Transcript Preventive Treatment - Samved Orthopaedic Hospital

Introduction
Haldemann (1977) 26 causes
Whyke (1976) 20 categories
BACK ACHE
DR.BHARAT PATEL
M.S.(Ortho)
SAMVED HOSPITAL
Introduction
Hazleman and Bulgar (1979)
Disc prolapse over diagnosed
Introduction
Moorey and Robertson
Benign lumbar pain syndromes
Classification of low back pain
Spondylogenic back pain
Neurogenic back pain
Viserogenic back pain
Vascular back pain
Psychogenic back pain
CAUSES OF BACK PAIN
Causes of back pain
Poor Posture
Disturbed normal “natural
S” shape of spine leads to
back pain.
Causes of back pain
Out of Shape
Your overall physical
condition can affect
your back.
Causes of back pain
Tension and Stress
Causes of back pain
Aging and Disease
 Loss of muscle strength
with aging.
 “slip disc”
 Osteoarthritis, a form of
aging arthritis, can cause
back pain.
Causes of back pain
Impact Trauma
Causes of back pain
 Obesity
Causes of back pain
Adolescent acute back
12 to 14 yrs in girls
14 to 16 in boys
Disc space infection
Herniated lumbar disc
Spondylolysis or lysthesis
Lumbar Instability
The tall young man
House wife
Post surgical patient
The keep-fit enthusiast
Young man in
osteochondrosis.
his
20’s
Mature woman between
spondylolisthesis.
with
40-50
undetected
with
lumbar
degenerative
The man fearful of his back
Over 40 and in past years suffered probably a minor
episode of back pain.
Because of this temperament, combined at the time
with a strongly worded caution from his doctor to take
care, the patient has lost all confidence in the health
and durability of the low back.
Time dependent back ache
Particular movement aggravates the pain.
Particular time aggravates pain – rising in the
morning.
Over stressed labourers back
Strong solidly built man
Farmer
No sciatica
Insidious onset
The Equinox Syndrome
Severe leg pain limb cold
Feel of numbness
Unless the neurological involvement is multiradicular,
normal muscle power regained in 10 wks.
Spinal stenosis
Congenital stenosis.
Acquired stenosis – facet joint arthrosis, ligamentum
flavum thickening, disc trespass, posterior vertebral
lipping, spondylolisthesis, venous congestion, isolated
disc resorption, degenerative stenosis, disc prolapse.
Chair bound back ache
40 year old physically active in the past, but risen
professionally to assume responsibility which entail
much administrative work.
Obese.
Lumbar stiffness on rising in the morning.
Low back pain in
pregnant women
50% of the pregnant women.
Sweden is the highest 70% (9 wks of sick leave).
Common with multiparus women.
Mechanism :
Increased lumbar lordosis.
Hormone relaxing.
How to prevent by
exercise programme
Before pregnancy & during 1st trimester.
Can be continued in 2nd and 3rd trimester.
Low back pain in children
Rare complaint.
Often illusive – Delayed diagnosis because of rarity.
Must be investigated.
Causes :
Mechanical
Developmental
Inflammatory
Neoplastic
Tethered cord
Psychogenic
Sports related low back ache
Collapsed back with kissing spine
Women in late middle age
Lumbar ache on standing
Degenerated all joints
DISORDERS OF IV DISC
Backache Leads To……
Pain
Disability to pursue activities of daily leaving
Absenteeism
Sexual dysfunction
Financial and psychological set back
Diagnosis of back pain
Physical Examination
&
Investigations
Diagnosis of back pain
Physical Examination
Diagnosis of back pain
Investigation :
•
Blood Ix
•
Radiological Ix
- Plain X-ray
- Myelography
- CT scan
- MRI
Management of back pain
Conservative
Treatment
Operative Treatment
Preventive Treatment
Conservative treatment
Medicines
Pain killers
Muscle relaxants
Vitamins
Conservative treatment
Bed rest
Conservative treatment
Physiotherapy
Activity modification
Conservative treatment
Manipulation of back
Conservative treatment
– Orthosis(belts)
Conservative treatment
Weight reduction
Conservative treatment
Injection therapy
( epidural steroids)
Operative treatment
Operative treatment
WHY
WHEN
?
?
WHERE
?
Preventive Treatment
DO’S & DON’TS
Preventive treatment
While working in standing
position, use a small stool
under one foot to avoid
back strain.
Preventive treatment
While carrying
weights, divide the
load into two equal
halves
Preventive treatment
Always climb up to bring
heavy
object
from
height. Avoid stretching
your back.
Preventive treatment
Sit with back straight &
well supported while
doing
work.
Avoid
stooping.
Preventive treatment
Reduce weight
keep slim &
active
Preventive treatment
Always carry weight
near the body.
Preventive treatment
Correct sleeping posture
After a heavy day
at work A good
way to rest your
back
A firm mattress,
A small pillow under head
& neck
A small bolster under the
knees
Preventive treatment
Simple exercises to keep the back fit
Preventive treatment
Reduce brightness to
avoid strain
Elbow
support
Correct table
height
Back
support
Low back
support
Foot support
Correct
distance
between table and
chair
Follow this posture & avoid back, neck & shoulder pain
THANK YOU