home | anatomy | physiology | pathology | clinical guides
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| 1: Has there been a fall/RTA/trauma? | |
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no, next |
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| 2: Has there been sudden onset of low back pain following an action of lifting/ twisting? | |
yes, next |
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| 3: Bending forwards, is it painful? | |
 yes, next |
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| 6: Is the patient standing with a lateral pelvic shift? | |
 yes, next |
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| 7: Palpate Lumbar segments, is it painful? | |
 yes, next |
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| 8: Sitting slouched, straighten patient’s leg, lift toes, and bend head forward. Is it painful or is altered sensation felt? | |
 yes, next |
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| 9: Therapist lifts painful leg straight up into the air. Is it painful or is altered sensation felt? Patient may lift head to test further | |
 yes, next |
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| 10: Test reflexes, myotomes, and dermatomes. Are some positive? | |
 yes |
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 Disc pain
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| Has there been a fall/RTA/trauma? | |
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no, next |
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| Has there been sudden onset of low back pain following an action of lifting/ twisting? | |
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no, next |
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| Palpate Lx segments, is it painful | |
 yes, next |
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| Is patient over 50yrs old? | |
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 yes, next |
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| When walking up hill or bent forward, is it less painful? | |
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 yes |
| Lumbar stenosis
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| Has there been a fall/RTA/trauma? | |
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no, next |
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| Has there been sudden onset of low back pain following an action of lifting/ twisting? | |
yes, next |
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| Bending forwards, is it painful? | |
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no, next |
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| Bending backwards, is it painful? | |
 yes, next |
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| Palpate Lumbar segments, is it painful? | |
yes, next |
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| Is patient under 50yrs old? | |
yes |
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| Facet joint pain
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| Has there been a fall/RTA/trauma? | |
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no, next |
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| Has there been sudden onset of low back pain following an action of lifting/ twisting? | |
yes, next |
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| Bending forwards, is it painful? | |
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no, next |
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| Bending backwards, is it painful? | |
yes, next |
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| Bending to the right and left, is it painful? | |
 yes, next |
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| Is increased muscle tension evident in muscles along back? | |
 yes, next |
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| Feel the muscle bellies along the lower spine and above the pelvis is it painful to touch? | |
 yes |
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| Muscle spasm/ strain
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| Has there been a fall/RTA/trauma? | |
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no, next |
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| Has there been sudden onset of low back pain following an action of lifting/ twisting? | |
|
no, next |
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|
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| Palpate Lumbar segments, is it painful? | |
yes, next |
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| Is patient over 50yrs old? | |
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yes, next |
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| When walking up hill or bent forward, is it less painful? | |
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yes |
| Arthritis
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| Has there been a fall/RTA/trauma? | |
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no, next |
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| Has there been sudden onset of low back pain following an action of lifting/ twisting? | |
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no, next |
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| Palpate Lumbar segments, is it painful? | |
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no, next |
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| Feel the muscle bellies along the lower spine and above the pelvis is it painful to touch? | |
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no, next |
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| Pick up skin, and roll it between fingers. Does it feel painful and tight? | |
 yes |
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| Myofascial tightness
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| Has there been a fall/RTA/trauma? | |
yes, next |
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| Has the patient had an x-ray? | |
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 yes, next |
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| Did the x-ray indicate a fracture? | |
 yes, next |
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| Is the fracture unstable? | |
 yes |
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Unstable
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