Lower Back Pain Examination
NPTE Clinical Files | Physical Therapy
Kyle Rice
4.9 • 631 Ratings
🗓️ 27 November 2019
⏱️ 12 minutes
🧾️ Download transcript
Summary
Chelsea is a gymnast with complaints of diffuse lower back pain and feelings of instability. The physical therapist is challenged with determining the MOST likely pathology that fits the subjective assessment and physical examination
How well do you know your lumbar pathologies? Let's test your skills in this excellent episode about lower back pain orthopedic examination.
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Transcript
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| 0:00.0 | You are now tuning in to the MPTE Clinical Files, two mock MPTE-based questions told and solved week by week. |
| 0:08.1 | Thank you for tuning in to the MPT Clinical Files. My name is Kyle Rice, the MPT Prep Coach, the founder of the PT Hustle and the creator of the MPT Prep Success Coaching Program. |
| 0:18.3 | And if you would like a free cheat sheet that goes along with this specific |
| 0:22.4 | question, tune in to the end of this episode. And I'm going to give you more information on how to |
| 0:27.7 | get that. All right. So for our next MPT clinical file, we have our patient. Chelsea. And Chelsea is a |
| 0:33.3 | gymnast with complaints of diffuse lower back pain and feelings of instability. The patient |
| 0:39.3 | reports that trunk flexion and holding her breath alleviate the symptoms. During the examination, |
| 0:46.3 | the therapist finds that the L4 spinaus process is anteriorly displaced relative to the segment |
| 0:53.8 | below. |
| 0:54.6 | Which of the following is the most likely present? |
| 0:57.7 | So we have A, L4-5 anterioralesthesis, B, lumbarization of the sacrum, C, L-4-herniated nucleus |
| 1:08.4 | propulsus, and D, L- L5s1 anterioralesthesis. |
| 1:13.7 | So let's go up here to the top. |
| 1:16.1 | We have Chelsea is a gymnast with complaints of diffuse lower back pain and feelings of instability. |
| 1:22.9 | And that's where I want to slow up. |
| 1:24.6 | I want to slow up because we have this gymnast and we don't know how old |
| 1:29.9 | she is, so we don't want to assume anything. But I mean, she's more than likely relatively |
| 1:35.5 | young and she has lower back pain and feelings of instability. One of the pathologies when it comes |
| 1:41.4 | down to the lumbar spine that's very consistent with a patient who's a gymnast |
| 1:46.5 | is spondylolisthesis and if you're not familiar with that that's where there's a fracture |
| 1:52.4 | bilaterally of the pars interarticularis and so there is actually a slippage of one vertebra |
| 2:00.4 | over the level below. |
... |
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