Accelerated rehabilitation after lumbar discectomy
•
0 likes•1,194 views
Presented by: Stephen Boyd – Physiotherapist Nathan Wade – Exercise Physiologist Event: Challenges in the Sporting Spine - 2014
Report
Share
Report
Share
Download to read offline
Recommended
Mechanical diagnosis & therapy mckenzie method
The McKenzie Method is a system of diagnosing and treating spinal pain developed in the 1960s. It focuses on classifying pain based on responses to specific movements and positions. The goal is to centralize pain away from extremities and abolish it completely through repeated end-range movements informed by the assessment. Studies show centralization occurs in 70% of subacute and 52% of chronic back pain patients. The McKenzie Method emphasizes patient education and active involvement to restore function and minimize visits through self-treatment guided by therapists.
Mckenzie exercise
Hello everyone here I upload mckenzie exrercise basic details and some of its position.Its technique for use to cervical, Lumabar pain relief via particular position.Thank you.
Maitland concept
Maitland's concept focuses on a clinical approach based on the constant clinical presentation of the patient. Therapists take a positive personal commitment to truly understand the patient's problems in their own words using both verbal and non-verbal communication with an open mind. The concept involves a "two compartmental mode" that separates the theoretical and clinical aspects with a "permeable brick wall" that allows information to flow between the two. Examinations are conducted with depth and intensity while considering the patient's behavior, pain relationships, and both subjective and objective findings. Techniques involve four grades that change as symptoms change and are applied for both physiological and accessory purposes. Assessment of the patient occurs during and between treatment sessions. Thorough
Positional release technique
Positional Release Therapy is form of manual therapy used in physiotherapy and chiropractic practices.
Positional release technique
A type of manual therapy in which the muscle or the joint is altered and placed in a position of comfort for certain duration after which the pain disappears completely or gets reduced. this slide show explains about the principles, mechanism and Phases of PRT
Impingement syndrome rehabilitation
The document provides information on shoulder impingement syndrome, including its definition, mechanisms of injury, clinical presentation, diagnosis, management, and physical therapy treatment. Shoulder impingement syndrome occurs when structures in the shoulder become compressed between the humeral head and acromion. It can be caused by factors like rotator cuff weakness, tight posterior shoulder capsule, impaired scapular movement, and posture. Patients experience shoulder pain that is worsened by overhead activities. Physical therapy focuses on modalities, stretching, strengthening exercises and education to improve range of motion and reduce pain.
Combined movement patterns in the spine by muhammad arslan yasin(sukhera illu...
Combined movement patterns in the spine by muhammad arslan yasin(sukhera illu...Muhammad Arslan Yasin Sukhera
Cervical spine:
A) Coupled Movement:
Region Combined Movement Direction Combined Movement Pattern, Combined movement patterns in the spine by muhammad arslan yasin(sukhera illustratorz),
Coupled Movements, Non Coupled Movements, Manual TherapyMuscle imbalance
Various types of muscle imbalance occurs in human body due to either articular, fascial or neural causes. as described by Janda this slide show elaborates on the same aspect and also differentiates two schools of thoughts on muscle imbalance, its assessment and treatment in the view of physiotherapy.
Recommended
Mechanical diagnosis & therapy mckenzie method
The McKenzie Method is a system of diagnosing and treating spinal pain developed in the 1960s. It focuses on classifying pain based on responses to specific movements and positions. The goal is to centralize pain away from extremities and abolish it completely through repeated end-range movements informed by the assessment. Studies show centralization occurs in 70% of subacute and 52% of chronic back pain patients. The McKenzie Method emphasizes patient education and active involvement to restore function and minimize visits through self-treatment guided by therapists.
Mckenzie exercise
Hello everyone here I upload mckenzie exrercise basic details and some of its position.Its technique for use to cervical, Lumabar pain relief via particular position.Thank you.
Maitland concept
Maitland's concept focuses on a clinical approach based on the constant clinical presentation of the patient. Therapists take a positive personal commitment to truly understand the patient's problems in their own words using both verbal and non-verbal communication with an open mind. The concept involves a "two compartmental mode" that separates the theoretical and clinical aspects with a "permeable brick wall" that allows information to flow between the two. Examinations are conducted with depth and intensity while considering the patient's behavior, pain relationships, and both subjective and objective findings. Techniques involve four grades that change as symptoms change and are applied for both physiological and accessory purposes. Assessment of the patient occurs during and between treatment sessions. Thorough
Positional release technique
Positional Release Therapy is form of manual therapy used in physiotherapy and chiropractic practices.
Positional release technique
A type of manual therapy in which the muscle or the joint is altered and placed in a position of comfort for certain duration after which the pain disappears completely or gets reduced. this slide show explains about the principles, mechanism and Phases of PRT
Impingement syndrome rehabilitation
The document provides information on shoulder impingement syndrome, including its definition, mechanisms of injury, clinical presentation, diagnosis, management, and physical therapy treatment. Shoulder impingement syndrome occurs when structures in the shoulder become compressed between the humeral head and acromion. It can be caused by factors like rotator cuff weakness, tight posterior shoulder capsule, impaired scapular movement, and posture. Patients experience shoulder pain that is worsened by overhead activities. Physical therapy focuses on modalities, stretching, strengthening exercises and education to improve range of motion and reduce pain.
Combined movement patterns in the spine by muhammad arslan yasin(sukhera illu...
Combined movement patterns in the spine by muhammad arslan yasin(sukhera illu...Muhammad Arslan Yasin Sukhera
Cervical spine:
A) Coupled Movement:
Region Combined Movement Direction Combined Movement Pattern, Combined movement patterns in the spine by muhammad arslan yasin(sukhera illustratorz),
Coupled Movements, Non Coupled Movements, Manual TherapyMuscle imbalance
Various types of muscle imbalance occurs in human body due to either articular, fascial or neural causes. as described by Janda this slide show elaborates on the same aspect and also differentiates two schools of thoughts on muscle imbalance, its assessment and treatment in the view of physiotherapy.
Nerve Gliding Exercises - Excursion and Valuable Indications for Therapy
This document discusses nerve gliding exercises and their benefits for therapy. It describes how nerve glides can help increase nerve mobility and blood flow. Specific nerve glides are presented for common nerve entrapment syndromes like cubital tunnel syndrome (ulnar nerve) and carpal tunnel syndrome (median nerve). The document emphasizes performing glides symptom-free and using sliding techniques over tensioning. Nerve glides are recommended to prevent nerve adhesions after injuries or surgery.
Correct your posture
This document discusses posture and techniques for correcting abnormal posture. It describes upper and lower crossed syndromes which are postural issues characterized by problems like shoulder protraction and pelvic tilt. Poor posture can lead to issues like trigger points, breathing problems, and weak immunity. The document provides examples of corrective stretches and strengthening exercises that target specific muscles like the deep neck flexors and scapula. Functional exercises are also recommended along with posture education to help patients maintain proper alignment and avoid prolonged bad postures.
Core stabilization
The document discusses the core and its importance for optimal functioning of the kinetic chain. It defines the core as the lumbo-pelvic-hip complex and describes the muscles involved. Various assessment tests are provided to evaluate core strength, endurance, neuromuscular control and overall functionality. Guidelines are given for developing a comprehensive core stabilization training program with emphasis on progression from stabilization to integrated strength training across multiple planes and functional activities.
Muscle energy technique
This document discusses different types of muscle contractions that can occur during physical therapy. It describes isometric contractions where the operator and patient forces match so no movement occurs. It also describes isotonic eccentric contractions where the operator force overcomes the patient's effort, moving the joint in the opposite direction. The effort of the patient should be 20% of their strength and held for 7-10 seconds.
Ankle & Foot Physiotherapy Management SRS
This document discusses common ankle injuries including sprains and fractures. It describes the ligaments surrounding the ankle and classifications of ankle sprains. The acute, subacute, and maturation stages of rehabilitation are outlined with goals, interventions, and sample exercises described for each stage. Criteria for return to activity are provided, with warnings about potential increases in pain or inflammation. References are listed at the end.
kinesioTaping
This document provides an overview of kinesio taping, including its origins, mechanisms of action, applications, and techniques. The key points are:
- Kinesio tape was developed in the 1980s by Dr. Kenzo Kase to mimic skin and avoid sensory stimuli. It can facilitate or inhibit muscles depending on application tension.
- It works by lifting the skin to enhance muscle, joint, and circulatory function. It can be used to support injured structures in all injury phases from acute to rehab.
- Common applications include pain relief, swelling reduction, improved biomechanics and range of motion. Different cut techniques like I, Y, X are used for specific conditions.
-
Physiotherapy in psychiatry
This document discusses psychiatric disorders and abnormal behavior. It begins by defining mental disorders and abnormal behavior. It notes that mental disorders involve distress or disability that is not developmentally or socially normative. Abnormal behavior is defined as deviating from statistical or socio-cultural norms or causing personal discomfort. The document then discusses characteristics of normal and abnormal behavior. It also discusses models of abnormality, classifications of mental disorders, and characteristics of commonly abused substances and corresponding substance use disorders.
SPINAL STABILIZATION PPT
Spinal stabilization involves surgical procedures to treat acute spinal injuries and conditions by restoring vertebral alignment and removing bone fragments. The degree of stabilization depends on the severity of the problem. Surgery involves inserting instruments like screws and plates in the back to stabilize the spine and facilitate fusion after decompression. Minimally invasive procedures perform stabilization through small incisions without damaging muscles. Recovery takes around six months with limited activity and physical therapy starting in the first week.
Myofascial Release Presentation
Presentation slides from our recent workshop on Myofascial Release. This workshop was delivered from our St John Street Clinic in Manchester on Saturday 17th March.
Shoulder arthroplasty & Physiotherapy
Dr. Satyendra Bhattacharyya's document discusses the history and procedure of shoulder arthroplasty. It begins with the first documented shoulder replacement in 1894, but focuses on developments starting in 1951 by Dr. Charles Neer, who created the first hemi-arthroplasty and total shoulder replacement. The document then discusses factors that influence arthroplasty outcomes, indications for the procedure for conditions like osteoarthritis and rheumatoid arthritis, and details each step of the surgical procedure. It concludes by describing postoperative rehabilitation protocols.
History of physiotherapy
Physiotherapy has been used for thousands of years to treat pain and physical impairments through techniques like massage, manual therapy, and hydrotherapy. Greek physicians like Hippocrates were early practitioners of manual manipulation for pain relief. In the 1800s, Per Henrik Ling established schools of Swedish gymnastics and massage therapy. Physiotherapy treats patients through physical exercise and understanding of human biomechanics, while pharmacy focuses on biochemistry and recommending medication to treat illnesses. Physiotherapists work directly with patients, using exercise and manual therapy, whereas pharmacists treat patients by advising on appropriate drug-based treatments.
Tennis elbow(le)
This document provides information on lateral epicondylitis (tennis elbow), including its anatomy, causes, symptoms, diagnosis, and treatment options. It describes how lateral epicondylitis is an overuse injury caused by repetitive microtrauma to the common extensor tendon at the lateral epicondyle. The diagnosis is typically made based on physical examination findings of tenderness over the lateral epicondyle with resisted wrist and finger extension. Both non-operative treatments like physiotherapy, bracing, and steroid injections and surgical options are discussed for managing lateral epicondylitis.
POSTURE AND PAIN - Gisurgery.info
Practicing good posture can make a big different in your health, well-being, mood and your appearance. Learn More how Good posture affects both your physical body as well as your emotional and mental well-being. For more health Tips, Visit at http://gisurgery.info
NAGs_Natural Apophyseal Glides The Mulligan Concept
Introduction on NAGs_Natural Apophyseal Glides
Application_How to apply NAGs
In which we can apply NAGs?
Evidence on NAGs.
core muscle strengthening
The core muscles can be categorized as stabilizers or mobilizers. Stabilizers like the transversus abdominis and multifidus are deeply placed, have slow twitch fibers, and help provide stability. Mobilizers like the rectus abdominis are more superficial and have fast twitch fibers for movement. Chronic low back pain is associated with weakness in the transversus abdominis and multifidus as well as decreased flexibility. A core strengthening program focuses on training these local stabilizer muscles in three stages: 1) local segmental control, 2) closed chain exercises, and 3) open chain exercises and functional progression. Exercises target the transversus abdominis, multifidus, and glute
MET: Muscle Energy Technique
Muscle energy technique, a manual therapy technique with a long term history and 8 variations which can be used in various condition to treat muscle as well as joints. This slide show consists of detailed history, variations/types and summary of MET in detail.
History of Manual Therapy and Arthrology
The document provides a history of manual therapy, outlining important figures and developments from Hippocrates in 460 BC to current practice. It discusses the evolution of osteopathy, chiropractic, and physical therapy. Key developments include Andrew Still establishing osteopathy in the US in 1874, Daniel Palmer founding chiropractic in 1895, and the establishment of physical therapy programs and professional organizations in the early 20th century. Current manual therapy practice draws from various techniques and philosophies.
Adhesive Capsulitis
This document provides an overview of adhesive capsulitis or "frozen shoulder" presented by Dr. Shazia Khalfe. It defines adhesive capsulitis as a condition characterized by pain and loss of shoulder range of motion. There are two types: primary which is idiopathic, and secondary which occurs after shoulder injuries or immobilization. Clinical presentation includes pain and limited range of motion. Treatment involves exercises to improve range of motion and strengthen muscles, modalities like heat for pain relief, and patient education on home exercises and prognosis. The goal is to regain full range of motion and normal shoulder function.
Factor influencing strength
Factors that influence muscle strength include energy stores and blood supply, fatigue, recovery from exercise, age, gender, and psychological factors. Muscle requires adequate energy and blood flow to contract and resist fatigue. Fatigue occurs from repeated contractions and diminishes muscle response over time. Recovery allows oxygen and energy stores to replenish while waste is removed from 1 hour to several days after exercise depending on the factor. Strength is also affected by age, gender, and psychological states that can positively or negatively impact movement ability and effort.
Muscle Energy Technique.(soft tissue mobilization)
This document discusses muscle energy technique (MET), a manual therapy that uses precisely controlled voluntary muscle contractions against resistance applied by a therapist. It describes the types of muscle contractions used in MET, including isotonic, eccentric, concentric, and isometric contractions. MET can utilize post-isometric relaxation or reciprocal inhibition to lengthen or relax muscles. The document provides examples of procedures and discusses indications like acute muscle spasm or restricted joints, as well as contraindications like fractures or unstable joints. Potential benefits of MET include restoring normal muscle tone, strengthening weak muscles, and improving joint mobility.
Current concepts in management of lumbar disc prolapse
A discectomy is a last resort surgery for herniated discs that do not improve with more conservative treatments. The perfect indication for discectomy is a patient with a history of intolerable radicular pain for over six weeks, physical exam findings of nerve compression or tension, and an MRI confirming a large herniated disc. Earlier surgery may be considered for moderate nonradicular pain of less than six weeks if supported by physical exam findings and a small disc herniation is seen. Steroid nerve root blocks can help determine if surgery is needed by relieving radicular pain temporarily. A recent trial studied a Barricaid device implanted during discectomy to prevent reherniation.
Guidelines for return to sport after cervical trauma
The document discusses return to activity guidelines after various cervical injuries, including sprains/strains, burners/stingers, neuropathies, disc herniations, fractures, and surgery. It notes that there is no consensus between spinal surgeons on return to play. Generally, athletes can return when they have no symptoms or neurological deficits, full range of motion without pain, and adequate healing time from the injury, though risk of reinjury remains. The severity of the original injury and any subsequent surgery or abnormalities determine how quickly and safely athletes can safely return to their sport.
More Related Content
What's hot
Nerve Gliding Exercises - Excursion and Valuable Indications for Therapy
This document discusses nerve gliding exercises and their benefits for therapy. It describes how nerve glides can help increase nerve mobility and blood flow. Specific nerve glides are presented for common nerve entrapment syndromes like cubital tunnel syndrome (ulnar nerve) and carpal tunnel syndrome (median nerve). The document emphasizes performing glides symptom-free and using sliding techniques over tensioning. Nerve glides are recommended to prevent nerve adhesions after injuries or surgery.
Correct your posture
This document discusses posture and techniques for correcting abnormal posture. It describes upper and lower crossed syndromes which are postural issues characterized by problems like shoulder protraction and pelvic tilt. Poor posture can lead to issues like trigger points, breathing problems, and weak immunity. The document provides examples of corrective stretches and strengthening exercises that target specific muscles like the deep neck flexors and scapula. Functional exercises are also recommended along with posture education to help patients maintain proper alignment and avoid prolonged bad postures.
Core stabilization
The document discusses the core and its importance for optimal functioning of the kinetic chain. It defines the core as the lumbo-pelvic-hip complex and describes the muscles involved. Various assessment tests are provided to evaluate core strength, endurance, neuromuscular control and overall functionality. Guidelines are given for developing a comprehensive core stabilization training program with emphasis on progression from stabilization to integrated strength training across multiple planes and functional activities.
Muscle energy technique
This document discusses different types of muscle contractions that can occur during physical therapy. It describes isometric contractions where the operator and patient forces match so no movement occurs. It also describes isotonic eccentric contractions where the operator force overcomes the patient's effort, moving the joint in the opposite direction. The effort of the patient should be 20% of their strength and held for 7-10 seconds.
Ankle & Foot Physiotherapy Management SRS
This document discusses common ankle injuries including sprains and fractures. It describes the ligaments surrounding the ankle and classifications of ankle sprains. The acute, subacute, and maturation stages of rehabilitation are outlined with goals, interventions, and sample exercises described for each stage. Criteria for return to activity are provided, with warnings about potential increases in pain or inflammation. References are listed at the end.
kinesioTaping
This document provides an overview of kinesio taping, including its origins, mechanisms of action, applications, and techniques. The key points are:
- Kinesio tape was developed in the 1980s by Dr. Kenzo Kase to mimic skin and avoid sensory stimuli. It can facilitate or inhibit muscles depending on application tension.
- It works by lifting the skin to enhance muscle, joint, and circulatory function. It can be used to support injured structures in all injury phases from acute to rehab.
- Common applications include pain relief, swelling reduction, improved biomechanics and range of motion. Different cut techniques like I, Y, X are used for specific conditions.
-
Physiotherapy in psychiatry
This document discusses psychiatric disorders and abnormal behavior. It begins by defining mental disorders and abnormal behavior. It notes that mental disorders involve distress or disability that is not developmentally or socially normative. Abnormal behavior is defined as deviating from statistical or socio-cultural norms or causing personal discomfort. The document then discusses characteristics of normal and abnormal behavior. It also discusses models of abnormality, classifications of mental disorders, and characteristics of commonly abused substances and corresponding substance use disorders.
SPINAL STABILIZATION PPT
Spinal stabilization involves surgical procedures to treat acute spinal injuries and conditions by restoring vertebral alignment and removing bone fragments. The degree of stabilization depends on the severity of the problem. Surgery involves inserting instruments like screws and plates in the back to stabilize the spine and facilitate fusion after decompression. Minimally invasive procedures perform stabilization through small incisions without damaging muscles. Recovery takes around six months with limited activity and physical therapy starting in the first week.
Myofascial Release Presentation
Presentation slides from our recent workshop on Myofascial Release. This workshop was delivered from our St John Street Clinic in Manchester on Saturday 17th March.
Shoulder arthroplasty & Physiotherapy
Dr. Satyendra Bhattacharyya's document discusses the history and procedure of shoulder arthroplasty. It begins with the first documented shoulder replacement in 1894, but focuses on developments starting in 1951 by Dr. Charles Neer, who created the first hemi-arthroplasty and total shoulder replacement. The document then discusses factors that influence arthroplasty outcomes, indications for the procedure for conditions like osteoarthritis and rheumatoid arthritis, and details each step of the surgical procedure. It concludes by describing postoperative rehabilitation protocols.
History of physiotherapy
Physiotherapy has been used for thousands of years to treat pain and physical impairments through techniques like massage, manual therapy, and hydrotherapy. Greek physicians like Hippocrates were early practitioners of manual manipulation for pain relief. In the 1800s, Per Henrik Ling established schools of Swedish gymnastics and massage therapy. Physiotherapy treats patients through physical exercise and understanding of human biomechanics, while pharmacy focuses on biochemistry and recommending medication to treat illnesses. Physiotherapists work directly with patients, using exercise and manual therapy, whereas pharmacists treat patients by advising on appropriate drug-based treatments.
Tennis elbow(le)
This document provides information on lateral epicondylitis (tennis elbow), including its anatomy, causes, symptoms, diagnosis, and treatment options. It describes how lateral epicondylitis is an overuse injury caused by repetitive microtrauma to the common extensor tendon at the lateral epicondyle. The diagnosis is typically made based on physical examination findings of tenderness over the lateral epicondyle with resisted wrist and finger extension. Both non-operative treatments like physiotherapy, bracing, and steroid injections and surgical options are discussed for managing lateral epicondylitis.
POSTURE AND PAIN - Gisurgery.info
Practicing good posture can make a big different in your health, well-being, mood and your appearance. Learn More how Good posture affects both your physical body as well as your emotional and mental well-being. For more health Tips, Visit at http://gisurgery.info
NAGs_Natural Apophyseal Glides The Mulligan Concept
Introduction on NAGs_Natural Apophyseal Glides
Application_How to apply NAGs
In which we can apply NAGs?
Evidence on NAGs.
core muscle strengthening
The core muscles can be categorized as stabilizers or mobilizers. Stabilizers like the transversus abdominis and multifidus are deeply placed, have slow twitch fibers, and help provide stability. Mobilizers like the rectus abdominis are more superficial and have fast twitch fibers for movement. Chronic low back pain is associated with weakness in the transversus abdominis and multifidus as well as decreased flexibility. A core strengthening program focuses on training these local stabilizer muscles in three stages: 1) local segmental control, 2) closed chain exercises, and 3) open chain exercises and functional progression. Exercises target the transversus abdominis, multifidus, and glute
MET: Muscle Energy Technique
Muscle energy technique, a manual therapy technique with a long term history and 8 variations which can be used in various condition to treat muscle as well as joints. This slide show consists of detailed history, variations/types and summary of MET in detail.
History of Manual Therapy and Arthrology
The document provides a history of manual therapy, outlining important figures and developments from Hippocrates in 460 BC to current practice. It discusses the evolution of osteopathy, chiropractic, and physical therapy. Key developments include Andrew Still establishing osteopathy in the US in 1874, Daniel Palmer founding chiropractic in 1895, and the establishment of physical therapy programs and professional organizations in the early 20th century. Current manual therapy practice draws from various techniques and philosophies.
Adhesive Capsulitis
This document provides an overview of adhesive capsulitis or "frozen shoulder" presented by Dr. Shazia Khalfe. It defines adhesive capsulitis as a condition characterized by pain and loss of shoulder range of motion. There are two types: primary which is idiopathic, and secondary which occurs after shoulder injuries or immobilization. Clinical presentation includes pain and limited range of motion. Treatment involves exercises to improve range of motion and strengthen muscles, modalities like heat for pain relief, and patient education on home exercises and prognosis. The goal is to regain full range of motion and normal shoulder function.
Factor influencing strength
Factors that influence muscle strength include energy stores and blood supply, fatigue, recovery from exercise, age, gender, and psychological factors. Muscle requires adequate energy and blood flow to contract and resist fatigue. Fatigue occurs from repeated contractions and diminishes muscle response over time. Recovery allows oxygen and energy stores to replenish while waste is removed from 1 hour to several days after exercise depending on the factor. Strength is also affected by age, gender, and psychological states that can positively or negatively impact movement ability and effort.
Muscle Energy Technique.(soft tissue mobilization)
This document discusses muscle energy technique (MET), a manual therapy that uses precisely controlled voluntary muscle contractions against resistance applied by a therapist. It describes the types of muscle contractions used in MET, including isotonic, eccentric, concentric, and isometric contractions. MET can utilize post-isometric relaxation or reciprocal inhibition to lengthen or relax muscles. The document provides examples of procedures and discusses indications like acute muscle spasm or restricted joints, as well as contraindications like fractures or unstable joints. Potential benefits of MET include restoring normal muscle tone, strengthening weak muscles, and improving joint mobility.
What's hot (20)
Nerve Gliding Exercises - Excursion and Valuable Indications for Therapy
Nerve Gliding Exercises - Excursion and Valuable Indications for Therapy
NAGs_Natural Apophyseal Glides The Mulligan Concept
NAGs_Natural Apophyseal Glides The Mulligan Concept
Muscle Energy Technique.(soft tissue mobilization)
Muscle Energy Technique.(soft tissue mobilization)
Viewers also liked
Current concepts in management of lumbar disc prolapse
A discectomy is a last resort surgery for herniated discs that do not improve with more conservative treatments. The perfect indication for discectomy is a patient with a history of intolerable radicular pain for over six weeks, physical exam findings of nerve compression or tension, and an MRI confirming a large herniated disc. Earlier surgery may be considered for moderate nonradicular pain of less than six weeks if supported by physical exam findings and a small disc herniation is seen. Steroid nerve root blocks can help determine if surgery is needed by relieving radicular pain temporarily. A recent trial studied a Barricaid device implanted during discectomy to prevent reherniation.
Guidelines for return to sport after cervical trauma
The document discusses return to activity guidelines after various cervical injuries, including sprains/strains, burners/stingers, neuropathies, disc herniations, fractures, and surgery. It notes that there is no consensus between spinal surgeons on return to play. Generally, athletes can return when they have no symptoms or neurological deficits, full range of motion without pain, and adequate healing time from the injury, though risk of reinjury remains. The severity of the original injury and any subsequent surgery or abnormalities determine how quickly and safely athletes can safely return to their sport.
Licina low back pain
This document discusses acute versus chronic low back pain. Acute low back pain results from tissue trauma and is self-limiting, usually resolving with staying active. Chronic low back pain lasts a long time and may be caused by segmental instability, discogenic pain, facetogenic pain, soft tissue problems, or unknown causes. It often requires a multidisciplinary treatment approach using non-operative treatments that are generally ineffective. The decision to operate for chronic low back pain is difficult as surgery is not always effective and degeneration does not necessarily cause pain.
On-field management of cervical injuries
This document provides guidance on managing cervical spine injuries on the field. It recommends manually stabilizing the neck and spine in-line, applying a rigid collar on the field, log rolling the player onto a stretcher, and then transporting them from the field. Additional resources for further information include the International Rugby Board website, their Player Welfare/Match Day section, and instructional videos on YouTube.
Causation and decision making
The document discusses factors that contribute to spinal compensation issues and determining whether back pain is work-related or requires surgery. It notes that genetics play a dominant role in disc degeneration, explaining 74% of cases, rather than physical loading as previously thought. When evaluating work-relatedness, multiple factors are considered like the injury mechanism, pain onset relationship, preexisting issues, current pathology, and presentation consistency. For surgery approval, considerations include the treated condition, nonoperative treatment effectiveness, surgery effectiveness, return to work likelihood, and surgeon capability.
Licina lumbar disc herniation
This document discusses disc herniation, including its causes, symptoms, signs, imaging, treatment options of observation, nerve root blocks, and surgery. It provides details on when surgery is appropriate and outcomes, which is typically relief of leg pain and satisfactory results in 90% of cases. However, surgery may not work when symptoms are primarily back pain rather than radicular pain or there are psychosocial issues. The document also includes examples of patients who may be candidates for surgery, nerve root blocks, or further observation and treatment.
Pars defects and spondylolisthesis
Presented by:
Dr Paul Licina – Spine surgeon
Dr Mark Young – Sports and musculoskeletal physician
Event:
Challenges in the Sporting Spine - 2014
This unbearable pain
Presented by:
Dr Brendan Moore — Pain Medicine Specialist Physician
Event:
The Team Approach to Low Back Pain - 2014
Surgery for low back pain
The document discusses different types of spine surgery for low back pain, including discectomy for disc herniation and fusion surgery. Discectomy has good outcomes, with patients typically able to return to sedentary duties in 3 weeks and sports in 6 weeks, and a 90-95% success rate. Fusion surgery results are not as good for low back pain compared to discectomy or when done for deformities or instability. Fusion may be suitable for patients with a specific diagnosis, clearly defined pain source, who are otherwise healthy candidates and have no psychosocial issues. The technique used should match the underlying pathology.
Where do I fit in?
The document discusses the role of a physiotherapist working in a multidisciplinary spine clinic. The physiotherapist has over 30 years of experience working with spinal and orthopaedic patients. In the clinic, they assess, educate, treat, and manage patients. Sessions involve assessment, education, manual therapy and exercise. The physiotherapist works as part of a team, following patients before and after surgery, conducting joint sessions with surgeons and an exercise physiologist, and liaising with other specialists. The goal is to provide continuum of care for patients.
Where do I fit in?
Elena Yusim is a psychologist located at Level 7 of the Brisbane Private Hospital. She conducts consultations every second Monday and offers remote sessions by telephone. As a psychologist, she reviews medical histories, performs in-depth psychosocial assessments and assessments of psychological state. She assesses client willingness and expectations and develops approximate 6 session treatment plans while liaising with other practitioners and reviewing progress. Seeing a psychologist can help investigate the impact of thoughts, empower self-management techniques, assist with realistic goal setting, return to work strategies, and relapse prevention strategies.
How we think about back pain?
Presented by:
Dr Adrian Nowitzke — Neurosurgeon
Event:
The Team Approach to Low Back Pain - 2014
Where do I fit in?
This document provides information about Nathan Wade, an Accredited Exercise Physiologist (AEP). It discusses his role as a consultant for Spine Plus Clinic, where he helps develop individually tailored exercise programs for patients undergoing rehabilitation for back pain and other injuries. As an AEP, Nathan specializes in prescribing exercises for chronic disease management and uses a progressive approach to improve mobility, flexibility and functional strength. His goal is to act as a bridge between clinical rehabilitation and normalized training programs for patients.
Core Stability Programme
Presented by:
Stephen Boyd — Physiotherapist
Nathan Wade — Exercise Physiologist
Event:
Core Stability Programme
Initial Post Discectomy Programme
This document outlines an exercise program for patients who have undergone a lumbar discectomy. The goals within 3 weeks are to do 2-3 exercise sessions per day, walk for a total of 5km split into two sessions, and lift weights up to 5kg. The program focuses on core stabilization exercises using a transversus abdominis contraction to protect the low back during movements. Exercises progress from basic stretches and isometric contractions on the floor to movements with a ball and concluded with standing exercises.
Pain management
This document discusses various interventional pain procedures for chronic pain management, including their indications and how they are performed. It describes epidural injections, facet joint injections, sacroiliac joint injections, medial branch blocks, and radiofrequency nerve ablation. Epidural injections are most effective for nerve root compression and spinal stenosis. Facet joint injections target back pain from facet joints, while sacroiliac joint injections are for referred pain in the low back or lower extremities. Medial branch blocks and radiofrequency ablation can provide diagnostic information and long-term pain relief by denervating facet joints. Proper patient selection, aseptic technique, imaging guidance, and monitored sedation are important for safety. The document also reviews
Back Rehabilitation
Presented by:
Stephen Boyd — Physiotherapist
Nathan Wade — Exercise Physiologist
Event:
The Team Approach to Low Back Pain - 2014
Pain management
This document discusses interventional pain procedures for chronic pain, including epidural injections, facet joint injections, medial branch blocks, and radiofrequency nerve ablation. It provides details on how each procedure is performed, when they are appropriate, and their potential benefits which include temporary pain relief and allowing patients to progress in rehabilitation. It also covers guidelines for opioid prescribing for chronic pain, including maximum recommended doses, conversion between opioid medications, requirements for authorities to prescribe, and factors to consider in opioid trials and maintenance therapy.
Core and Functional Strength Exercises
Presented by:
Stephen Boyd — Physiotherapist
Nathan Wade — Exercise Physiologist
Event:
The Team Approach to Low Back Pain - 2014
Appropriate imaging for low back pain
1) The document discusses appropriate imaging for back pain, describing different imaging modalities like X-rays, CT scans, bone scans, and MRI.
2) It categorizes back pain into 3 groups: nonspecific low back pain, back pain associated with radiculopathy, and back pain associated with a specific cause needing prompt evaluation.
3) Guidelines recommend triaging patients into these 3 categories and only imaging those with red flags, severe/progressive neurological symptoms, or if considering surgery/injections. Imaging is not recommended for nonspecific back pain.
Viewers also liked (20)
Current concepts in management of lumbar disc prolapse
Current concepts in management of lumbar disc prolapse
Guidelines for return to sport after cervical trauma
Guidelines for return to sport after cervical trauma
Similar to Accelerated rehabilitation after lumbar discectomy
The Effects of Early Ambulation Post-Hip Arthroplasty
Early physical therapy and ambulation following hip replacement surgery may decrease length of hospital stay and costs compared to delayed physical therapy. Two studies found patients who began intensive therapy within 3 days of surgery experienced shorter hospital stays and lower costs than those who began intensive therapy at 7 days. It is recommended that patients ambulate frequently and intensely following surgery under a physical therapy regimen in order to reduce recovery time and healthcare costs. Further research is needed to verify these findings.
Matt Lewis Law Dallas Texas - ODG - July 11, 2008
ODG: Medical Treatment For Back And Neck Injuries - 2008
Rule 137.100 Treatment Guidelines
HCP’s shall provide treatment in accordance with the current edition of the Official Disability Guidelines – Treatment in Workers’ Comp unless the treatment requires preauthorization under Rule 134.600
Services provided in accordance with the Guidelines is presumed reasonable and reasonably required (medically necessary).
jurding 1 kiki.pptx
The document summarizes a study that evaluated the efficacy of a joint mobilization apparatus in treating frozen shoulder. The study involved 48 patients with frozen shoulder who were randomly assigned to either a control group receiving regular physical therapy or an experimental group receiving physical therapy plus treatment with the joint mobilization apparatus. Outcome measures including range of motion and pain were assessed at baseline and after 4 and 8 weeks of treatment. The results showed that the experimental group had significantly greater improvements in range of motion and reductions in pain levels compared to the control group receiving only physical therapy. The study concluded that the joint mobilization apparatus combined with physical therapy can further improve shoulder function and relieve pain in patients with frozen shoulder compared to physical therapy alone.
Thoracic spine manipulation
Presented an in-service on the evidence behind and the application of thoracic spine manipulation to the Martinsburg VA Medical Center's rehabilitation staff including: 7 PTs, 8 PTAs, 3 OTs, and 4 students.
Presentation1.pptx
- The document summarizes a landmark study on the timing of surgery for acute spinal cord injuries.
- The study randomized 64 patients with cervical spinal cord trauma to either early surgery (<72 hours) or late surgery (>5 days).
- The study found no significant differences in neurological or functional outcomes between early and late surgery groups.
- While the study provides evidence that waiting over 72 hours does not negatively impact outcomes, critics note that surgery within the first 24 hours may still provide benefits not captured by this study.
WVU Inservice
This document discusses the benefits of early mobilization for patients undergoing total hip or knee arthroplasty. Early mobilization is defined as walking within 24 hours of surgery. The document reviews two studies that found early mobilization decreased length of stay, improved functional outcomes, better controlled pain, and decreased risks of blood clots compared to protocols with later initial walking. Both studies found early mobilization improved mobility distances over time and allowed more patients to be discharged home.
SAM-now available wrs
Delivering sustained acoustic medicine for effective, safe, drug-free pain relief and recovery, sam Professional uses ZetrOZ’s proprietary miniaturization technology to provide controlled-release, long duration ultrasound treatment, for up to four hours daily. No other medical technology is available to provide daily multi-hour therapeutic intervention to assist with conservative care and help injured patients get back to work sooner without surgical intervention.
sam Professional works by providing continuous mechanical energy directly into tissue. Battery-powered, rechargeable, and comfortable to wear, the deep-penetrating ultrasonic energy reduces inflammatory pain and accelerates recovery of overuse injuries to tendons, ligaments and muscles, relieves chronic muscle spasms, and increases local circulation.
Used successfully by a wide range of professional dancers, famous athletes, individuals who work in labor-intensive jobs, and others looking to more effectively manage chronic pain, sam Professional is available by prescription in the US. It is also cleared for sale in Europe, Canada, and Asia.
Discectomy
The document summarizes evidence from studies on the indications and timing of surgery for lumbar disc herniation. It finds that while early surgery (within 6-12 weeks of symptoms) provides faster relief of sciatic leg pain compared to conservative treatment, there is no difference in long-term outcomes between early surgery and conservative treatment. The optimal timing for surgery is not clearly defined by the evidence presented.
Goodwin efetividade da fisio supervisionada num período prec
This randomized controlled trial evaluated the effectiveness of supervised physical therapy plus a home program versus a home program alone for 84 patients who underwent arthroscopic partial meniscectomy. Patients were randomly assigned to receive either 6 weeks of supervised physical therapy plus a home program or just a home program. Outcome measures were collected at 5 and 50 days post-surgery and found no differences between the groups, indicating that the supervised physical therapy used in this study provided no additional benefits in the early period after uncomplicated arthroscopic partial meniscectomy compared to a home program alone.
Introduction to Chiropractic
Learn about chiropractic and how to choose a proper and qualified chiropractor quickly.
Visit http://www.chiropractorhunter.com for finding chiropractors near you!
Subacromial pain daniel
The document discusses shoulder pain, specifically subacromial pain/non-specific shoulder pain. It notes that shoulder pain is prevalent, can impact daily activities, and for 40% of patients the pain is ongoing or recurrent after 12 months. Imaging and physical exams are not always reliable in diagnosing the source of pain. Exercise appears to be the most promising intervention for shoulder pain, though what type or amount of exercise is unclear. A proposed intervention focuses on teaching patients self-management skills and a home exercise program with 1-5 sessions from a physiotherapist and proactive follow-up.
Progressive mobility ipad
The document discusses the concept of progressive mobility, which involves early ambulation of ICU patients starting on the first day. It outlines the benefits of early mobility such as improved morale, health, and faster recovery times. Additionally, it discusses how prolonged immobility can lead to physical disabilities, weakness, and inability to return to work. The document then describes the components and goals of progressive mobility programs, which include head of bed elevation, verticalization techniques like tilt tables, standing, and walking training. It provides evidence that early and frequent mobilization can safely be achieved in the ICU with positive outcomes such as better functional status and lower complication rates.
Sedation and mobility in ICU
This document discusses changing practices around sedation and mobility for critically ill patients. It notes that while organ systems have traditionally received highest priority, long-term physical deconditioning and cognitive impairment are underappreciated complications. Several studies are summarized that show early, aggressive mobilization for critically ill patients, even while mechanically ventilated or in the ICU, is feasible and safe, and associated with better short and long-term outcomes like physical function, walking ability, and likelihood of returning home directly rather than to a rehabilitation center. The paradigm is shifting from liberal sedation and immobilization to minimal sedation and early mobilization.
cimt.pptx
Constraint-induced movement therapy (CIMT) involves restricting use of an unaffected limb while intensively training an affected limb for several hours per day. It is based on research showing that restricting use of a monkey's unaffected forelimb led to improved use of the affected limb. Studies in humans found that restricting an unaffected arm along with task-specific training of the affected arm improved function of that arm. The EXCITE trial, a large randomized controlled trial, provided strong evidence of CIMT's efficacy for improving arm function after stroke. While very effective, the intensive nature of CIMT presents challenges to implementation in clinical settings. Modified versions have aimed to address these issues.
Constrained induced movement therapy
CIMT involves constraining the unaffected limb, along with intense therapy, in order to force the use of the affected limb with intent to improve motor function.
ACPIN Presentation
Constraint Induced Movement Therapy (CIMT) is an evidence-based rehabilitation technique for improving motor function in patients with neurological impairments. It involves restraining the less impaired limb while intensively training the more impaired limb for several hours per day. The theory is that this reverses "learned non-use" of the impaired limb. Studies show CIMT results in cortical reorganization and significantly improves arm function and real-world use in both adults and children with conditions like stroke and cerebral palsy. While effects are positive, CIMT does not restore normal movement and its benefits gradually reduce after treatment ends.
Pregabalin in chronic Post-thoracotomy Pain
Pregabalin is an effective and safe adjuvant for reducing chronic
post-thoracotomy pain, without significant side effects, in all age
groups and either gender. The pain relief becomes statistically
significant after three weeks of treatment and it continues till six
months. However, larger randomized and placebo-controlled trials
of longer durations are required to further validate these findings.
Effectiveness of cpm and conventional physical therapy after total knee arthr...
This randomized clinical trial compared the effectiveness of 3 in-hospital rehabilitation programs following primary total knee arthroplasty (TKA): 1) conventional physical therapy alone, 2) conventional physical therapy with 35 minutes of continuous passive motion (CPM) daily, and 3) conventional physical therapy with 2 hours of CPM daily. Outcome measures included range of motion, functional ability, and length of stay. The results showed no significant differences between the groups for any outcomes, suggesting that adding CPM to conventional physical therapy provided no additional benefits after primary TKA.
IWTC in Portland, USA 2006
This study examined whether early improvement in neck function predicted overall response to a cervical strengthening program for chronic neck pain. 214 patients completed a 3-week strengthening program and were assessed for changes in neck disability index (NDI) scores. Patients with a positive change in NDI scores after 3 weeks had a 25 times greater odds of overall improvement. Early improvement likely reflects motor skill acquisition rather than muscle hypertrophy. While early responders saw small additional gains, continued strengthening may provide further benefits like reduced muscle co-activation.
Similar to Accelerated rehabilitation after lumbar discectomy (20)
The Effects of Early Ambulation Post-Hip Arthroplasty
The Effects of Early Ambulation Post-Hip Arthroplasty
Goodwin efetividade da fisio supervisionada num período prec
Goodwin efetividade da fisio supervisionada num período prec
10.The dos and don’ts post rotator cuff repair.pptx
10.The dos and don’ts post rotator cuff repair.pptx
Effectiveness of cpm and conventional physical therapy after total knee arthr...
Effectiveness of cpm and conventional physical therapy after total knee arthr...
More from SpinePlus
Some WorkCover fusions work
- The study examined outcomes of 42 WorkCover fusion patients compared to 465 privately insured patients over 10 years
- WorkCover patients showed less improvement in ODI and VAS scores postoperatively, especially those with significant back pain preoperatively
- However, WorkCover patients with dominant leg pain preoperatively had similar outcomes to privately insured patients with leg pain
- The presence of leg pain may predict better outcomes for WorkCover fusion patients than significant back pain
Operative management for common back conditions
This document discusses common lumbar spine conditions like disc herniations and spinal stenosis. It provides 5 facts about disc herniations including what causes them, typical symptoms, and treatment options like steroid injections or surgery. It also outlines 5 facts about spinal stenosis including what it is, typical symptoms, and potential surgical treatment. The document seeks to address 3 common misconceptions about spinal fusion surgery, noting risks are low, it is often successful when combined with decompression, and adjacent level degeneration is usually due to preexisting conditions, not the fusion itself.
Pain management
This document discusses interventional procedures for chronic pain, specifically in the lumbar back region. It describes common origins of lumbar pain such as degenerative discs and stenosis. Invasive treatment options are then outlined, including various injection procedures like epidural, facet joint, and medial branch nerve ablation using radiofrequency. The document provides details on how these procedures are performed and their goals in potentially providing temporary pain relief and allowing rehabilitation. Maximum recommended opioid doses and conversions between opioids are also presented.
Imaging for back pain
This document discusses several issues related to spine imaging. It covers the importance of radiation exposure from various imaging modalities like CT and highlights strategies to reduce radiation dose. Guidelines for imaging low back pain recommend no imaging for non-specific back pain but imaging if neurological deficits are present or specific causes are suspected. The document reviews imaging modalities like X-ray, bone scan, CT and MRI and what each shows. It provides details on MRI sequences and appearances of common spine findings.
Non-operative management for common back conditions
Lumbar disc herniation and stenosis are common causes of low back pain that often improve without surgery. Post-surgery rehabilitation focuses on education, low-impact exercises, and a gradual return to normal activities. Key goals include reducing pain and improving function to allow patients to return to work and daily life. Appropriate exercises target the lumbar spine, hips, and core muscles while avoiding positions that increase pain. Outcomes are best with a multidisciplinary approach including exercise prescription managed by a physiotherapist or exercise physiologist.
Patient cases
Dave is a 38-year old factory worker who presents with worsening back pain that has failed to improve with rest, over-the-counter medications, and a prescription for Endone. He wants advice on his diagnosis, pain management options, submitting a workers' compensation claim, and the possibility of surgery. A comprehensive assessment and multidisciplinary approach is needed to properly manage Dave's chronic back pain.
Surgery for common lumbar conditions
This document discusses common degenerative conditions of the lumbar spine, including disc herniation, spinal stenosis, and spondylolisthesis. It provides details on symptoms, treatments like steroid injections or surgery, and outcomes. It aims to dispel misconceptions about spinal fusion surgery, noting that while risks exist, severe damage is rare and fusion is usually successful when performed for the right reasons. Fusion may not necessarily lead to more problems at adjacent levels in the future. The document includes examples of patients who had good outcomes from fusion surgery for conditions like isthmic spondylolisthesis and post-discectomy.
Common conditions of the lumbar spine
Common conditions of the lumbar spine include:
1. Degenerative disc disease, which occurs in nearly everyone over 50 due to disc degeneration and affects the lower lumbar spine the most.
2. Disc herniations, where a tear in the disc allows the nucleus to migrate and press on nerves, commonly causing leg pain.
3. Spinal stenosis, a narrowing of the spinal canal from bone spurs or thickened ligaments that compresses nerves and causes leg symptoms improved by sitting or bending forward.
4. Spondylolisthesis, the slipping of one vertebra over another, most often affecting L4 on L5 due to degeneration.
Non-operative treatment for common back conditions
Lumbar disc herniation and stenosis are common causes of low back pain that often improve without surgery. Post-surgery rehabilitation focuses on education, low-impact exercises, and a gradual return to normal activities. Key goals include reducing pain and improving function to allow patients to return to work and daily life. Appropriate exercises target areas like the lumbar spine, hips, and core to improve mobility and reduce recurrence, while avoiding movements that increase pain. Outcomes are best with a multidisciplinary approach including exercise prescription tailored to individual needs and abilities.
Case Presentation
Dave, a 38-year old factory worker, sees a doctor for worsening back pain that radiates down his left leg. Imaging reveals chronic pars defects, grade 1 spondylolisthesis, and disc degeneration. He is referred to specialists, prescribed medications, and advised to file a workers compensation claim to receive treatment including epidural injections and physical rehabilitation with the goal of a gradual return to work.
The role of surgery in common lumbar conditions
The document discusses common lumbar spine conditions including disc herniation, spinal stenosis, and chronic low back pain. It describes the causes, symptoms, treatments including surgery, and outcomes. For disc herniation, surgery in the form of discectomy is recommended for severe or unremitting leg pain and can provide relief in 90% of cases. Spinal stenosis is treated initially with physiotherapy or epidural injections, with surgery as an option for severe, unresolved symptoms. Fusion surgery is not usually indicated for chronic low back pain alone but may be used for instability or certain structural deformities.
Lumbar Stretching
The document describes an exercise program for lumbar stretching rehabilitation. It includes 18 different stretching exercises targeting the lower back and hips. The exercises involve movements such as rolling the knees from side to side, bringing the bent knee towards the chest, tightening stomach muscles to lift the bottom, rocking backwards on hands and knees, and rotating the leg outwards while pulling it towards the chest. Each exercise provides instructions on body position, movement, and number of repetitions.
Lumbar Stabilisation
The document outlines an exercise program for lumbar stabilization rehabilitation. It provides 15 different exercises that involve contracting the transversus abdominis muscle to stabilize the spine. Each exercise lists instructions on positioning, muscle activation, and repetitions. The goal is to perform the full series of exercises while maintaining control of the lower back and pelvis.
Discectomy Activity Guide
Presented by:
Stephen Boyd — Physiotherapist
Event:
GP Education Day - 2013
6 week discectomy
The document provides instructions for a 6-week lumbar rehabilitation exercise program following back surgery. It includes over 20 different exercises targeting the lower back, core, and legs. Exercises should be done 2-3 times per day and include stretches, strengthening moves using balls, bands, and body weight as well as exercises done in standing, kneeling, and various positions on the floor or ball. The full range of motion and correct form are emphasized to protect the back during rehabilitation.
3 week discectomy
This exercise program outlines rehabilitation exercises over 3 weeks following a lumbar discectomy surgery. The goals by 6 weeks include exercising 2-3 times per day, increasing walking, and lifting up to 10kg. The document provides detailed instructions for 20 different core-focused exercises involving positions like lying on the back or side, kneeling, and standing. Each exercise describes muscle activation and movements to help recovery while avoiding movements that could cause pain.
Initial Discectomy
This document outlines an exercise program for patients who have undergone a lumbar discectomy. The goals within 3 weeks are to do 2-3 exercise sessions per day, walk for a total of 5km split into two sessions, and lift weights up to 5kg. The program focuses on core stabilization exercises using a ball and includes exercises to do lying down, kneeling, sitting, and standing to strengthen the back and abdomen. Proper form is emphasized by engaging the transversus abdominis muscle and maintaining a neutral spine alignment throughout. Exercises are to be done in sets of 10-15 repetitions and held for 3-10 seconds, progressing to weight added as tolerated.
Pain diagram and questionnaire
The document contains a pain diagram and questionnaire for a patient to report their back pain. The pain diagram has the patient mark areas of pain and tingling. Two pain scales have the patient rate their average back and leg pain in the past week from 0 to 10. The back pain questionnaire has 10 sections for the patient to select the statement that best describes how their back pain affects daily activities like personal care, lifting, walking, sitting, standing, sleeping, social and work life, and traveling.
Rehabilitation for back pain
This document provides guidance on rehabilitation for non-operative and operative back pain. It discusses assessing abnormalities and treating to correct them. For severe back pain, it recommends reducing pain and inflammation through comfort positions, movement, medications, modalities, and exercise away from aggravation. For sub-acute back pain, it recommends manual therapy, restoring range of motion and flexibility/strength training. Post-episode, it recommends modifying activities, correcting biomechanical abnormalities, and implementing a home exercise regime. Core stability and stabilization exercises are emphasized for retraining deep muscles to maintain functional stability. Post-operative rehabilitation focuses on early mobility, exercises in neutral spine, and functional control prior to discharge with a home program.
Interventional Procedures and Opioids
Presented by:
Dr Brendan Moore — Pain Medicine Specialist Physician
Event:
GP Education Day - 2013
More from SpinePlus (20)
Non-operative management for common back conditions
Non-operative management for common back conditions
Non-operative treatment for common back conditions
Non-operative treatment for common back conditions
Recently uploaded
Does Over-Masturbation Contribute to Chronic Prostatitis.pptx
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
REGULATION FOR COMBINATION PRODUCTS AND MEDICAL DEVICES.pptx
It includes regulation of combination products and medical devices. FDA and industry liaisons.
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by Stamler, Verified Chapters 1 - 33, Complete Newest Version Community Health Nursing A Canadian Perspective, 5th Edition by Stamler, Verified Chapters 1 - 33, Complete Newest Version Community Health Nursing A Canadian Perspective, 5th Edition by Stamler Community Health Nursing A Canadian Perspective, 5th Edition TEST BANK by Stamler Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Pdf Chapters Download Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Pdf Download Stuvia Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Study Guide Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Ebook Download Stuvia Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Questions and Answers Quizlet Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Studocu Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Quizlet Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Pdf Chapters Download Community Health Nursing A Canadian Perspective, 5th Edition Pdf Download Course Hero Community Health Nursing A Canadian Perspective, 5th Edition Answers Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Ebook Download Course hero Community Health Nursing A Canadian Perspective, 5th Edition Questions and Answers Community Health Nursing A Canadian Perspective, 5th Edition Studocu Community Health Nursing A Canadian Perspective, 5th Edition Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Pdf Chapters Download Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Pdf Download Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Study Guide Questions and Answers Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Ebook Download Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Questions Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Studocu Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Stuvia
Adhd Medication Shortage Uk - trinexpharmacy.com
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
Role of Mukta Pishti in the Management of Hyperthyroidism
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Post-Menstrual Smell- When to Suspect Vaginitis.pptx
Do you have abnormal smell after periods? It may be vaginitis. Do not worry, herbal medicine Fuyan Pill can help you get a cure.
The Best Ayurvedic Antacid Tablets in India
Treat the symptoms of indigestion, heartburn and stomach reflux with the 10 Best Ayurvedic Antacid Tablets in India.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptx
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.Part II - Body Grief: Losing parts of ourselves and our identity before, duri...
Learn about body grief and ways to cope with it. We will also explore methods to heal from this challenging experience.
Efficacy of Avartana Sneha in Ayurveda
Avartana Sneha is a unique method of Preparation of Sneha Kalpana in Ayurveda, mainly it is indicated for the Vataja rogas.
Best Ayurvedic medicine for Gas and Indigestion
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Recently uploaded (20)
Does Over-Masturbation Contribute to Chronic Prostatitis.pptx
Does Over-Masturbation Contribute to Chronic Prostatitis.pptx
REGULATION FOR COMBINATION PRODUCTS AND MEDICAL DEVICES.pptx
REGULATION FOR COMBINATION PRODUCTS AND MEDICAL DEVICES.pptx
Ear and its clinical correlations By Dr. Rabia Inam Gandapore.pptx
Ear and its clinical correlations By Dr. Rabia Inam Gandapore.pptx
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...
Vestibulocochlear Nerve by Dr. Rabia Inam Gandapore.pptx
Vestibulocochlear Nerve by Dr. Rabia Inam Gandapore.pptx
CHEMOTHERAPY_RDP_CHAPTER 6_Anti Malarial Drugs.pdf
CHEMOTHERAPY_RDP_CHAPTER 6_Anti Malarial Drugs.pdf
Muscles of Mastication by Dr. Rabia Inam Gandapore.pptx
Muscles of Mastication by Dr. Rabia Inam Gandapore.pptx
Role of Mukta Pishti in the Management of Hyperthyroidism
Role of Mukta Pishti in the Management of Hyperthyroidism
Post-Menstrual Smell- When to Suspect Vaginitis.pptx
Post-Menstrual Smell- When to Suspect Vaginitis.pptx
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptx
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptx
Part II - Body Grief: Losing parts of ourselves and our identity before, duri...
Part II - Body Grief: Losing parts of ourselves and our identity before, duri...
Accelerated rehabilitation after lumbar discectomy
- 1. Accelerated rehabilitation for discectomy patients Stephen Boyd – Physiotherapist Nathan Wade – Exercise Physiologist
- 3. The reasoning Case 1 • 32-year-old male • employed as excavator operator • 10 days unbearable sciatica • unable to sleep • large doses of analgesics • disc herniation on MRI • discectomy surgery
- 4. The reasoning Case 1 Seen at 6 days post-op (Barricaid filming) • minimal pain • functioning equivalent to 3 week stage • accelerated rehabilitation implemented
- 5. The reasoning Case 1 2 weeks post-op • minimal pain • returned to full duties using excavator • OTC medications • returned to all normal activities
- 6. The reasoning Pre-op 2 weeks post-op
- 7. The reasoning Case 2 • 39-year-old male • employed as a barge deckhand • WorkCover claim • 5 month history of sciatica • failed to settle with injections • large disc herniation on MRI • discectomy surgery
- 8. The reasoning Case 2 Seen at 10 days post-op • early review as wanted to return to work • minimal pain • cleared for work
- 9. The reasoning Pre-op 10 days post-op
- 10. The reasoning Case 2 Seen at 6 weeks post-op • reported that had worked 30 days straight • performed full duties as a deckhand • minimal pain • OTC medications
- 11. The reasoning Case 3 • 25-year-old stock filler • Back and leg pain after lifting and twisting • WorkCover patient • Typical presentation and surgery • Red flags • Prolonged recovery Not suitable for accelerated rehabilitation
- 12. The reasoning Pre-op 3 months post-op
- 13. The evidence
- 14. The evidence Caragee et al. (1996) “lifting of post-operative activity restrictions allowed shortened time to return to work” “average work loss was 1.2 weeks” Kjellby-Wendt & Styf (1998) “Patients rehabilitated according to the early active training program (commenced 1 day post- op) had a better short-term outcome of objective values” McGregor, Burton, Sell (2007) “early activation and return to full activities as soon as possible produces better relief of pain, and return to work”
- 15. The evidence Caragee et al. (1996) “very early return to work did not correlate with either recurrent sciatica, reherniation or clinical outcome” McGregor, Burton, Sell (2007) “early rehabilitation programmes may improve function” “early return to work is not harmful, it can be helpful” Newsome et al. (2009) “Immediate commencement of exercise following lumbar microdiscectomy enabled patients to return to work sooner” “no increase in the rate of revision surgery”
- 16. Our evidence Out of the 257 discectomy surgeries performed in 2012-2013 the revision rate at 12 months was 3%. Only 3 recurrences (1%) occurred in the first 6 weeks. • 1 occurred in hospital at 4 days post-op • 1 occurred 5 days post-op • 1 occurred 4 weeks ago None were activity related
- 17. The process
- 20. The future
- 21. • Goal based vs time based • Web based videos http://www.spineplus.com.au/patient- info/rehabilitation/spineplus-accelerated- rehabilitation-program/discectomy-accelerated- rehabilitation-videos/ • Regular communication (Skype) The future
- 22. The future Immediate (stage 1) Progress to stage 2
- 23. The future Stage 2 Progress to stage 3