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Neck Pain 背痛
Most mechanical causes of neck pain result in asymmetric lesions
and asymmetrically limited or painful movements
Foraminal compression test (Spurling test)
The Spurling test is a medical maneuver used to assess nerve root pain (also known as radicular pain).
The examiner turns the patient's head to the affected side while extending and applying downward pressure to the top of the patient's head.
A positive Spurling's sign is when the pain arising in the neck radiates in the direction of the corresponding dermatome ipsilaterally.
It is a type of cervical compression test.
Patients with a positive Spurling's sign can present with a variety of symptoms,
including pain, numbness and weakness.
In addition to the clinical history, the neurological examination may show signs suggesting a cervical radiculopathy.
Abduction relief sign
The patient place the hand of the affected upper extremity on the top of his or her head to obtain relief,
may indicate soft disk protrusion causing radicular pain.
肩膀外展緩解疼痛 -> Radicular pain
肩膀外展惡化疼痛 -> Musculoskeletal pain
When neck pain occurs on the side away from head movement, suspect a ligamentous or muscular source. 肌肉痛
Lhermitte’s sign which is indicative of possible cord compression.
Hoffman’s sign indicates an upper motor neuron lesion.
https://www.youtube.com/watch?app=desktop&v=GJ-Q2ibYAHs
Back Pain 背痛
Straight leg raise testing (SLRT)
Patient lying supine, lift each leg separately to approximately 70 degrees in an attempt to produce radicular pain.
A positive SLRT causes a radicular pain radiating below the knee of the affected leg.
This pain is worsened by ankle dorsiflexion and improved with ankle plantar flexion or decreasing leg elevation.
** Reproduction of the patient’s back pain or pain in the gluteal or hamstring area when the leg is raised is not a positive result.
必須要傳到小腿的痛才算
背痛, 大腿痛不算
SLRT is a screening examination for a herniated disk
A positive SLRT is 68-80% sensitive for a L4–L5 or L5–S1 herniated disk.
Crossed straight leg raise test :
Radicular pain down the affected leg when lifting the asymptomatic leg
A positive result is highly specific but insensitive for nerve root compression by a herniated disk.
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