The physiotherapy management of Lower Back Pain in amputees: Difference between revisions

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== Introduction<br>  ==
== Introduction<br>  ==


The previous Physiopedia page 'Lower Limb Amputees and Lower back Pain' (add hyperlink) adresses the epidemiology and aetiology of lower back pain (LBP) in the lower limb amputee population as well as some of the biomechanical and psychosocial elements that may cause or influence this pain.
The previous Physiopedia page 'Lower Limb Amputees and Lower back Pain' (add hyperlink) adresses the epidemiology and aetiology of lower back pain (LBP) in the lower limb amputee population as well as some of the biomechanical and psychosocial elements that may cause or influence this pain.  


This page aims to provide an overview of possible physiotherapy interventions to decrease and manage LBP in amputees.
This page aims to provide an overview of possible physiotherapy interventions to decrease and manage LBP in amputees.
 
 
 
Limb amputations lead to a dramatic change in the biomechanical and neurophysiological relationships developed since birth (Latash, 1998). As common as LBP is in the general population, amputees seem to be at even greater risk for back pain. Back pain has been reported to affect 52% to 89.6% of lower-limb amputees (add 3 ref)&nbsp;This LBP can cause chronic disability (Gailey et al 2008). The chronic LPB in amputees is not said to have any correlation to the time since amputation (Ephraim et al., 2015).&nbsp;
 
It is often not the amputation that primarily impairs the patient, but rather the pain (Marshall 2002). Marshall et al. (1992) found amputees with LBP have more disability than amputees without.
 
Given the high incidence of back pain within the Western hemisphere, a number of the population of people with amputation may be predisposed to LBP regardless of limb loss. (Gailey, 2008).


== Causes of LBP in amputees<br>  ==
== Causes of LBP in amputees<br>  ==

Revision as of 17:45, 10 January 2016

 

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Introduction
[edit | edit source]

The previous Physiopedia page 'Lower Limb Amputees and Lower back Pain' (add hyperlink) adresses the epidemiology and aetiology of lower back pain (LBP) in the lower limb amputee population as well as some of the biomechanical and psychosocial elements that may cause or influence this pain.

This page aims to provide an overview of possible physiotherapy interventions to decrease and manage LBP in amputees.


Limb amputations lead to a dramatic change in the biomechanical and neurophysiological relationships developed since birth (Latash, 1998). As common as LBP is in the general population, amputees seem to be at even greater risk for back pain. Back pain has been reported to affect 52% to 89.6% of lower-limb amputees (add 3 ref) This LBP can cause chronic disability (Gailey et al 2008). The chronic LPB in amputees is not said to have any correlation to the time since amputation (Ephraim et al., 2015). 

It is often not the amputation that primarily impairs the patient, but rather the pain (Marshall 2002). Marshall et al. (1992) found amputees with LBP have more disability than amputees without.

Given the high incidence of back pain within the Western hemisphere, a number of the population of people with amputation may be predisposed to LBP regardless of limb loss. (Gailey, 2008).

Causes of LBP in amputees
[edit | edit source]

Poor socket fit and poor prosthetic alignment
Postural changes 
Leg-length discrepancy
Muscle imbalance 
General deconditioning
Hypersensitivity 
Yellow Flags

Management [edit | edit source]

Poor socket fit and poor prosthetic alignment
Postural changes and scoliosis
Leg-length discrepancy
Muscle imbalance
General deconditioning
Hypersensitivity
Yellow Flags

Exercise

Stretching 
Cognitive Behavioural Therapy (CBT) and the psychosocial approach

Transcutaneous Electrical Nerve Stimulation (TENS) Acupuncture Manual Therapy 

Case Study[edit | edit source]

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Video References[edit | edit source]

     


References

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