Introduction

Back pain is pain, muscle tension or stiffness in any part of the back. The pain may spread to the buttocks or legs.

Back pain can be classified to the level of acute, chronic and relapsing (Recurrent)

Back pain may result from :

• Muscle Injury
• Spinal Fracture
• Changes to the disc
• Improper posture
• Narrowing of the spinal canal (spinal stenosis)

The objective of Physiotherapy Treatment

1. To reduce pain
2. To strengthen the back and abdominal muscles
3. To maintain the range of movement of the body
4. To increase the range of movement of the body
5. To help patients perform daily activities to the maximum without pain

Sign and Symptom

• Acute back pain – pain experienced during the period of 1 day to 3 months
• Chronic back pain – pain that occurred more than 3 months
• Recurrent back pain (Recurrent) – recurrent pain in less than 3 months

Complication

Limitations in daily activities due to pain

Prevention

Ensure proper posture in all positions while sitting, standing, lying down or while performing daily activities :

While lying

• Select a firm mattress. This will support your spine properly.
• Proposed Position: side lying, lean body forward with a pillow between your knees

During walking

• Wear comfortable low-heeled shoes

While sitting

• Use chair with a back rest that will support the spine
• Use a small pillow or a lumbar roll to support the back

While standing

• On prolonged standing, rest your feet alternately on a small low stool.

Tips:

• Use the correct technique of lifting / transferring
• Perform regular exercise
• Control your weight
• Maintain fitness

Rehabilitation

1. 1. Pain management
      • Ice pack – for acute back pain.
        • How to use : wrap the ice pack with a wet cloth and place at the area of pain for 15 minutes.
        • Make sure that the area has not been rubbed with hot ointment before the ice pack is placed.
      • Hot pack – for chronic back pain and repetitive pain.
        • How to use: wrap the hot pack using adequate layers of towels (to make sure it is not too hot) and place it on the painful area for 20 minutes.
   2. Back exercise programe

3. Lumbar stabilization Exercises

• Position: lie down on a flat surface, both knees bent
• How to Perform: contract the abdominal muscles, keep the body in a neutral position. Then lift your right leg as high as 12 inches, with the right knee in a straight position, hold 3 seconds and lower the leg.
• Repeat this exercise at least 5 times.

References

1. Care protocol Low Back Pain oleh Jawatankuasa teknikal Profesion Fisioterapi, KKM
2. Janie Hampton, 1992, Aches and Pain, Oxford Health Publications for the international League Against Rheumatism.
3. Marilyn Moffat, 2006, Muskuloskleletal Essentials , Applying the preferred Physical Therapist Practice Patterns, SLACK Incorporated
4. Tarek, M. Khalil, 1993, Ergonomics in Back Pain, A Guide to Prevention and Rehabilitation,New York, Van Nostrand Reinhold