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Sunday, November 29, 2015

Physiotherapy and Tips for Back Pain prevention

Back Pain (Guideline)

Back Pain Snippets
About 85% of Malaysians experience back trouble by age 50.
Back problems are the most frequent cause of activity limitations in working-age adults.
In the long run, surgery, chiropractic care, etc., are considered no more effective than no treatment in reducing low back pain.

The Spinal Column
The human spinal column is the center of postural control.
It is built to provide stability and at the same time allow flexibility. 
These two seemingly incompatible functions of support (inflexibility) and movement (flexibility) are at opposite ends of a spectrum of movement, and this fact is one reason the spine is so vulnerable to injury.

The Spine - Disk Nutrition
Located between the vertebrae in our backs are discs which act as the shock absorbers for the spine.
Discs begin losing blood supply by age 20. 
We feed our disks by moving fluids into and out of them through mechanical compression and decompression (one reason to move about while at work).

Forces Acting on the Spine
Compressive forces push bones and discs together.
Tensile forces act (pull) on ligaments, tendons and muscles.
Typically these forces occur simultaneously, for example, when lifting objects, or when “slouching.”

Back Injury Risk Factors – Acute
Acute (traumatic) back injury may occur due to:
slips, trips and falls;
auto accidents;
sedentary lifestyle (with occasional lifting);
heavy and/or awkward loads;
improper lifting technique.

Back Injury Risk Factors – Chronic
Chronic back injury may result from poor posture and/or improper lifting technique combined with repetitive lifting.
Additionally, genetics and overall physical fitness may affect spine health.

Back Injury Risk Factors – Chronic
Maintaining a neutral spinal posture is important when seated as well as during lifting tasks. 
If sitting without back support, rotate the hips forward until a neutral posture is achieved. 
If using the backrest, sit back in the chair to allow the backrest to help maintain a neutral posture and reduce muscle loading

Risk Reduction - Engineering/Design
You can design a safer lifting environment by: 
avoiding very high and very low object placement;
reducing object weight and size;
providing handles;
eliminating the need for twisting motions;
eliminating bending and stooped postures; and
by providing mechanical assistance.

Risk Reduction - Lifting Tips
When lifting, you can substantially reduce your risk of low back injury and pain by:
keeping the object close to you;
bending your knees;
maintaining your lumbar curve (bend knees and stick buttocks out);
not twisting or bending sideways;
avoiding rapid, jerky movements; and
asking for assistance with heavy and/or bulky loads.

Risk Reduction at Home
Maintaining a neutral spinal posture  when stooped (e.g., when shaving, brushing teeth, bathing children, repairing cars, shoveling, etc.) may reduce your risk of back injury and discomfort.
Planning your lifts, getting assistance, and using mechanical advantage are examples of risk reduction strategies.

Back Pain - When to Seek Help
For common back strain, give home remedies a try for 72 hours.
In rare cases, back pain can indicate a serious problem - seek medical attention if:

  • you have weakness or numbness in either leg;
  • you have a fever along with back pain;
  • you notice new bladder or bowel control problems;
  • your pain increases with lying down; or
  • you have a history of significant chronic disease, such as osteoporosis, cancer or diabetes

Medical Intervention Snippets
Less than 5% of back pain is caused by serious diseases (e.g., cancer or infection) or by anatomical problems that require surgery.
Surgery is almost always elective, possibly providing faster relief of symptoms but may have little effect on long term outcomes.
Non-specific pain could originate with the muscles, ligaments, facet joints or discs and it is generally impossible to be certain of the exact cause.

Medical Intervention Snippets
In a small fraction of cases, the pain will move down the leg into the foot, usually as a result of a disc herniation; however, only about 2% of persons with back pain undergo surgery.
Most herniated disc symptoms abate without surgery and have been found to be surprisingly common even in non-symptomatic adults.
  
Stretching and Exercise
Stretching and exercise are often recommended for back pain, however, some of these activities may aggravate some conditions.
Some discomfort is considered acceptable during the activity, but should not persist when the activity is discontinued.
Speak to your physician or other health care practitioner for stretches and exercises suited to your specific condition.

Back Belts
The National Institute for Occupational Safety & Health has concluded that:
there is insufficient data to support back belt endorsement;
there is a potential for cardiovascular problems and;
back belts are not considered personal protective equipment.
To issue a back belt, ISU requires:

  • job analysis
  • medical recommendation
  • fitting 
  • employee training



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