Clinical Practice Patterns for Lumbar Spine Pain

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Abstract:
According to the World Health Organization lumbar spine pain is the leading cause of disability. Disc herniation is often attributed as the cause of pain based on frequent findings on MRIs that may or may not correlate with the patient´s symptoms. Non-disc related pain is often diagnosed as non-specific low back pain. In a recent informal Facebook poll, many athletic trainers do not feel they have a working knowledge of appropriate treatment strategies for patients with low back pain. This presentation is designed to identify back pain generators beyond the disc. Specific active and passive movements will be discussed to confirm or rule out contributions to pain and movement dysfunction related to structural issues (disc, fractures), hypermobility issues including instability, and movement restrictions (neurofascia, joint capsule). Conditions will be addressed in evidence-inspired sections consisting of anatomy review, pathomechanics, subjective complaints, red flag screen, movement impairments, and appropriate interventions based on the tissue specific impairment.

Objectives:

  • Participants will be able to list anatomical structures that are pain generators in back pain., 
  • Participants will differentiate mechanical low back pain from non-orthopedic causes., 
  • Participants will identify common movement patterns of the lumbar spine.,
  • Participants will select appropriate interventions correlated to the dysfunctional movement pattern.

Level:
Advanced

Domains:
Domain 2: Assessment Evaluation and Diagnosis

CEUs:
1.25 Category A

Keywords: lumbar, spine, disc, herniation, fracture, joint, dysfunction, intervention

On-Demand (Enhanced Access) Course Expiration:
Courses registered for after February 5, 2025, must be completed by December 31, 2025, at 11:59 p.m. CST.
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Steve Middleton, PT, DPT, MS, ATC, CSCS

Dr. Steve Middleton serves as the Director of the Master of Athletic Training Program at William Woods University in Fulton, MO and a Contributing Faculty at the University of St Augustine for Health Sciences. In addition to maintaining national accreditation, he also teaches Examination I: Lower Extremities and Lumbar Spine, Examination III: Upper Extremities and Cervical Spine, Interventions II: Manual Therapy, and Interventions III - Therapeutic Exercise. He previously taught in the Department of Kinesiology at Southern Illinois University as well as serving as both a clinical instructor for the Athletic Training Program and as a guest lecturer in the Master of Physician’s Assistant program during their orthopedic rotations. Dr. Middleton also maintains a clinical practice running a pro bono Physical Therapy & Sports Medicine Clinic as part of William Woods University’s Student Health Services where he specializes in lumbo-pelvic-hip disorders and equestrian medicine. Dr. Middleton earned his Doctor of Physical Therapy degree from the University of St Augustine for Health Sciences with an emphasis in manual physical therapy. He holds a Master of Science in Exercise Science & Health Promotion from California University of Pennsylvania and a Bachelor of Science in Athletic Training from Southern Illinois University. In addition to his academic degrees, he holds additional certifications from the National Academy of Sports Medicine, the National Strength & Conditioning Association, the International Kinesio Taping Association, and Graston Technique. Dr. Middleton is certified in Fascial Movement Taping (FMT) and has become a foremost authority in the field integrating a variety of manual therapy techniques.

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