Lordosis Assessment: Would you Play Guessing Games with your Lower Back Pain or would you like your Treatment to be based upon Fact?
Why is the Lordosis Assessment is an important Step prior to Hyperlordosis treatment?
Treatment without assessment would be incorrectly based upon assumptions without facts or information, and would adversely impact the effectiveness of any legitimate Treatment Plan. The Assessment will provide us with the information we need to find out what the problem might be in order to create an appropriate and effective Treatment Plan. The Pain Assessment is normally conducted by someone whom is aware about the information that needs to be obtained to create an effective treatment plan. This would be someone whom is experienced in applying Postural Analysis, Biomechanical testing, and other similar tests, such as a Physician, Medical Massage Therapist or Chiropractor.
What information do we need to collect for the Assessment?
Medical History of the problem regarding testing and treatment for the problem
If the Problem has been diagnosed by a Doctor and when that occured
A Pain Scale Map for Visual Pain Representation of the problem
Copies of Imaging Diagnostics of the problem such as X-Rays
What makes the Pain better or Worse
Postural Analysis, Gait Analysis
Palpation Assessment
ROM- Range of Motion Test Results
To find out if we can re-produce the symptoms of the problem
What health-related issues the problem may be causing
What should the medical history tell me?
At a minimum, the medical history of the Lordosis Pain Assessment should reveal a history of Lower Back Pain symptoms. Ask if the patient has seen a doctor for this problem. Numerous questions about prior experiences with all possible causes as well as symptoms need to be asked that will help us to consider the elimination of unrelated causes. Ask about the shoes that are worn for the better part of the day. Ask if High-Heeled Shoes are worn for long periods of time. Ask if the patient has had foot problems or leg problems. Radiating pain is a very serious symptom that could have Radicular (nerve root compression) origins.
Utilize a Pain Scale Map to get a Visual Representation of Pain Scale Levels and Representation.
The Pain Scale Map is a visual map of a illustration representing the human body. There should be a Legend of symbols that represent different forms of soft tissue dysfunction and joint position such as Spasm, Trigger Point, or Rotation and Elevation, as well as pain scale levels. A 0-4 pain scale indicates a pain experience at a functional level. A pain scale of 5-7 indicates pain at an uncomfortable level. When the pain scale hits 8-9, that is a level of pain that causes a person to become bed-ridden. Unbearable pain is when the pain scale hits 10. The diagram should then be mapped with the appropriate symbol, pain scale and location
What makes the pain better or worse?
Ask about what movements exacerbate or decrease pain, and how the movements increase the pain, if the pain is continuous or intermittent, and what time of day the pain is at its worst and what has or has not been done to decrease pain.
Physician involvement may be needed.
With such a large number of possible causes, and some being very serious, Physician involvement and interaction is recommended for prescription medication, Imaging Diagnostics, application of Nerve Block Diagnostics, and other such tests.
Were there any Xrays or other Imaging Diagnostics taken?
We need to find out if x-rays, or CT Scans, or MRI’s or other imaging diagnostics were taken and what the prognosis or results were. At a minimum, The Imaging Diagnostics should allow us to observe the Hyperlordotic lumbar spinal curvature.
Are there any Lordosis Visual Symptoms I can expect to see, and what can I do to reveal them?
A Postural Analysis will reveal weight bearing characteristics, and lower back curvature. Pay attention to foot position while standing upright and relaxed, because external rotation is a hint of leg length inequality, and leg length inequality is a hint of pelvic positioning differences. Pelvic positioning has everything to do with Lordosis, because Lordosis is created by excessive anterior pelvic rotation. Observation of the affected area might possibly reveal the excessive Lordotic curve, but you might not see anything remarkable either. A Gait Analysis might reveal the severity of the problem if leg movement affects the Lower back, or if any walking movement is unnatural, or weight transfer characteristics upon movement.
What should the affected areas feel like when palpated?
Lower back Palpation might reveal hypertonicity, pain and/or tenderness in the lower back. Glute palpation would not normally reveal hypertonic tissues in that area, just the opposite. Anticipate hypertonic Hip Flexors and anterior upper leg muscles as well as soft abdominal tissues. Check to see if Trigger Points are present in the soft tissue structures. Check for individual temperature, tone, pain and tenderness of each specific location. Increased temperature indicates possible inflammation; decreased temperature could indicate poor circulation. Muscle tissues should be supple, because hypertonicity or flaccid tissues indicate possible circulatory or nerve related problems.
Don’t forget to check for Joint Mobility
A joint mobility test of the the Lumbar Spine and Sacroiliac Joint of each hip will check for Facet Joint Pain and Sacroiliac Joint Dysfunction or SI Joint Pain and fixations or restrictions that could be a source of pain symptoms.
What Lordosis Assessment Range of Motion Tests should I be doing?
Active(AROM), Passive(PROM), as well as Resisted Range of Motion(RROM) Testing for the Pelvis and Lower Back portion of the Lordosis Assessment should be conducted to specifically determine the movements that exacerbate pain, how the pain scale for each movement is affected, the ROM for each movement, and the quality of the movements as to whether the movement is smooth, segmented, spastic, or rigid. Movements checked should primarily be Flexion and Extension. Check Hip positioning, Hip Flexor movement and ROM, and Femur Internal and External ROM.
