Lower Back Pain


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Lower Back Pain

  1. 1. Lower Back<br />Pain <br />
  2. 2. Today’s session<br /><ul><li> Develop a better understanding of chronic low back pain
  3. 3. Learn about the anatomy of the spine
  4. 4. Common causes of low back pain (LBP) and injury
  5. 5. Chronic/persistent pain
  6. 6. How to look after your back and manage your pain</li></li></ul><li>
  7. 7.
  8. 8.
  9. 9.
  10. 10. BACKINJURIES<br />
  11. 11.
  12. 12.
  13. 13. Common causes of LBP<br /><ul><li>Disc lesion (bulge, herniation, protrusion)
  14. 14. Degeneration of vertebrae/discs
  15. 15. Muscular strain/tightness
  16. 16. Nerve root compression
  17. 17. Instability
  18. 18. Postural related pain
  19. 19. Wear and tear (osteoarthritis and degeneration)
  20. 20. Other.......</li></li></ul><li>DISCS<br /><ul><li>Thought to be one of the most commonly injured structure s in the back
  21. 21. Extremely strong structures and can bear a lot of force
  22. 22. Discs will naturally lose height and degenerate
  23. 23. Outside layer is highly innervated with nerves
  24. 24. Poor blood supply and heal slower</li></li></ul><li>MUSCLES<br /><ul><li>Actually very hard to strain a muscle
  25. 25. They can weaken, or tighten, and therefore contribute to pain
  26. 26. Fast healers – rich blood supply
  27. 27. Important for dynamic stability of the spine</li></li></ul><li>JOINTS<br /><ul><li>Also commonly injured in the back
  28. 28. Provide static support, so prevent movement in certain directions
  29. 29. Joints love movement!!</li></li></ul><li>NERVES<br /><ul><li>Composed of neurones (nerve cells) and ligaments
  30. 30. May notice pins and needles, numbness, tingling, burning night pain, skin changes (reduced sensation)
  31. 31. Nerve compression can occur by the discs and joints
  32. 32. Nerves move and slide, and will get irritated if stuck in an area</li></li></ul><li>Acute vs Chronic LBP<br /><ul><li>Acute & Subacute – 0-6 weeks </li></ul>(can be longer)<br /><ul><li>Tissue healing and inflammation occurs
  33. 33. Pain and swelling subsides slowly as tissue heals</li></li></ul><li>Chronic Pain<br /><ul><li>Pain lasting longer than 3 months
  34. 34. Inflammation no longer
  35. 35. Tissue may have already healed
  36. 36. So where is the pain coming from??</li></li></ul><li>PAIN<br /><ul><li> 5-10 % of people experience ongoing pain after an injury
  37. 37. Many people suffer ongoing disability after a back injury
  38. 38. Back pain is on of the most common pain complaints and cause of work loss in the general population</li></li></ul><li>When it hurts...<br /><ul><li> We are likely to be less active, as we associate movement with pain
  39. 39. Avoid certain activities as we believe they may hurt
  40. 40. May have the wrong beliefs of what we can and cannot do</li></li></ul><li>Tissue injury and pain<br /><ul><li>The pain you feel does not always reflect the amount of tissue damage
  41. 41. If you experience pain, it does not necessarilymean you are causing further damage </li></li></ul><li>PAIN PATHAYS<br /><ul><li> In a nutshell:
  42. 42. Pain pathways become heightened immediately following an injury
  43. 43. Nerves (in your back) detect painful stimuli much more than they used to (sensitization)
  44. 44. The brain learns to recognise pain easier (cortical smudging)
  45. 45. Responses are heightened</li></li></ul><li>The end result is<br /><ul><li>You feel pain more often, and at times when there is no real threat to your tissues
  46. 46. The Brain is extremely clever, and is only doing this to protect you!!</li></li></ul><li>How is this affecting recovery??<br /><ul><li> Muscles and joints stiffen and become weak from not being used
  47. 47. Core becomes weaker, and strain and tension on spine and ligaments is increased
  48. 48. The less you move, the more your brain learns to avoid that movement
  49. 49. The sensitization of pain pathways persists, so you continue to feel pain</li></li></ul><li>Emotional effects of LBP<br /><ul><li>Decreased mood
  50. 50. Loss of motivation
  51. 51. Stress
  52. 52. Time off work, so more stress!
  53. 53. Family problems</li></li></ul><li>Management<br /><ul><li> Get treatment
  54. 54. If you have never had treatment, get some!
  55. 55. Physiotherapists/doctors can help diagnose your condition
  56. 56. May be shown useful stretches and exercises to do
  57. 57. You will be better educated and prepared to deal with your low LBP</li></li></ul><li>Management<br /><ul><li>Exercise!
  58. 58. Evidence has shown that general exercise can help improve the general strength of your body and therefore your back
  59. 59. Exercise is a great way to de-stress, so you feel great afterwards!
  60. 60. Releases endorphins and improves mood, which helps you to deal with pain
  61. 61. Recommended guidelines of 30 minutes per day</li></li></ul><li>Management<br /><ul><li>Take care of your back
  62. 62. Lift CORRECTLY
  63. 63. Good sitting and standing posture
  64. 64. Frequent changes in posture
  65. 65. Work place postures</li></li></ul><li>Pain Management Strategies<br /><ul><li> Get to know your pain: knowledge is the great liberator!
  66. 66. Know that your hurts won’t harm you
  67. 67. Pacing and graded exposure
  68. 68. Accessing the virtual body
  69. 69. Relaxation techniques</li></li></ul><li>Catalyst Injury management<br />We can provide you with the following:<br /><ul><li>Supervised exercise program with physiotherapist
  70. 70. Hydrotherapy sessions
  71. 71. Physiotherapy treatment: assessment and education
  72. 72. Pilates assessment and treatment
  73. 73. Gym Program</li></li></ul><li>That’s all!<br />Thank you for coming <br />today<br />Look forward to seeing <br />you next session<br />