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OPP Lect 30 LBP III

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Effective treatment for chronic LBP   1.Manipulation (more so than acute). 2.Exercise therapy. 3.Back to school (intensive multidisciplinary biopsychosocial intervention)  
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What is a Lumbar Step-off a sign of?   Spondylolithesis  
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What is the cause of a UNIlateral Iliolumbar ligament syndrome?   Short leg (anatomical or functional). **Treat the Short leg.  
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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.  
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Where will pain present with Iliolumbar ligament syndrome?   1.Lateral Hip. 2.Inner thigh.  
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What are the 4 main causes of Chromic LBP?   1.Coccydynia. 2.Iliolumbar Ligament Syndrome. 3.Pelvic Pain. 4.Sacroiliitis.  
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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.  
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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.  
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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)  
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Is pelvic pain common?   YES  
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Are radiologic and laparoscopic evaluation usually negative with Pelvic pain?   YES  
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Pelvic pain is much more common in men or women?   WOMEN, after several births.  
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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)  
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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).  
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Somatic Dysfunctions associated with Coccydynia   1.Glut max strain. 2.Sacrotuberous ligament sprain. 3.Pelvic floor muscle strain (Birth). 4.Coccyx flexion.  
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Key Indicator of Iliolumbar ligament syndrome   Bilateral Upper pole L5 tennderpoints OR iliolumbar lig tenderness.  
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Key Indicator of Sacroiliitis   1.Diffuse tenderness in the joints, 2.ASIS compression reproduces the pain, 3.FABER test/Patrick maneuver (Ant hip pain).  
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Key Indicators of Pelvic Pain   1.Anterior Pelvic tenderpoints.  
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Key Indicators Coccydynia   Sacrococcygeal tenderness, Palpation of coccyx is anterior is reproduces pain.  
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