Taxi driver

anatomy of the spine
1. joints
  1. intervertebral disc, zygapophyseal joint, atlanto-occipital joint, atlanto-axial joint, lumbosacral joint, sacrococcygeal joint
2. ligaments
3. bones
4. movements
  1. flexion
    1. extension
      1. lateral flexion
        rotation
5. muscles
6. veins passing through
sciatica
1. caused by impingement on nerve root
  1. by degeneration of annulus fibrosis and nucleu pulposis
2. start with
  1. HX.
    1. age, job
      1. daily act
        place, time
        symptoms
        blader incon
    2. VAS
      1. visual analogue scale test that is used to scale the pain of a patient and is usually done by patient. it is usually scaled from 0-100 mm
  2. natural HX
    1. improves with time, average 2 weeks
      1. 1 pain
        slow improv
3. management
  1. alternative
    1. massage
      1. yoga
        chairopractor
        acupuncture
  2. active/ rest
    1. NSAIDS
      1. physiotherapy
  3. placebo effect
    1. unexplained improvements that depends on: belief of patient, situation, pat-doc relationship
  4. second line
    1. traction steroid
    2. surgery
      1. sciatic nerve decompression
        discectomy
        laminectomy, laminotomy
    3. absolute: increase neurological deficit, blader icon
      1. relative: failing treatment, disabling pain
4. physical examination
investigation of back pain
1. history
  1. onset of pain
    1. location of pain
      1. medical history
        types and severity of pain
        aggravating and releiving factors
2. radiographic evaluation
  1. bone scintigraphy
  2. ct scan
  3. MRI scan
3. physical examination
  1. overreaction
  2. tenderness
  3. pain stimulating test
  4. nonorganic regional disturbances
  5. look, feel, move
  6. special tests
    1. straight leg raising
    2. the upper and lower neurovascular test
    3. schobers test
    4. abdominal exam
4. labratory tests
5 dimensions of adherence
lower limb dermatomes

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Taxi driver

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	Created by Ahmed salah about 6 years ago