What is it
Low back pain is pain
located in the lower or lower part of the back, whose origin has to do with
the musculoskeletal structure of the spine.
According to the best physiotherapist in
Delhi, it is a local pain accompanied by referred or irradiated
pain that does not occur as a result of fractures, spondylitis,
trauma or neoplastic, neurological, infectious, vascular, endocrine, metabolic,
gynecological or psychosomatic causes.
This pathology affects
both young people, adults and seniors and appears both in sedentary
jobs, and in those that involve great physical effort.
Approximately 80 percent of the
population has had or will have some low back pain during their life and up to
70 percent of the young people before their 16th birthday have experienced this
back pain.
Causes
Formerly it was believed that the
pain appeared because there was some alteration of the structure of the spine,
such as scoliosis or herniated disc. However, physiotherapy doctor in
Dwarka says that this is a mistake.
The pain of low back pain appears due to a neurological mechanism that
involves the activation of the nerves that transmit pain and the triggering of
muscle contracture and inflammation. Sometimes, it can also involve
compression of the nerve root.
This mechanism can be triggered
by an alteration in the structure of the spine, such as a herniated disc or
significant degeneration of the intervertebral joint, but in most cases the initial cause that
triggers it cannot be ascertained, and It is attributed to pain due to
contracture or muscle overload, says physiotherapist in Dwarka.
Symptom
The most common manifestations of
low back pain explained by top physiotherapist in
Dwarka are local or
irradiated pain, inflammation and the presence of muscle contractures.
On the other hand, depending on
the degree of radicular involvement and compression, alterations in sensitivity
can occur (anesthesia, hypoanesthesia, hyperesthesia, tingling, etc.) and
movement disorders (paresis, paralysis, among others).
Prevention
"To avoid back pain is
advisable to exercise or, in any case, stay physically
active, avoid sedentary lifestyle, adopt a brave mental attitude to
pain and meet the standards of postural hygiene designed to
perform daily activities so that the back support the least possible load,
"explains best
physiotherapy doctor in Dwarka.
Physiotherapist in Dwarka
points out that, in general, they can increase somewhat the risk of suffering
from back pain those that subject the body to vibrations, those that require
flexion-extension or torsion movements and those that force to maintain flexion
or hyperextension postures. However, performing physical exercises that
develop a balanced musculature can alleviate the adverse effects.
Types
At present there is no specific
classification of low back pain. However, many specialists distinguish two
categories:
- Specific back pain: This type includes
the diagnosis of low back pain with a known cause, approximately 20
percent of cases.
- Nonspecific low back pain: It is the
remaining 80 percent and includes all cases in which the specific cause of
the pain is not known.
Diagnosis
The most important sources of
information to know the causes of back pain are the patient's medical history and physical
examination.
The rest of the tests
(radiological, analytical or functional) only have value if the results
correspond to those of the physical examination. Since some are painful
and others involve certain risks, home
physiotherapist in Dwarka recommends resorting to them only when
the results of the interrogation or physical examination determine their
convenience.
Treatments
Physiotherapy clinic in
Dwarka recommends:
General measures
Avoid resting in bed, if possible
The patient should avoid
resting in bed as a treatment for back pain. If the pain forces
to keep it, it should be as short as possible. Studies show that this
measure delays recovery.
Stay as active as possible
Physiotherapist in
Janakpuri points out that the patient should maintain as much
activity as possible and try to normalize it as soon as possible.
Postural hygiene: Avoid overloading the back
During the painful episode, the
patient should try to keep the rhythm of activity within normal but, always
avoiding overloading the back.
To achieve this it is convenient
to know and apply postural hygiene rules, which describe how to
adopt postures and perform movements or efforts so that the back supports the
least possible load and the muscles reduce their work. This allows that,
if at any given moment the patient has to make an effort, he knows how to do it
reducing the risk of overcoming his possibilities.
"Whatever the reason,
studies agree that education focused on active management (avoiding
rest and maintaining the highest level of activity that pain allows) and
exercise (interrupting only in the most acute phase of pain and restarting
progressively as soon as possible) have an effect of a clinically relevant
magnitude and much greater than postural hygiene. In fact, it is
impossible to constantly comply with the rules of postural hygiene, but when
the musculature is trained and well developed, it does exercise its protective
function automatically and constantly, " physiotherapy doctor in
Dwarka adds.
When transmitting knowledge of
postural hygiene it is important to insist that these norms are only
theoretical coadjuvants in the context of active management and exercise and
never the essence of a treatment or prevention program. In addition, the
rules of postural hygiene have to be clear, understandable and applicable, so
that the method of transmission of knowledge is as important as its content.
Apply heat or cold
If relieved, the patient can
apply heat or cold in the painful area, although no scientific studies have
been done to evaluate its effect. In general, the cold is applied
immediately after the injury and the heat in the exacerbation of chronic
ailments.
Pharmacotherapy
It is applied in three phases:
- Phase 1 : In the beginning, and
especially if the pain is not very intense and only affects the back -and
there is no pain radiating to the arm or leg-, analgesics are
recommended .
- Phase 2 : If analgesics are not
effective, their replacement by nonsteroidal anti-inflammatory drugs
should be considered. In general, its use is not recommended more than
14 days in a row.
- Phase 3 : If it is not enough to control
pain, the specialist should consider adding a short course of muscle
relaxant, for less than 1 week.
Neuroreflexotherapy intervention (NRT)
If the back pain, with or without
irradiated pain, persists after 14 days of pharmacological treatment, it is
indicated to perform an NRT intervention.
It is also advised as an option
in those cases in which pharmacological treatment is contraindicated, such as
pregnant women.
If the first intervention NRT
achieves the total disappearance of the symptomatology and the normalization of
the physical examination, it is not necessary to repeat it unless in the future
new painful episodes reappear. In the event that a partial or transitory
improvement is achieved, it can be repeated until a complete and definitive one
is obtained. If it does not get any effect, it does not make sense to
intervene again.
Exercises
In patients who have not returned
to their usual activities after 6 weeks, an attempt should be made to begin an
exercise regimen & physiotherapy in Dwarka.
Initially they can try soft
and generic activities, such as walking or swimming, to avoid weakening the
musculature. Later, specific exercises for the back can be started.
Once the painful episode has
passed, exercise and postural hygiene reduce the risk of a crisis appearing or
reproducing.
Surgery
In patients in whom there are
specific selection criteria, in specific cases of disc herniation, spinal
stenosis or spondylolisthesis or progressive scoliosis in children or adolescents,
orthopaedic surgeon in Delhi
can assess the performance of a surgery.
Rhizolysis can be considered in a
small subgroup of chronic patients if they are selected very rigorously with
specific criteria.
No comments:
Post a Comment