!"#$% '( )*+',)%,- #./"% 01234567 +/82#./"% 03219 4567 .:,';*. < 19 457 ,%./,,%;" %=*+')*.

>%) (?#$ )*+',)%,+

Cancei
Inflammatoiy uisoiueis
Infections
Fiactuies
!=%.*(*. @AB
Lateial canal stenosis
Cential stenosis
Bisc piolapse
Nouic changes
Sponuylolisthesis
!"#$%&%'( *+,- .%//0&"-0 1$-2 .&$3$."&
4/0,03-"-$%3
C';2+=%.*(*. @AB
No cleai patho-anatomical uiagnosis
(Localizeu oi geneializeu)

5",0# %3 .&$3$."& 06"*$3"-$%3 "3# /07$01 %8
"7"$&"9&0 /"#$%&%'(
B#*; 4*": D%.:#;*.#? 8%:#E*'/,
Pain that has a cleai anu consistent anatomical focus
Pain has a piopoitionate mechanical behavioi
(Piovokeu anu ielieveu with specific activities anu postuies)
B#*; 4*": ;';2D%.:#;*.#? 8%:#E*'/,
Spontaneous, constant geneializeu pain with no cleai
anatomical focus, eithei unielateu to mechanical factois oi a
uispiopoitionate exaggeiateu anu sustaineu pain iesponse to
minoi mechanical tiiggeis.



@*(%+"F?% #;) *;)*E*)/#? (#."',+
Patient questioneu iegaiuing:
1. Physical activity levels anu piefeiences: fiequency, uuiation, intensity levels pei week as iateu by patient, seuentaiy behaviouis
2. Woik ielateu factois - heavy iepeateu loauing, monotony, seuentaiy behaviouis, eigonomic consiueiations
S. Sleep ielateu pioblems anu sleep hygiene, eneigy anu vitality, smoking
4. Lifestyle - life stiess events, cuiient stiess levels, the basis of it anu theii peiceiveu levels of contiol ovei this
S. uoal setting iegaiuing lifestyle factois, activities they enjoy, peiceiveu baiiieis to activity, iealistic physical activity levels to attain
G'$;*"*E% #;) B+F.:'2+'.*#? (#."',+
Patient questioneu iegaiuing:
1. 50&$08, - iegaiuing the basis of theii pain, stiategies they peiceive will help them, auvice they have been given, futuie consequences
2. :0"/, - iegaiuing movement, activities, avoiuance behaviouis, woik, futuie consequences of pain uisoiuei
S. ;-/0,, "3# "36$0-( - cuiient levels, enquiie iegaiuing its basis (social factois, unueilying tiait anxiety, pain ielateu anxiety), stiess iesponsiveness
anu how it impacts on pain anu muscle tension, how this ielates to theii thoughts, feais anu behaviouis, levels of vigilance anu focus on pain
4. <%%# - levels of moou anu how this impacts on theii pain anu lifestyle factois
S. =%4$3' ,-/"-0'$0, - cuiient coping stiategies (avoiuant vs. enuuiance), whethei they have active coping stiategies foi theii pain, theii peiceiveu
ability to cope with anu manage theii pain, levels of pacing, willingness to engage in self management stiategies
6. >%/? @ 2%*0 ielateu factois - coping, levels of suppoit, life stiess, absenteeism, piesenteeism, seeking compensation
7. =%A*%/9$#$-$0, - psychological anu geneial health histoiy anu peiception
This aspect of the examination was integiateu with the 0iebio Scieening Questionnaiie (wheie scoie is >S foi ielateu specific items these items weie
specifically exploieu with the patient)




B#*; ,%?#"%) D'E%D%;" 8%:#E*'/,+
Iuentify anu examine the piimaiy pain piovocative functional impaiiments (postuies, movements anu activities as iepoiteu by patient)
Iuentify the postuial anuoi movement contiol stiategy auopteu with the activity (postuie anu movement analysis)
Iuentify pain behaviouis - avoiuance (limb loauing, activity oi movement), piopping with hanus, bieath holuing, biacing etc
Iuentify levels of bouy ielaxation, bieathing contiol, bouy contiol, awaieness anu movement plasticity uuiing piovocative movements anu postuies
Beteimine whethei the auopteu stiategy is piovocative (mal-auaptive) oi piotective (auaptive) of the uisoiuei
i.e. Boes ieinfoicing the 'patients' stiategy piovoke theii pain.
Beteimine how these behaviois ielate to the patients sense of self (bouy schema), beliefs, feais, anxiety levels, coping stiategies
Exploie whethei an alteinative movement oi postuial contiol stiategy be founu via ielaxation anu postuial aujustment, that ieuuces pain anu oi
facilitates functional capacity
Levels of conuitioning, muscle stiength anu enuuiance specific to functional impaiiments

G';",'? *D=#*,D%;" 8%:#E*'/,
Pain associateu with movement anuoi loauing in a specific movement uiiection
oi postuial task.
!" $"%&$&'( )$*+),$&'( in uiiection of pain piovocation uuiing piovocative
activity anu oi postuial task.
Auapting the movement contiol stiategy to ieuuce focal spinal loauing
(postuial aujustment anu oi ielaxation) uuiing the piovocative task /0#+.0, -20
4"$3 "3# 032"3.0, 8+3.-$%3"& ."4".$-(
Biiections: Extension, flexion, multi-uiiectional sensitivity
(Note: if pieuominantly a loauing pioblem theie may not be a uiiection of
piovocation)


H'E%D%;" *D=#*,D%;" 8%:#E*'/,
Pain associateu with movement anuoi loauing in a specific
movement uiiection oi postuial task.
-"%&$&'( )$*+),$&'( (guaiuing) in uiiection of pain
piovocation uuiing piovocative activity.
uiauuateu movement exposuie into the uiiection of pain
piovocation with contiolleu motoi ielaxation /0#+.0, 4"$3 "3#
032"3.0, 8+3.-$%3"& ."4".$-( uuiing piovocative task
Biiections: Extension, flexion, multi-uiiectional sensitivity



H/?"*2)*D%;+*';#? .?#++*(*.#"*'; +F+"%D (', #I*#? ?'4 8#.5 =#*;
(Pain uominant between T12 anu buttocks)


H*I%)
=,%+%;"#"*';