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  • Backpain Prof Kwan

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    Nurul Fahmiza Tumiran
    26 views7 pages
    The document discusses back pain and its causes, symptoms, and diagnosis. It describes how back pain can be caused by injuries to muscles, ligaments, discs, or facets, as well as conditions like stenosis, spondylolisthesis, fractures, tumors, or infections affecting the spinal unit. Symptoms include muscle/ligament pain, discogenic pain, facet pain, instability pain, referred pain, and psychosomatic pain. Neurological symptoms depend on whether the lateral or central canal is affected and include radicular leg pain or myelopathy. Physical exams can identify sensory and motor losses and reflex changes corresponding to affected nerve roots.

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    The document discusses back pain and its causes, symptoms, and diagnosis. It describes how back pain can be caused by injuries to muscles, ligaments, discs, or facets, as well as conditions like stenosis, spondylolisthesis, fractures, tumors, or infections affecting the spinal unit. Symptoms include muscle/ligament pain, discogenic pain, facet pain, instability pain, referred pain, and psychosomatic pain. Neurological symptoms depend on whether the lateral or central canal is affected and include radicular leg pain or myelopathy. Physical exams can identify sensory and motor losses and reflex changes corresponding to affected nerve roots.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as ppt, pdf, or txt
    26 views7 pages

    Backpain Prof Kwan

    Uploaded by

    Nurul Fahmiza Tumiran
    The document discusses back pain and its causes, symptoms, and diagnosis. It describes how back pain can be caused by injuries to muscles, ligaments, discs, or facets, as well as conditions like stenosis, spondylolisthesis, fractures, tumors, or infections affecting the spinal unit. Symptoms include muscle/ligament pain, discogenic pain, facet pain, instability pain, referred pain, and psychosomatic pain. Neurological symptoms depend on whether the lateral or central canal is affected and include radicular leg pain or myelopathy. Physical exams can identify sensory and motor losses and reflex changes corresponding to affected nerve roots.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as ppt, pdf, or txt
    of 7

    Back Pain

    Back Pain Back Pain + Lateral Canal Stenosis


    Back Pain + Central Canal Stenosis

    Symptoms

    Anatomical

    Patho-physiology
    Musculo-ligamentous injury/ sprain Disc disruption Facet synovitis or arthrosis. Disruption of spinal unit i.e. spondylolithesis, fracture, tumor and infection. Inflammation of the spinal unit i.e. inflammatory diseases, infection and metabolic Referred pain Psychosomatic

    MusculoMusculoligamentous pain ligamentous Discogenic pain

    Intervertebral disc
    Facet joint

    Mechanical Pain

    Facet pain

    Back pain

    Instability Pain

    Spinal unit

    Inflammatory pain Referred pain

    Rest pain and night pain Non specific

    Spinal unit

    Viscera organs Brain

    Psychosomatic Non specific pain

    Symptoms

    Anatomical

    Patho-physiology

    Unilateral

    Sciatica or radicular pain

    Lateral canal stenosis

    Radiculopathy compression of nerve root by the prolapse disc and facet hypertrophy.

    Neurological symptoms Bilateral

    Lumbar spinal stenosis due to posterior Intermittent or Central canal osteophyte and disc neurological stenosis anteriorly, hypertrophied claudication, (Lumbar spine) facet joints and ligamentum flavum posteriorly Upper motor neuron symptoms Central canal stenosis Myelopathy (Thoracic and cervical spine)

    Central Canal is bordered by the dural margin. Lateral Canal is divided into subarticular, foraminal and extraforaminal

    Sciatica or Radicular Pain

    Neurological Findings for Lumbar PID


    Level Nerve Root Sensory Loss Motor Loss Reflex Loss

    L1-L3
    L3-L4

    L2,L3
    L4

    Anterior thigh
    Medial calf Lateral calf and dorsum of foot Posterior calf, Plantar foot Perianal
    (Miller MD, 2000)

    Hip flexors Quadriceps, Tibialis Anterior


    EDL, EHL, EDM Gastronemious/ Soleus Bladder/ bowel

    None
    Knee jerk None/ Increase Ankle jerk

    L4-L5

    L5

    L5-S1

    S1

    S2-S4

    S2, S3, S4

    Cremasteric

    Level

    Nerve Root

    Sensory Loss

    Motor Loss
    Abductor of shoulder

    Reflex Loss
    Bicep reflex Brachiorad ialis reflex Tricep reflex

    C4-C5

    C5

    Lateral arm

    C5-C6

    C6

    Radial aspect of forearm Index and middle fingers

    Flexor of elbow

    C6-C7

    C7

    Extensor of elbow

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