Classification of Lumbar Spine Impairments
Introduction[edit | edit source]
"The best available evidence supports a classification approach that de-emphasizes the importance of identifying specific anatomical lesions after red flag screening is completed."[1]
Several classification systems have been published to help clinicians select an appropriate intervention for patients with low back pain, including:
- Treatment-based Classification (TBC)[2][3]
- Mechanical Diagnosis and Therapy (MDT) (also known as the McKenzie Method)
- Movement System Impairment (MSI)[4]
These classifications and others are discussed here: Treatment-based Classification for Low Back Pain.
This page supports the Plus course, Classification of Lumbar Spine Impairments, by Dr. Shala Cunningham. It discusses a classification system based on the TBC with several key differences:[1]
- the categories include specific International Classification of Functioning, Disability and Health (ICF) terminology related to impairments of body function
- additional categories related to cognitive / affective disorders and generalised pain categories have been included
- it considers the patient’s level of acuity
The categories are:
- low back pain with mobility deficits
- low back pain with movement coordination impairments
- low back pain with related lower extremity pain'
- low back pain with radiating pain
- low back pain with related cognitive or affective disorders
- low back pain with related generalized pain
To learn more about the ICF, please see: International Classification of Functioning, Disability and Health (ICF).
The following sections describe specific symptoms, impairments and possible interventions based on these categories.
References[edit | edit source]
- ↑ 1.0 1.1 Delitto A, George SZ, Van Dillen L, Whitman JM, Sowa G, Shekelle P, Denninger TR, Godges JJ; Orthopaedic Section of the American Physical Therapy Association. Low back pain. J Orthop Sports Phys Ther. 2012 Apr;42(4):A1-57.
- ↑ Delitto A, Erhard RE, Bowling RW. A treatment-based classification approach to low back syndrome: identifying and staging patients for conservative treatment. Phys Ther. 1995 Jun;75(6):470-85; discussion 485-9.
- ↑ Alrwaily M, Timko M, Schneider M, Stevans J, Bise C, Hariharan K, Delitto A. Treatment-based classification system for low back pain: revision and update. Physical therapy. 2016 Jul 1;96(7):1057-66.Delitto A, Erhard RE, Bowling RW. A treatment-based classification approach to low back syndrome: identifying and staging patients for conservative treatment. Phys Ther. 1995 Jun;75(6):470-85; discussion 485-9.
- ↑ Azevedo DC, Ferreira PH, Santos HD, Oliveira DR, de Souza JV, Costa LO. Movement system impairment-based classification treatment versus general exercises for chronic low back pain: randomized controlled trial. Physical therapy. 2018 Jan;98(1):28-39.
