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1. Anatomy of the Vertebral Column

   • bones
     • cervical vertebra
     • thoracic vertebra
     • lumbar vertebra
     • sacral vertebra
     • coccyx
   • joints
     • Intervertebral Discs
       • annulus fibrosus
       • nucleus pulposus
     • types
       • Zygapophyseal Joints
       • Atlanto Occipital Joint
       • Atlanto Axial
   • Ligaments
   • muscles
     • SUPERFICIAL LAYER
       • Trapezius
       • latissimus Dorsi
       • Rhomboideus major
       • Rhomboideus minor
       • levator scapulae
     • INTERMEDIATE LAYER
       • serratus post. superior
       • serratus post. inferior
     • DEEP LAYER
       • Splenius
         • capitis
         • cervicis
       • Erector spinae
         • spinalis
         • longissimus
         • Iliocostalis
       • Transversospinalis

2. causes

   • Muscle or ligament strain
   • Bulging or ruptured disks
   • Arthritis
   • Skeletal irregularities
   • Osteoporosis
   • LUMBAR DISK DISEASE
   • DEGENERATIVE CONDITIONS
   • REFERRED PAIN FROM VISCERAL DISEASE

3. Risk factors

   • Age
   • Lack of exercise
   • Excess weight
   • Carrying too much weight
   • arthritis
   • cancer
   • Improper lifting
   • Psychological conditions

4. Investigation of back pain

   • HISTORY
     • Onset of pain
     • Location of pain
     • Type and character of pain
     • Aggravating and relieving factors
     • Medical history
   • PHYSICAL EXAMINATION
     • tenderness
     • Pain with simulated testing
     • Inconsistent responses with distraction
     • Nonorganic regional disturbances
     • Overreaction
   • LABORATORY TESTS
   • RADIOGRAPHIC EVALUATION
     • MRI
     • CT SCAN
   • Visual Analogue Scale
   • demographic data

5. sciatica

   • pain caused by irritation of the sciatic nerve
   • Causes
     • Lumbar Bulging Disc or Herniated Disc
     • Lumbar Spinal Stenosis
     • Spondylolisthesis
     • Trauma
     • Piriformis Syndrome
     • Spinal Tumors
   • Sings and symptoms
     • Shooting pain from the lower back, through the buttock, and down the back of either leg
     • Numbness in the leg along the nerve
     • Tingling sensation
   • Complications
     • Loss of feeling in the affected leg
     • Weakness in the affected leg
     • Loss of bowel or bladder function

6. therapy

   • dietary supplements
   • megadose vitamins
   • herbal preparations
   • massage therapy
   • physiotherapy
   • spiritual healing
   • drugs
     • NSAIDS & Muscle relaxants

7. Surgical Intervention

   • Sciatic Nerve Decompression
   • Microdiscectomy & Discectomy

8. physical examination

   • general
     • look
     • feel
     • move
   • special tests
     • Straight leg raising
     • abdominal exam
     • femoral nerve stretch test
     • schober's test
     • the lower limb neurovascular status
     • the upper limb neurovascular status

9. Associated symptoms with different kinds of pain

   • Aching
     • Anemia
     • Vitamin D deficiency
   • Throbbing
     • Throbbing
   • Stabbing
     • Muscle tear or ligament tear
   • Sharp
     • Herniated disk

10. Radiated Pain VS Referred Pain

    • Radiating pain is pain begins in one place and travels to another location along the path of a nerve
    • Referred pain is pain perceived at a location other than the site of the painful stimulus.

11. Physiological Basis of EMG

    • Motor unit recruitment

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