Transcript LOW BACK PAIN(Dr.Aman Sachdeva).

Dr.Aman Sachdeva
Senior Physiotherapist
SitaramBhartia Institute of
Science and Research
LOW BACK ACHE
BACK ACHE AND MOTHER IN LAW
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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
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Bones: 33 vertebra
Ligaments
Muscles
Nerves & Spinal
Cord
CAUSES OF LOW BACK PAIN
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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
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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, DLC
ESR
Calcium/ Phosphate
Alkaline 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
PREVENTION
OF LOW BACK PAIN
EDUCATION IS THE KEY
TO PREVENTION
WHAT SHOULD WE KNOW
• RISK FACTORS
• IDEAL POSTURES
• EXERCISES
POSTURE : THE RULE OF
THUMB
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STATIC POSTURE
SITTING
DRIVING
LYING
STANDING
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DYNAMIC
POSTURES
WALKING
LIFTING
GETTING UP FROM
BED
GETTING UP FROM
CHAIR
IDEAL POSTURES
SITTING
STANDING
STANDING
IDEAL POSTURES
LYING
DRIVING
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
WALLET
FOOTWEAR
OVERLOADED
BAG
EXERCISES
DEPENDS UPON THE CAUSE OF PAIN
INCLUDES
• SPINAL MOBILIZATION EXERCISES
• STRECHING EXERCISES
• STRENGTHENING EXERCISES
• GENERAL CONDITIONING EXERCISES
GOALS OF TREATMENT
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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
QUESTIONS
THANK YOU