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Dr.Aman Sachdeva. Senior Physiotherapist SitaramBhartia Institute of Science and Research. LOW BACK ACHE. BACK ACHE AND MOTHER IN LAW. Most people have got it If you don’t have it, it will come sometimes If you are lucky it wont visit you for long - PowerPoint PPT Presentation
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Dr.Aman Sachdeva
Senior Physiotherapist
SitaramBhartia Institute of Science and Research
LOW BACK ACHE
BACK ACHE AND MOTHER IN LAW
• Most people have got it
• If you don’t have it, it will come sometimes
• If you are lucky it wont visit you for long
• When it leaves you hopefully it wont take away too much
• Even when it goes away there is always a chance it will come back
KNOW YOUR BACK
Anatomy : Complex structure of bones & cartilge supported by muscles
• Bones: 33 vertebra• Ligaments• Muscles• Nerves & Spinal
Cord
CAUSES OF LOW BACK PAIN• Non Specific• Nerve root entrapment- Sciatica• Spondylolysis• Spine fracture• Infection eg. TB• Cancer• Arthritis eg Ankylosing Spondylitis• Traumatic• Metabolic- Osteoporosis/ Osteomalacia• Referred pain from abdomen
RISK FACTORS
• Overweight
• Sedentary lifestyle
• Heavy manual workers
• Prolonged standing in an awkward posture
• Physical factors such as heavy physical work, frequent bending, twisting, lifting, pulling and pushing, repetitive work, static postures and vibrations.
CLASSIFICATION
• MECHANICAL
• NEUROLOGICAL
MECHANICAL BACK PAIN• By far the commonest type, possibly related to
posture/ activities cannot identify any disease process
• Dysfunction of ligamentous or musculoskeletal structures)
Ligament strain Facet joint strain Muscle strain Disc degeneration• Types
– Acute– Chronic
MECHANICAL BACK PAIN cont ...
• Acute Low back pain
Less than 6 weeks old
Overall good prognosis
Postural cause very common
May be related to over activity ,lifting weights/ twisting
• Chronic back pain
Over 6 weeks duration
Needs evaluation
DIAGNOSIS• History• Examination• Blood test
Hb, TLC, DLCESRCalcium/ PhosphateAlkaline Phosphatase
• Radiological investigations X rays CT Scan MRI Bone Scan Bone Density
RED FLAGS Worry
• Very young and very old with first onset of pain (below 20 yrs & above 55yrs)
• History of Cancer• History of fever & weight loss• Night pain• Ill health or other medical problems• Bladder & Bowel problems• Mid back pain • Significant & progressive weakness
PREVENTIONOF LOW BACK PAIN
WHAT SHOULD WE KNOW
• RISK FACTORS
• IDEAL POSTURES
• EXERCISES
EDUCATION IS THE EDUCATION IS THE KEY TO PREVENTIONKEY TO PREVENTION
POSTURE : THE RULE OF THUMB
STATIC POSTURE• SITTING• DRIVING• LYING• STANDING
DYNAMIC POSTURES
• WALKING• LIFTING• GETTING UP FROM
BED• GETTING UP FROM
CHAIR
IDEAL POSTURES
SITTING STANDING
STANDING
IDEAL POSTURES
DRIVING
LYING
PICKING UP
OFFICE OF HORRORS !
WHAT TO CHECK
• WORKSTATION AND YOUR POSTURE
IDEAL SITTING POSTURE AT DESKTOP
CORRECTING POSTURE
CORRECTING POSTURE
FEW MORE CULPRITS
MATTRESS FOOTWEAR
WALLET OVERLOADED BAG
EXERCISES
DEPENDS UPON THE CAUSE OF PAIN
INCLUDES
• SPINAL MOBILIZATION EXERCISES
• STRECHING EXERCISES
• STRENGTHENING EXERCISES
• GENERAL CONDITIONING EXERCISES
GOALS OF TREATMENT
• To recognize red flags • To recognize disability from simple low back
pain • To relieve pain • To improve ability to function and alleviate
disability • To prevent recurrence and the development of
chronicity
TREATMENT
• REST
• MEDICINES
• PHYSIOTHERAPY
Electrotherapy
Exercises
Postural care
• SURGERY
THANK YOU