Looking for fear

[bernard]

Hi SomaSimplers,

Many LBP and back problems patients experience some fear about movement.
Here is a thread to find this behaviour.

I tried to find a simple examination that help us with this problem?!

1/ Starting Position

http://www.somasimple.com/images/lumbar_exam/lumbar_start1.jpg

Patient is lying suppine with knees bent comfortably.
One hand controls the abdominal wall and the other grasps the knees.
http://www.somasimple.com/images/lumbar_exam/lumbar_sart1.jpg

[bernard]

2/ Testing the lumbar area

http://www.somasimple.com/images/lumbar_exam/lumbar_one1.jpg

http://www.somasimple.com/images/lumbar_exam/lumbar_two1.jpg
Move slowly and a little 20/30 cm the legs with the hand on the knees in chest direction. If you feel an abdominal contraction thus it is possible that is a defensive behaviour. If patient experiences pain with this passive motion then fear is almost a component of lumbar motion.

[bernard]

3/ Excluding some root problems!

http://www.somasimple.com/images/lumbar_exam/lumbar_latR1.jpg

http://www.somasimple.com/images/lumbar_exam/lumbar_latL1.jpg

Testing the lumbar region with gentle manoeuvres will exclude some huge root problems, simply. patient will not allow you to move or feel some pain in these directions.

[bernard]

4/ Completing the back examination

http://www.somasimple.com/images/lumbar_exam/backR1.jpg

http://www.somasimple.com/images/lumbar_exam/backL1.jpg

While sitting, some resistance and abnormal motion may be found with these simple adds. It works fine to find some painful spots on shoulder blades.

[cedric]

someone i have here has all of those signs...
so what can we do know?

[bernard]

hmmm,

You're searching a reply in French and English. It may differ in English since Barrett would say Simple Contact, some members would say MFR.
Since I'm unfortunate and haven't been trained with these two, I use my simple ones =>

Always begin by an abdominal breathing! (http://www.somasimple.com/forums/showthread.php?t=41)
Hip and Lumbar Relaxation (http://www.somasimple.com/forums/showthread.php?t=792)
Low Back Pain (http://www.somasimple.com/forums/showthread.php?t=60)

[cedric]

my answer will be much more complete in french, my english has many limits...
maybe you can help :)