3. SEVERE LOW BACK PAIN
• AIM TO REDUCE PAIN AND INFLAMMATION
• COMFORT POSITONS – NEUTRAL SPINE
• ENCOURAGE MOVEMENT THAT RELIEVES
• BED REST<48HRS
• +/- TAPING
• ANALGESIA /NSAIDS
• LOCAL MODALITIES FOR PAIN/SPASM ( HEAT, ICE , ELECTRO, MANUAL
TH.)
• EXERCISE AWAY FROM AGGRAVATION
• WATCH FOR NEURAL SIGNS
4. SUB-ACUTE LOW BACK PAIN
OFTEN WITH ASSOC. MUSCLE SPASM / IRRITATION, INCREASED NEURAL
TENSION
HYPOMOBILE SEGMENTS –UTILISE MANUAL THERAPY
• POOR POSTURES, BIOMECHANICS
• REDUCE PAIN / INFLAMMATION
• RESTORE ROM ( MANUAL THERAPY, EXERCISE)
• FLEXIBILITY AND STRENGTH
• CARDIO FITNESS
• EDUCATION
5. REHABILITATION AFTER BACK
PAIN EPISODE
• MODIFY ACTIVITIES
• CORRECT BIOMECHANICAL ABNORMALITIES
• POSTURAL ASSESSMENT OF FUNCTIONAL POSITIONS
• LIFTING MECHANICS
• CORE STABILITY : LOCAL THEN GLOBAL
• ASSESS / STRETCH TIGHTNESS
• EDUCATION
• HOME EXERCISE REGIME
6. FUNCTIONAL STABILITY
NEED TO UTILISE BOTH MUSCLE FORCES AND PASSIVE STRUCTURES TO
DYNAMICALLY STABILISE THE SPINE FUNCTIONALLY
ANY DEFICITS ASSESSED NEED TO BE ADDRESSED IN A REHAB. PLAN
7. CORE STABILITY
• MUSCULAR CONTROL TO MAINTAIN FUNCTIONAL STABILITY
• MUSCULAR CORSET
• STABILITY INVOLVES PASSIVE AND ACTIVE STIFFNESS
• INSTABILITY WHEN EITHER COMPONENT DISTURBED
8. CORE STABILITY
• GLOBAL : DYNAMIC / PHASIC MUSCLES = ACTIVE TRUNK MOVEMENT
• RECTUS ABDOMINIS
• EXTERNAL OBLIQUES
• ILIOCOSTALIS (THORACIC PART)
• LATISSIMUS DORSI
• LINK PELVIS TO THORACIC CAGE