Back Education Program
Original Editors - Hannah Anderson, Dan McCoy, Rebecca Porter and Millie Ware
Top Contributors - <img _fck_mw_template="true" _fckrealelement="1" _fckfakelement="true" src="http://www.physio-pedia.com/extensions/FCKeditor/fckeditor/editor/images/spacer.gif" class="FCK__MWTemplate"> - Elaine Lonnemann (Advisor)
|
An Evidence-Informed Back Education Program |
|---|
About Low Back Pain[edit | edit source]
Are you experiencing low back pain? You are not alone! Look at these statistics...
- As many as 80% of Americans have symptoms of low back pain during their lifetime[1]
- Low back pain is the leading cause of injury and disability for those younger than 45 years old[1] (pic)
- Each year, approximately $26 billion dollars are spent in the United States for the treatment of low back pain[2]
Is pain always bad? No. Pain is a warning sign to our body that something is not physiologically correct. We feel pain when there is structural damage, sign of an infection, a previous structure has been reinjured, etc. Pain is a helpful indicator for us to get treatment to heal our bodies.
Before you are able to truly understand back pain, it is important to understand the body's anatomy.
Your spine is made up of 33 small bones called vertebrae. Together, they form what is know as the vertebral column. There are 7 vertebrae in the cervical region which is your neck; 12 vertebrae in the thoracic region which is your upper back; 5 vertebrae in your lumbar spine which is your lower back; and 5 sacral vertebrae and 4 coccyx which are below that.
(pic)
Between each of the vertebrae is a disc that acts as a cushion and a shock absorber. These intervertebral discs are made up of two parts-- the nucleus pulposis and the annulus fibrosis. The nucleus pulposis is in the middle of the disc and is jelly-like due to its large water content; it is composed of up to 80% water!. The annulus fibrosis surrounds this nucleus and so forms the outer part of the disc. These discs play an important role in keeping the back healthy! For more information on these discs, click (have link).
(pic)
Other important parts of the spine: (pic with arrows -- spinal cord, facet, foramen, nerves)
Your spine has three main natural curves that begin to develop from the moment a baby starts to lift his/her head and gravity begins to work on the body. The curves keep the spine from being completely rigid and help the spine to tolerate a little bit more compression. To understand the normal curves of a spine, there are 2 terms you need to know—lordosis and kyphosis. Lordosis is when the spine curves inward and a kyphosis is when the spine curves outward. The cervical portion of the spine is in a lordosis, the thoracic portion is in a kyphosis, and the lumbar spine is in a lordosis. These nice curves of the back increase the load bearing capacity of the spine.
(pic)
The spine has 4 main motions—forward bending, backward bending, sidebending, and rotation. These motions can also be coupled. For instance, you can have forward bending with rotation or backward bending with sidebending. Below, we demonstrate these motions and report typical lumbar spine active range of motion.
'Forward bending (flexion): 60 degrees''''''[1]
Backward bending (extension): 25 degrees[1] (pic of ourself)
Lateral flexion (sidebending): 25 degrees to each side[1] (pic of ourself)
Rotation: 30 degrees to each side[1] (pic of ourself)
An example of coupled motion: Forward bending with coupled rotation (pic of ourself)
Many muscles work together to help make these spinal motions possible!
1.
About Neck Pain[edit | edit source]
Prevalence
Neck pain reported to be 2nd most common musculoskeletal disorder that leads to disability and injury claims
2002: 13.8% of population > 18 years old in U.S. reported neck pain
Risk factors for neck pain:
Working at a desk that is ill fitting to your body
Working at a computer for long periods of time
Sitting with bad posture for long periods of time
Working on above head activities (i.e. painting) for long periods of time
Why Does My Back hurt?[edit | edit source]
Pain Science
What can I do about my Low Back Pain?[edit | edit source]
For Physical Therapists: What subjective and objective information should you be collecting when treating a patient with low back pain? The following classification system by Stanton et al. will lead you to which treatment a patient would benefit from.[3]
Manipulation or Mobilization Category
Subjective:
1). Symptoms < 16 days
2). Symptoms not below knee
3). Not afraid to work (FABQ < 19)
Objective:
1). Lumbar hypomobility
2). Hip internal rotation > 35 degrees for at least one hip
Stabilization Category
Subjective:
1). Age < 40 degrees
Objective:
1). Average straight leg raise > 90 degrees
2). Abberant movement present
3). (+) prone instability test
Specific Exercise Category
Subjective:
1). Symptoms distal to buttocks
Objective:
1). Pain centralizes with a specific movement (can be flexion or extension)
Traction Category
Subjective:
1). Symptoms distal to buttocks
Objective:
1). Pain peripheralizes with a specific movement (can be flexion or extension)
2). (+) Crossed straight leg raise
What can I do about my Neck Pain?
[edit | edit source]
Resources
[edit | edit source]
Recent Related Research (from Pubmed)[edit | edit source]
References[edit | edit source]
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 Olson, KA. Manual Physical Therapy of the Spine. St. Louis, MO: Saunders; 2009.
- ↑ Hebert J, Koppenhaver S, Walker B. Subgrouping Patients with Low Back Pain: A Treatment-Based Approach to Classification. Sports Health. 2011; 3:534-542.
- ↑ Stanton T et. al. Evaluation of a Treatment-Based Classification Algorithm for Low Back Pain: A Cross-Sectional Study. Physical Therapy. 2011; 91:496-509.
