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OPP Lect 30


Effective treatment for chronic LBP 1.Manipulation (more so than acute). 2.Exercise therapy. 3.Back to school (intensive multidisciplinary biopsychosocial intervention)
What is a Lumbar Step-off a sign of? Spondylolithesis
What is the cause of a UNIlateral Iliolumbar ligament syndrome? Short leg (anatomical or functional). **Treat the Short leg.
What are the causes of BIlateral Iliolumbar ligament syndrome? 1.Hyperlordosis. 2.Overuse strain. 3.Postureal weakness (from lack of activity w/ aging). 4.Spondylolysis (degeneration from OA). 5.Spondylolisthesis (Ant shift of vertebrae). 6.Sacroiliitis.
Where will pain present with Iliolumbar ligament syndrome? 1.Lateral Hip. 2.Inner thigh.
What are the 4 main causes of Chromic LBP? 1.Coccydynia. 2.Iliolumbar Ligament Syndrome. 3.Pelvic Pain. 4.Sacroiliitis.
How would you start treating a patient with Iliolumbar ligament syndrome? 1.Back stretching. 2.Abdominal strengthening. **Can tolerate back strengthening only once pain is gone and abdomen is strong.
Causes of Sacroiliitis 1.Ankylosing Spondulitis. 2.Psoriatic Arthritis. 3.Reactive Arthritis. 4.Gouty Arthritis. 5.Vit A/ Retinoid toxicity. 6.DISH syndrome. **Will have Sacral pain with an ASIS compression test.
OMT for Acute Arthritis 1.Indirect tech to relieve pain. 2.Lymphatic tech to reduce swelling. 3.Direct tech w/ traction to improve motion & avoid stressing joint (adding the traction will make it effective if it doesn't produce pain)
Is pelvic pain common? YES
Are radiologic and laparoscopic evaluation usually negative with Pelvic pain? YES
Pelvic pain is much more common in men or women? WOMEN, after several births.
What should you treat to help with pelvic pain? 1.Pelvic Diaphragm. 2.Sacrum. 3.Hips (retraining iliopsoas function: hip extensor stretch, supine lef lift)
SDs associated with Chronic Pelvic Pain 1.Pubic Shear or compression. 2.Innominate shear. 3.Psoas Syndrome. 4.Pelvic Diaphragm weakness. 5.Coccydynia (Coccyx pain, often from fall/fracture).
Somatic Dysfunctions associated with Coccydynia 1.Glut max strain. 2.Sacrotuberous ligament sprain. 3.Pelvic floor muscle strain (Birth). 4.Coccyx flexion.
Key Indicator of Iliolumbar ligament syndrome Bilateral Upper pole L5 tennderpoints OR iliolumbar lig tenderness.
Key Indicator of Sacroiliitis 1.Diffuse tenderness in the joints, 2.ASIS compression reproduces the pain, 3.FABER test/Patrick maneuver (Ant hip pain).
Key Indicators of Pelvic Pain 1.Anterior Pelvic tenderpoints.
Key Indicators Coccydynia Sacrococcygeal tenderness, Palpation of coccyx is anterior is reproduces pain.
Created by: WeeG