low back pain

                       LOW  BACK  PAIN

The  low back pain is the one of the most common  cause of  painful  life. The  cause of LBP  varies from individual  to individual  like poor posture  ,sedentary Lifestyle,prenatal and postnatal   muscular  weakness disc  herniation  etc.whatever  the  cause of it but the patient   who suffers from it is only  know  the impact  of  it on his own  personal  , financial  and social  life  style. 
            Now  a days  physiotherapy  can play  an  important  role  in   assessment   and  management  of  low  back pain.
             Before  planning  the  treatment  protocol   physiotherapy  assessment  is  an important  part of whole procedure.In assessment  the physiotherapist  

Identify the  causative  factor  of patient's  low back pain and according  to  it plan the treatment.
ASSESSMENT:
The  assessment  includes  :
A  DEMOGRAPHIC  DATA:-
B   HISTORY:-

1. History  taking  including  cause,onset,mode of onset that is sudden or gradual
2. Past medical history
3. Past surgical  history  
4. Past medication  history  
5. Accidental  or any history  of trauma 
6. History of  any neurological  condition etc.

. OBSERVATION:-
The  observation  includes:-

1. Posture assessment  in sagittal  and frontal  planes.
2. Swelling 
3. Any deformity  
4. Gait etc.

EXAMINATION :-

The examination  includes:-

1. MOTOR ASSESSMENT :-

Includes  examination  of  muscle  bulk, muscle  strength, gait examination, coordination and involuntary  movement  examination. 

2. SENSORY   EXAMINATION :-

It  includes  examination of   Superficial  combined   and  deep  sensory  examination  for  identify  any type of  anesthesia  and paraesthesia  which is common  in  neurogenic pain like disc herniation  .

3.GAIT EXAMINATION :-

It  includes  examination  of  normal   or pathological  gaits  like  tredlenberg  gait due to hip abductors  parasis or paralysis. 

4.FUNCTIONAL  EXAMINATION :- 

It  includes  examination  of various functional  activities  like forward  bending for  weight  lifting  , side bending  ,backward  bending ,walking  , sitting etc  which may aggravate  or  releave the pain

SPECIAL  TESTS:-  

The  special  tests varies according  to condition:-

• Single leg raise
• Slump test 
• SI joint  compression  and distraction  test
• Feber  test 
• Hower test etc.

INVESTIGATION :-  It includes:-

1. X RAYS 
2. MRI

DIFFERENTIAL  DIAGNOSIS  AND  FINAL DIAGNOSIS 

TREATMENT :_    :-

GOALS:-SHORT TERM:-

1.     Pain relief
2.  Spasm  relief 

LONG  TERM  :-

1.       Posture correction 
2.       Gait correction
3.        Improve  functional activities. 
4.         Sensory motor  improved 

TREATMENT:-

• MODALITIES :-  
• SWD  
• TENS  
• IFT
• Hot water  fermentation 
• Lumbar traction in case of disc herniation 
• EXERCISES :-
• Core stability  exercises
• Cat  and camle 
• Bridging exercise 
• Back isometrics
  

BEST EXERCISES FOR BACK PAIN