Back And Lumbar Problem

1. MUSCLE SPASM

Certain conditions of the spine can cause the muscles of either side of the spine to go into spasm which can cause severe pain and restricted movements of the spine.
Muscle spasm usually occur as a result of injury to a deeper structure of the spine, overuse injury, if the part is over stretched.
Chronic neck or back pain may also result in recurrent muscular spasm because of the development of the arthritic changes.
Muscle spasm is an alarming sign that indicates that either your body needs rest or there is more serious underlying issue in your spine.

Treatment

Cryotherapy or heat therapy
Electrotherapy modalities to reduce spasm
Proper rest and positioning
Muscle stretching
Soft tissue manipulation

2. FACET JOINT ARTHROPATHY:

The facets joints of the spine can be sprained or become locked when placed under stress such as with extreme movements beyond the normal range or with poor posture or poor lifting technique.
The degenerative arthritis results in the breakdown of the cartilage between the facet joints resulting in mechanical pain and joint stiffness.
When facet joints are locked it results in restriction of movement often only in one direction.
The pain gets worsened with movement (mostly bending backwards) and may be associated with muscle spasms and localised tenderness.
Aggravating factors- sitting and travelling, extension, side bending, improper lifting, prone lying on soft surface, slouched sitting.

Treatment-

Cryotherapy or Heat therapy
Electrotherapy for pain relief
Postural ergonomics with frequent rest intervals
Osteopathic or chiropractic manipulation
Lumbar stabilisation exercises

3. POOR/ FAULTY POSTURE:

Prolonged sitting in poor posture is a very common cause of back pain in office workers. Sitting in a poor posture can actually put twice the amount of stress through the lower back compared to standing.
Poor posture results in muscular imbalances and shifting of the centre of gravity.
The pain worsens as the day goes on and can sometimes be relieved by stretching or exercises.

Treatment-

General body rehabilitation
Postural correction exercises
Stretching
Osteopathic and Chiropractic manipulation techniques.
Postural ergonomics

4. PIRIFORMIS SYNDROME:

Piriformis syndrome is a condition characterised by pain in the buttock region causing spasm.
The piriformis muscle can also irritate the sciatic nerve and cause pain, numbness, and tingling along the back of the leg and into the foot.
Pain may worsen on sitting, squatting or walking.

Treatment-

Combined stretching exercises
Dynamic isometric exercises
Soft tissue manipulation to release tender point
Manual therapy techniques
Electrotherapy modalities
Piriformis rehabilitation exercises

5. SCOLIOSIS:

It is the sideways (lateral tilt) curvature of the spine with vertebral rotation.
The curve is usually “S” or “C” shaped which may cause stress and pressure upon the spinal discs, nerves, ligaments, muscles or facet joints causing mid or low back pain depending upon the location.
It causes local inflammation around the strained muscles causing pain, difficulty in breathing in severe cases as the rib cage can twist and tighten the space available for the lungs.

Treatment-

Osteopathic and chiropractic manipulation
Combined manual therapy techniques
Postural correction
Ergonomics in ADL

6. SCIATICA:

Sciatica refers to the pain in the leg caused by the irritation of nerve roots of lower lumbar or lumbosacral spine where the sciatic nerve is located.
Symptoms of sciatica appear as numbness, tingling or weakness in the legs associated with burning sensation.
Constant pain only one side of buttock/ leg.
Pain worsens on sitting/ standing up/ coughing.

Treatment-

Electrotherapy modalities
Dynamic isometric exercises
Combined stretching exercises
Certain manual therapy techniques
Core muscle strengthening protocol

7. SPINAL INSTABILITY:

Spinal instability usually refers to the abnormal movement between one vertebra and other, generally seen in cases of disc degeneration as the disc loses its turgor (tension), increasing the movement between the vertebra often leading to disc bulge.

Treatment-

Cryotherapy
Core muscle strengthening
Postural ergonomics
Manual therapy techniques

8. SPINAL STENOSIS:

The narrowing of the spinal column or the narrowing of the opening where the spinal nerves emerges is known as spinal stenosis. The spinal canal narrows and compresses the spinal cord and nerves at the level of lumbar vertebrae.

Symptom includes –

Burning pain or numbness in your back, buttocks, thighs.
Incoordination
Painful extension movement
Difficulty in prolonged standing and during travelling
Pain gets worsens on coughing and sneezing.
Local tenderness

Treatment-

Flexion bias strengthening exercises
Gait training
Range of motion and stability exercises
Postural re-education
Manual therapy techniques

9. SPONDYLOLISTHESIS:

This is the anterior (forward) slipping of one vertebra over the other.
It could be a birth defect wherein the spine was damaged or by trauma, degenerative disc disease or arthritis.
It most commonly occurs in lumbar spine (low back) and may lead to squeezing or pinching of nerve roots leading to back pain, weakness or numbness in one or both legs.
It may cause limping in cases of overuse injury most likely seen in gymnasts and weight lifters.

Treatment-

Electrotherapy modalities
Postural re-education
Core muscle strengthening
Manual therapy techniques
Functional rehabilitation

10. OSTEOARTHRITIS OF SPINE:

Osteoarthritis is the medical term for the thinning of bone tissue and bone density loss.
Osteoarthritis is a progressive disease, so it tends to worsen over time leading to faster degeneration.

Treatment-

Weight bearing exercises to increase bone density
Core strengthening exercises to support the spine
Functional rehabilitation programme

11. STRAIN:

The most common cause of pain in the back is due to muscular strains generally caused by over-lifting of weights, or poor posture.
Pulled back muscles may lead to stiffness in back or restricted movements of spine.It may resolve in few days or may take upto 3-4weeks.

Treatment-

Electrotherapy modalities
Gentle ROM exercises
Cryotherapy
Soft tissue manipulation
Functional rehabilitation

12. POTT’S SPINE:

It refers to the tuberculosis of the spine where the intervertebral joints are affected. Tissue necrosis and breakdown of inflammatory cells results in paraspinal abscess.

Symptoms-

High fever with chills
Persistent back pain
Deformities like scoliosis/ kyphosis
Sensory defects
Spasticity
Muscle spasm
Disc space narrowing seen on x-ray or MRI

Treatment-

Trunk stabilisation exercises
Aerobic exercises
Pain management
Balance and gait training
Muscle re-education
Functional rehabilitation

13. ANKYLOSING SPONDYLITIS:

It is a chronic generalised inflammatory disease of spine where the vertebras fuse with each other resulting in rigid spine, more common in males.
It has a strong association with HLA-B27.
It most commonly affects sacro-iliac joints

SYMPTOMS-

Backache worse in morning and at night or during rest
Stiffness
Intercostal muscles tenderness
Increase in thoracic curve and straightening of lumbar spine which may leads to stooped-over posture.

Treatment-

General body rehabilitation
Strengthening exercise protocol
Pain management
Postural correction
Correct breathing patterns

14. KYPHOSIS:

It is the condition characterised by excessive rounded curvature of the spine, known as hunchback. It may be due to aging, muscular weakness in upper back, osteoporosis, bone degeneration, postural faults.

Treatment-

Postural correction
Strengthening exercise
Correction of muscular imbalances
Trunk stabilisation programme

15. PROLAPSED INTERVERTEBRAL DISC (PIVD):

This condition refers to the rupture of the gel-like substance of the disc present between two vertebras which acts as shock absorber for the spine.
The bulging disc material may cause pressure on nearby nerves causing pain and loss of function.
It is caused due to external trauma, heavy weight lifting, or hyper function of spine leading to low back pain with or without radiating to back of leg (sciatica) or front of thigh.
It is accompanied by numbness or tingling sensation travelling down the leg with muscle weakness or even difficulty in walking.
The pain gets worse at night or with prolonged standing or sitting or bending forward.
The pain may increase with coughing or sneezing.

Treatment-

Electrotherapy modalities
Cryotherapy
Abdominal strengthening exercises
Core strengthening exercises
Postural ergonomics
Manual therapy techniques
Dynamic isometric exercises
Combined stretching techniques
Kinesiotaping

16. STRAIGHTENING OF LUMBAR SPINE:

It refers to the abnormal inward curvature of the spine leading to flat back. It is the result of frequent muscular spasms as a result of poor posture and a main leading cause of back pain.

Treatment-

Postural correction
Muscle re-education
Manual therapy techniques
Core strengthening exercises

17. S.I. JOINT DYSFUNCTION:

The condition resulting in dull, sharp-stabbing pain over the sacro-iliac joints, most commonly triggered when standing after prolonged sitting on the chair.
It may radiate to buttocks, thigh or groin region.
Pain is felt on one side of the lower back.
The pain gets worse in the morning and gets better during the day.
It may be caused due to excessive joint play or due to hypomobility or joint fixation as in ankylosing spondylitis.

Treatment-

Cryotherapy or heat therapy
Electrotherapy modalities
Manual therapy techniques
Stabilisation exercises
Osteopathic and chiropractic techniques

18. LOWER CROSSED SYNDROME:

It refers to the weakness of lengthening of deep abdominal muscles and tightness or shortening of the spine extensors leading to muscular imbalances which results in forward tilt of the pelvis and generalised low back pain.

Treatment-

Muscle re-education
Postural correction
Pelvic tilt correction
Core muscles strengthening
Manual therapy techniques

19. MECHANICAL LOW BACK PAIN OR LUMBAGO:

This condition of pain in low back is generally without any serious cause, mostly due to muscular imbalances or due to postural faults.
It is characterised by morning stiffness which lasts less than 30 minutes.
The pain may be increased on initiating the movement, forward bending or rotation and is relieved on rest.

Treatment-

Postural correction
Trunk stabilisation exercises
Core muscle strengthening
Manual therapy techniques

20. SPINA BIFIDA:

It is a birth defect where the spinal cord fails to develop properly resulting in muscular weakness specially legs.

Treatment-

Gentle ROM exercises
Positioning techniques
Postural correction
Functional re-education
Strengthening exercises

21. POST-OPERATIVE CASES OF SPINE:

Treatment-

Core muscles strengthening
Manual therapy techniques
Functional re-education

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