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Lumbar exam in patients with Chronic Pain

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Low back pain exam in chronic pain Julio A. Martinez-Silvestrini, MD Outpatient Medical Director Baystate Physical Medicine and Rehabilitation Assistant Clinical Professor Tufts University School of Medicine
Disclosures ,[object Object]
Objectives ,[object Object],[object Object],[object Object],[object Object]
Low Back Pain ,[object Object],[object Object]
Low Back Pain ,[object Object],[object Object],[object Object],[object Object]
Case ,[object Object],[object Object],[object Object],[object Object],[object Object]
Case ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
History ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
History: “ Red Flags ” ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Chou R. Ann Int Med, Feb 2011.
Pitfalls ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pitfalls ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Physical Examination
 
Inspection
Inspection ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Palpation ,[object Object],[object Object],[object Object],[object Object]
Palpation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Range of Motion ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Anterior Posterior
 
 
Neurologic exam ,[object Object],[object Object],[object Object],[object Object]
Provocative maneuvers ,[object Object],[object Object],[object Object],[object Object]
Slump Test ,[object Object],[object Object],[object Object],[object Object]
Spinal Stenosis
Waddell ’ s signs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Common Diagnoses
Mechanical low back pain ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Mechanical LBP ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Radicular pain ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Sacroiliac joint pain ,[object Object],[object Object],[object Object],[object Object],[object Object]
 
 
Sacroiliac joint pain ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Sacroillitis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
SI Joint dysfunction
SI Joint dysfunction
SI Joint dysfunction
Piriformis syndrome ,[object Object],[object Object],[object Object],[object Object]
Piriformis syndrome
Piriformis stretch
Greater trochanteric bursitis ,[object Object],[object Object],[object Object],[object Object]
Hip Osteoarthritis ,[object Object],[object Object],[object Object],[object Object],[object Object]
Workshop ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Case ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
 
Contact information ,[object Object],[object Object]
Thanks!

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