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[1] [2] Waddell's signs may indicate non-organic or psychological component to chronic low back pain. Historically they have also been used to detect malingering in patients with back pain. While testing takes less than one minute, [2] it has been described as time-consuming and alternatives have been proposed. [3]
Waddell's signs: G. Waddell: primary care, psychiatry: chronic pain: identify non-organic sources of low back pain Waddell's triad: J.P. Waddell: paediatric trauma: child pedestrian struck by motor vehicle: Head trauma, thoracic and/or abdominal trauma, femoral fracture Watson's water hammer pulse: Sir Thomas Watson, 1st Baronet: cardiology ...
A back examination is a portion of a physical examination used to identify potential pathology involving the back. A spinal assessment is a way to examine the back for potential pathology. Medical inclinometers can be used to assess range of motion. This kind of assessment can help diagnosis scoliosis, kyphosis and degenerative disc disease. [1]
Magnetic resonance imaging (MRI) is the preferred modality for the evaluation of back pain and visualization of bone, soft tissue, nerves and ligaments. X-rays are a less costly initial option offered to patients with a low clinical suspicion of infection or malignancy, and they are combined with laboratory studies for interpretation.
Low back pain accounts for 17% of all physician visits of people aged 65 and older. [37] From this population, a large portion of radicular pain stems not from disk pathology, but from lumbar spinal stenosis. [37] According to Kalff et al., 21% of people over the age of 60 have lumbar spinal stenosis, as confirmed by radiological screening. [38]
The former is the most common, causing low back pain (lumbago) and often leg pain as well, in which case it is commonly referred to as sciatica. Lumbar disc herniation occurs 15 times more often than cervical (neck) disc herniation, and it is one of the most common causes of low back pain.
Two points are marked: 5 cm below and 10 cm above this point (for a total of 15 cm distance). Then the patient is asked to touch his/her toes while keeping the knees straight. If the distance of the two points do not increase by at least 5 cm (with the total distance greater than 20 cm), then this is a sign of restriction in the lumbar flexion. [1]
The parameters scored may vary, as well as the weighting of the scores for worsening deterioration. Some systems also assign scores to other parameters including urine output, oxygen saturation, flow rate of oxygen administration and pain scores. There is a lack of consensus on what constitutes the 'ideal' early warning score system.
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