associated with Disc Protrusion and S1 Radiculopathy,
More informationBack Pain. John W. Engstrom, MD December 16, Disclosures. A Clinical Approach to the Evaluation of Back Pain and Lumbar Radiculopathy
Disclosures Nothing to declare --- or --- Significant ownership interests Speaker bureaus, honorarium, grants A Clinical Approach to the Evaluation of and Lumbar Radiculopathy John Engstrom, MD Acute Low
More informationRadiographic Assessment for Back Pain
Radiographic Assessment for Back Pain North American Spine Society Public Education Series What Are Radiographic Assessments? Radiographic assessments for low back pain involve the use of X-rays to determine
More informationUpper back pain and blood in urine
Upper back pain and blood in urine Search 27-2-2018 For about 6 weeks I have been experiencing mid back pain when I wake up in the morning. The pain is so bad, I cannot go back to sleep, and NO position.
More informationLecture Notes The LocomotorSystem. W. P. Howlett 2017
Lecture Notes The LocomotorSystem W. P. Howlett 2017 Symptoms Main Symptoms Pain Stiffness Swelling Weakness The History Joints: involved Pain: onset, precipitating& relievingfactors Stiffness: pattern
More informationDiagnosis and Treatment of Low Back Pain: A Joint Clinical Practice Guideline from the American College of Physicians and the American Pain Society
Diagnosis and Treatment of Low Back Pain: A Joint Clinical Practice Guideline from the American College of Physicians and the American Pain Society Annals of Internal Medicine October 2007 Volume 147,
More informationL5 S1 Extruded Disc Relieved with Cox Technic Decompression Spinal Adjusting
1 L5 S1 Extruded Disc Relieved with Cox Technic Decompression Spinal Adjusting submitted by Joseph d'angiolillo DC 11 Clyde Road, Suite 103 Somerset, NJ 08873 (732) 873 2222 This is a case study of a patient
More informationChiropractic Healthcare
ebook 3 Chiropractic Healthcare Sciatica - Sleep Back Pain Prevention Chapter 1 3 My Doctor Told Me I Have Sciatica Chapter 2 7 Sciatica & Low Back Pain Prevention Chapter 3 12 Proper Sleeping Positions
More informationREVIEW QUESTIONS ON VERTEBRAE, SPINAL CORD, SPINAL NERVES
REVIEW QUESTIONS ON VERTEBRAE, SPINAL CORD, SPINAL NERVES 1. A 28-year-old-women presented to the hospital emergency room with intense lower back spasms in the context of coughing during an upper respiratory
More informationCONSULTATION ADMITTANCE FORM
CONSULTATION ADMITTANCE FORM Last Name: First Name: Address: City Postal Code: Home Phone: Work Phone: Age: Birth date (dd/mm/yr): Sex: M / F Height Weight Occupation: Alberta Health Care #: PLEASE CHECK
More informationVERTEBRAL COLUMN ANATOMY IN CNS COURSE
VERTEBRAL COLUMN ANATOMY IN CNS COURSE Vertebral body Sections of the spine Atlas (C1) Axis (C2) What type of joint is formed between atlas and axis? Pivot joint What name is given to a fracture of both
More informationEVALUATE, TREAT AND WHEN TO REFER RED FLAGS Mid Atlantic Occupational Regional Conference and Environmental Medicine October 6, 2018
EVALUATE, TREAT AND WHEN TO REFER RED FLAGS Mid Atlantic Occupational Regional Conference and Environmental Medicine October 6, 2018 Marc J. Levine, MD Rothman Institute Director Spine Surgery Program
More informationIndex. Note: Page numbers of article titles are in boldface type.
Index Note: Page numbers of article titles are in boldface type. A Adolescent athlete, anatomy and biomechanics of spine of, 424 425 back pain in. See Back pain, in pediatric and adolescent athlete. injury
More informationUpper back pain that gets worse when laying down
Upper back pain that gets worse when laying down The Borg System is 100 % Upper back pain that gets worse when laying down Upper back pain worse lying down. Get worse while laying down and waking up in
More informationwww.fisiokinesiterapia.biz Peak onset between 20 and 30 years Form of spondyloarthritis (cause inflammation around site of ligament insertion into bone) and association with HLA-B27 Prevalence as high
More information