Interrater Reliability of a Movement Impairment-Based Classification System for Lumbar Spine Syndromes in Patients With Chronic Low Back Pain

Abstract Background and Purpose. This case report describes the use of a classification system in the evaluation of a patient with chronic low back pain (LBP) and illustrates how this system was used to develop a management program in which the patient was instructed in symptom-reducing strategies for positioning and functional movement. Case Description. The patient was a 55-year-old woman with a medical diagnosis of lumbar degenerative disk and degenerative joint disease from L2 to S1. Rotation with extension of the lumbar spine was found to be consistently associated with an increase in symptoms during the examination. Instruction was provided to restrict lumbar rotation and extension during performance of daily activities. Outcomes. The patient completed 8 physical therapy sessions over a 3-month period. Pretreatment, posttreatment, and 3-month follow-up modified Oswestry Disability Questionnaire scores were 43%, 16%, and 12%, respectively. Discussion. Daily repetition of similar movements and postures may result in preferential movement of the lumbar spine in a specific direction, which then may contribute to the development, persistence, or recurrence of LBP. Research is needed to determine whether patients with LBP would benefit from training in activity modifications that are specific to the symptom-provoking movements and postures of each individual as identified through examination.

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Immediate effect of thoracic mobilization on trunk motion, pain sensation and lumbar spine muscle activity in patients with chronic low back pain

http://isrctn.com/ ◽

10.1186/isrctn75190733 ◽

2021 ◽

Author(s):

Amornthep Jankaew

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Lumbar Spine ◽

Chronic Low Back Pain ◽

Muscle Activity ◽

Low Back ◽

Pain Sensation ◽

Trunk Motion

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Effects of infrared radiation and shortwave diathermy on the patients with chronic low back pain due to osteoarthritis of the lumbar spine

Osteoarthritis and Cartilage ◽

10.1016/j.joca.2019.02.475 ◽

2019 ◽

Vol 27 ◽

pp. S443-S444

Author(s):

M.A. Shakoor

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Lumbar Spine ◽

Chronic Low Back Pain ◽

Infrared Radiation ◽

Low Back ◽

Shortwave Diathermy

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SPECT/CT imaging of the lumbar spine in chronic low back pain: a case report

Chiropractic & Manual Therapies ◽

10.1186/2045-709x-19-2 ◽

2011 ◽

Vol 19 (1) ◽

Cited By ~ 7

Author(s):

Michael H Carstensen ◽

Mashael Al-Harbi ◽

Jean-Luc Urbain ◽

Tarik-Zine Belhocine

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Case Report ◽

Lumbar Spine ◽

Chronic Low Back Pain ◽

Ct Imaging ◽

Low Back

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Clinical Review of Lumbar Spine Fusion for Chronic Low Back Pain Due to Degenerative Disc Disease

The Spine Journal ◽

10.1016/j.spinee.2012.08.382 ◽

2012 ◽

Vol 12 (9) ◽

pp. S147-S148 ◽

Cited By ~ 2

Author(s):

Frank M. Phillips ◽

Paul J. Slosar ◽

Jim A. Youssef ◽

Gunnar B. Andersson ◽

Frank J. Papatheofanis

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Lumbar Spine ◽

Clinical Review ◽

Chronic Low Back Pain ◽

Degenerative Disc Disease ◽

Spine Fusion ◽

Low Back ◽

Disc Disease ◽

Lumbar Spine Fusion

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Atraumatic Bilateral Lumbar Pedicle Fractures in a Patient with Back Pain and History of Long- Term Bisphosphonate Therapy: A Case Report

Pain Management Case Reports ◽

10.36076/pmcr.2020/4/97 ◽

2020 ◽

pp. 97-102

Author(s):

Alec L. Meleger

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Case Report ◽

Lumbar Spine ◽

Conservative Management ◽

Chronic Low Back Pain ◽

Bisphosphonate Therapy ◽

Low Back ◽

History Of ◽

Lumbar Pedicle

of atypical femoral fractures is a known complication of chronic bisphosphonate therapy; however, the finding of atraumatic lumbar pedicle fractures without a prior history of spinal surgery or contralateral spondylolysis is rare. While a few cases of osteoporotic pedicle fractures associated with adjacent vertebral compression fractures have been reported, only a single case of isolated atraumatic bilateral pedicle fractures has been published in a patient who had been on chronic risedronate therapy of 10-year duration. Case Report: The present case report illustrates a 63-year-old man who developed isolated atraumatic bilateral lumbar pedicle fractures after 3 years and 5 months on alendronate treatment. The patient’s past medical history had been significant for osteoporosis with a lumbar spine T-score of -2.7. At the time of initial diagnosis, a comprehensive work-up for secondary causes of osteoporosis proved to be negative; this was followed by initiation of bisphosphonate treatment with 70 mg of alendronate once per week. Ten months after starting bisphosphonate therapy, he underwent magnetic resonance imaging (MRI) of the lumbar spine for low back pain that had not responded to conservative management, with imaging not revealing any evidence of pedicle fractures or pedicle stress reaction. He was again seen in the spine clinic, for atraumatic exacerbation of his chronic low back pain with concurrent right lower extremity radiation, 6 months after stopping bisphosphonate therapy. Since the patient failed to respond to conservative management over the ensuing 6 months, a repeat MRI was obtained, which showed new acute/subacute bilateral L5 pedicle fractures. Conclusion: An isolated atraumatic lumbar pedicle fracture may be an additional type of atypical fracture associated with chronic bisphosphonate therapy in an osteoporotic patient. Key words: Chronic low back pain, bisphosphonate, alendronate, pedicle fracture Pain Medicine

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A Comparison of Pressure Pain Detection Thresholds in People With Chronic Low Back Pain and Volunteers Without Pain

Physical Therapy ◽

10.1093/ptj/85.10.1085 ◽

2005 ◽

Vol 85 (10) ◽

pp. 1085-1092 ◽

Cited By ~ 68

Author(s):

R Jason S Giesbrecht ◽

Michele C Battié

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Lumbar Spine ◽

Chronic Low Back Pain ◽

Primary Care Physicians ◽

Detection Threshold ◽

Test Site ◽

Low Back ◽

Pressure Pain ◽

Pain Detection

Abstract Background and Purpose. Palpation is often utilized in the physical examination of patients with low back pain. The purpose of this study was to compare the pressure pain detection threshold (PPDT) of people with chronic low back pain (CLBP) and subjects without pain. Subjects and Methods. Thirty female subjects with CLBP were recruited from the offices of primary care physicians and physical therapists and compared with 30 female volunteers without pain for differences in PPDT at 6 sites tested bilaterally. Results. A significantly lower mean PPDT was found for all test site groups in subjects with CLBP compared with subjects without pain. A lower global PPDT was found in subjects with CLBP compared with subjects without pain (5.6 lb/cm2 versus 6.9 lb/cm2). This also was the case for PPDT for the group of test sites unrelated to the lumbar spine (5.1 lb/cm2 versus 6.1 lb/cm2) and for PPDT related to the lumbar spine (5.9 lb/cm2 versus 8.0 lb/cm2). Discussion and Conclusion. Neurobiological or biopsychosocial influences may have contributed to the lower PPDT evident in subjects with CLBP. Subjects with CLBP demonstrated a lower global PPDT compared with subjects without pain, which should be taken into account when interpreting findings of pain or tenderness from palpation.

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