Low Back Pain

Pain in lower part of spine i.e lower thoracolumbar, lumbar and lumbosacral region of spine.

EPIDEMIOLOGY AND CAUSES

More than 80% Adults experience Low back pain at some point in life

Prevalence increases with age until 60-65 years age

Men and Women are equally affected

Second Common Reason for Medical Evaluation

Most Common Cause of Work Related Disability

CAUSES

Sudden Injury (Strains and Sprains)

Compression Fracture (Osteoporosis)

Cancer

Osteoarthritis

Lumbago

Sciatica

Herniated Disk

Spinal Stenosis

Degenerative disc disease

Lumbar Spondylosis

Spondylolisthesis

Paget’s Disease

Sacroiliac Joint Dysfunction

Kidney Stones

Pelvic Inflammatory Disease

Premenstrual Syndrome

Prostatitis

Spinal Abscess

Endometriosis

Ankylosing Spondylitis

Cervical (cervix) Dysplasia

Miscarriage

Osteomyelitis

Urethritis

Reactive Arthritis

Scoliosis

Kyphosis

Lordosis

Ectopic Pregnancy

Multiple Myeloma

PHYSICAL EXAMINATION AND DIAGNOSIS

In Physiotherapy following ” Special Tests” are applied to evaluate causes if low back pain

STRAIGHT LEG RAISE TEST
For detail watch video

Gaenslen’s Test
For detail watch video

Well Leg Straight Leg Raise Test
For detail watch video

Lasegue Maneuver
For detail watch video

Faber Test
For detail watch video

Femoral Nerve Stretch Test
For detail watch video

Thomas Test
For detail watch video

Kernig/Brudzinski Sign
For detail watch video

Lumbar Extension Test
For detail watch video

Bowstring Test
For detail watch video

More Special Tests are

Other diagnostic tools include

X-ray
CT scan, MRI
Ultrasound
Biopsy etc

PHYSIOTHERAPY MANAGEMENT

Physiotherapy management includes

PHASE I – Back Pain Relief & Protection

Physiotherapist uses various treatment tools to reduce pain and inflammation. These include ice, electrotherapy like TENS, acupuncture, de-loading taping techniques, soft tissue manipulation.

PHASE II – Restoring Normal ROM and Strength. Early Back Exercises

As your lower back pain and inflammation settles, your lower back pain may feel better but you are actually more vulnerable for re-injury during this period when you don’t have pain but your muscles and ligaments are weak. During this phase physiotherapist will turn their attention to restoring your normal lumbar spine motion, muscle length and resting tension, muscle strength and endurance, proprioception, balance and gait.

Specific Concentration on lower abdominal core stability program to facilitate your important muscles that dynamically control and stabilise your lower back and pelvis.

PHASE III – Restoring Full Function

Depending on your chosen work, sport or activities of daily living, the aim is to restore your back’s function to safely allow you to return to your desired activities.

PHASE IV – Back Exercises – Preventing a Recurrence

Recurrence of lower back pain can occur. The main reason it is thought to recur is due to insufficient rehabilitation. In particular, poor compliance with deep abdominal core muscle exercises. Continuation a version of these back exercises routinely a few times per week.

Techniques Used For Low Back Pain Management includes

Maitland Mobilisations Concept

Mulligan Mobilisation with Movement

Mckenzie Method

Myofascial Release Therapy

Mobilisation of Spine by Kaltenborn Method

Rehabilitation Exercise for Low Back Pain includes

Standing Hamstring Stretch

Cat and Camel

Pelvic Tilt

Partial Curl

Quadrapud arm/leg raise

Gluteal Stretch

Extension Exercise

Piriformis Stretch

Side Plank etc