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STENOSIS

STENOSIS. Outcomes. Be familiar with the causes of Stenosis . Be familiar with the clinical presentation of a patient with typical Stenosis . Be familiar with the most widely used physiotherapy treatment protocol for a patient with typical Stenosis . Causes.

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STENOSIS

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  1. STENOSIS

  2. Outcomes • Be familiar with the causes of Stenosis. • Be familiar with the clinical presentation of a patient with typical Stenosis. • Be familiar with the most widely used physiotherapy treatment protocol for a patient with typical Stenosis.

  3. Causes • Decreased space in the intervertebral canal and/or foramen • May be of genetic origin or a hypertrophic bone, ligaments, capsule and osteophytes

  4. Stenosis

  5. History • Slow onset of intermittent nerve-root symptoms • Pain in the calf may be confused with intermittent vascular claudications

  6. Signs and symptoms • Proximal pain • Patient experiences continuous cramps • Symptoms become worse during standing, extension, prone, walking and running (vertebral column goes into more extension) • Improvement of symptoms take place with sitting or during flexion

  7. Signs and symptoms • Central stenosis causes bilateral calf pain • The above can be confusedwith spondylolisthesis and intermittent vascular claudications • Intermittent claudications are relieved as soon as the patient stops walking or running

  8. Signs and symptoms • Stenosis patients have to sit or bend forward for relief • Spondylolisthesis patients display unstable signs when they return from flexion • A step can be observed in the vertebral column

  9. Treatment • In the early stages physiotherapy may temporarily relieve symptoms • Mobilisations: flexion exercises rotation in flexion traction in flexion • Trigger points • Neural mobilisations (be extremely careful and progress slowly!) • Stretching of back extensors and m psoas

  10. Treatment • Strengthening of abdominal stabilisers • Re-education of posture • Home advice: Avoid extension activities Correction of posture Stand with foot on bench

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