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
