Transcript POSTURAL PAIN SYNDROME - Learning

POSTURAL PAIN SYNDROME
Definition
 Postural pain syndrome is pain that develops in the
cervical, thoracic or the lumbar area due to poor
posture maintained over a long period of time.
Excessive tension is placed on these areas.
 Pain is relieved with activity.
Postural pain syndrome
 Includes:
 Postural overload

Causes unbalanced mechanical load.
 Postural overexertion
 Intensity and duration of work is higher than the capacity of
the muscles.
 Vibration syndrome
 Situations where continual compression is exerted on the
structures.
 Postural pain
 Bad posture in static positions.
Pathophysiology
 There is no significant damage or trauma to tissue.
 Pain is only experienced during activities where
constant stress is placed on normal tissue.
 When working at a desk, the sustained posture results
in reduced circulation to the neck and upper back
muscles, which then become tired and fatigued.
 These muscles fail to support good upright posture
and eventually become overstretched and weak.
Causes and Risk factors
 Some of the most common causes:
 Slouching in chairs
 Driving in hunched positions
 Standing badly
 Lifting incorrectly
 Sleeping on sagging mattresses
 Being unfit
 Inactivity and the wrong sort of movement
 Head and neck strain
Causes and Risk factors
 Musculoskeletal problems
 Work-related back problems
 Lower back pain
 Repetitive strain injury
 Carpal tunnel syndrome
Causes and Risk factors
 Common risk factors:
 Being unfit
 Being overweight
 Jobs involving lifting, bending or moving heavy objects
 Being seated in one place for long periods of time
 Frequent use of a telephone without a headset
 High levels of stress, anxiety and tension
Diagnosis
 Difficult for doctors to find the exact cause
 Pain usually starts a day or two after the injury has
occurred or only after several years.
Signs and symptoms
 Usually patients with postural pain syndrome have
normal and pain-free movement.
 When poor posture is maintained for a long time, pain
is experienced.
Treatment
 Physiotherapy may include:
 Soft tissue massage
 Electrotherapy e.g. ultrasound
 Postural tapping
 The use of posture support e.g. braces
 Mobilisation
 Dry needling
 Exercises to improve strength of weak muscles.
 Improve posture
 Stretch short and strong muscles.
Treatment
 Teach patient about kinetic handling.
 Correct biomechanics.
 Clinical Pilates
Do’s and Don’ts
 Do’s: (sitting)
 Sit in a chair that
supports your back in a
slightly extended
position.
 Hips and knees in 90° .
 Shoulders in retraction
and chin tucked in to
minimise postural
strain.
 Feet should be firmly
placed on the ground.
Do’s and Don’ts
 Don’ts: (sitting)
 Slump sit
 Lean forward and
downward to reach your
work.
 Sit with your neck
forward for an extended
period of time(move
around every 20
minutes).
Do’s and Don’ts
 Do’s: (standing)
 Put one foot up and change position often.
 Work at a comfortable height.
 Don’ts: (Standing)
 Wear high-heel, hard heeled or platform shoes for long
periods of time.
 Stand in one position for too long.
 Stand with knees locked.
 Stand bent forward at your waist with your work in a low
position.
X-Rays
Evidence based article
Getting your back back to work: pain
relief- where to start?
Evidence based article
 Focus is on dental health care workers poor posture
due to their job leading to back and shoulder pain.
 Presents a classification system for the treatment of
spinal pain created by physical therapist Robin
McKenzie.
 The approach has had favourable clinical acceptance
among therapists and patients and offers a
conservative alternative to treating back and neck
pain.
Evidence based article
 McKenzie characterized mechanical pain as;
 Pain that can be constant or intermittent
 Limited range of motion of the back or neck that
improves as symptoms diminish
 Movements in certain “incorrect,” or exacerbating
directions increases the pain while simultaneously
decreasing range of motion in the opposite direction.
Evidence based article
 He proposed three nonspecific mechanical
syndromes;
 Postural pain syndrome
 Dysfunction syndrome
 Derangement syndrome
Evidence based article
 Dental workers usually work in a slouched position.
 Slouched sitting causes the spinal musculature to
diminish its activity and place increasing stress on the
posterior ligamentous structures of the spine resulting
in increased length or “creep”
 Bogduk defines creep as a constant force, that if left
applied for a prolonged period to collagen tissue will
result in further movement or length of the
ligamentous tissue.
Evidence based article
 We often see significant weakness of the back extensor
and post. scapula musculature.
 Tightness of the ant. chest and shoulder musculature
in individuals having back and neck pain.
Evidence based article
 Eg. of an exercise;
 Slouch-overcorrect

From an extreme, slouched position to an exaggerated,
lordotic posture.
Evidence based article
 Indications
 Periods in the day when no pain is experienced
 Pain is confined to areas above the knee
 Symptoms are worse when sitting and generally better
with standing or walking
 Symptoms are worse when bending and with inactivity
 If symptoms are better when in supine
 Several episodes of back pain have been experienced
over the past few years.
Evidence based article
 Contra indications
 A first episode of back pain that persists for more than
ten days
 Bowel and bladder symptoms associated with back pain
 Back or neck pain caused by trauma
 Leg pain below the knee including numbness, tingling
or weakness
 Malaise
 Pain that disturbs sleep
Feeding an individual a fish takes care of
their hunger, while teaching them to fish
allows them to survive for life.(unknown)
References
 Caruso, T.J. and Pleva, D.J. 2006. Getting your back back to work: pain relief—
where to start? International Journal of Mechanical Diagnosis and Therapy.
1(1): 18-28. http://www.mdtjapan.org/therapist/2006IJMDT_1%20(1).pdf#page=19

Retrieved on 4 June 2012.
 http://ebookbrowse.com/postural-pain-syndrome-jan08-pdf-d79305710
 http://www.bbc.co.uk/health/physical_health/conditions/in_depth/back_pain
/causesback_types.shtml#top
 http://www.physicaltherapy.zoomshare.com/5.html
 http://www.physioadvisor.com.au/8390250/postural-syndrome-posture-painpoor-posture-.htm
References
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drome&um=1&hl=en&sa=N&biw=691&bih=352&tbm=i
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w=315&h=400&ei=eRjGT9azDYyYhQe17XaBQ&zoom=1
 http://www.the-good-doctor.net/posture-and-formsof-middle-back-pain/
References
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