Oh my back

8/10/2019 Oh my back

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Oh my back!Low back pain and its management


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What structures make up the back?

The spine consists of four main areas

Cervical (C1-C7)

Thoracic (T1-T12) Lumbar (L1-L5)

Sacrum/coccyx


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Statistics

LBP ranked highest in terms of disability (YLDs) inthe Global Burden of Disease 2010 research

It ranked sixth in terms of overall burden,measured in disability adjusted life years (DALYs)

Globally, 1 in 10 people had LBP

Prevalence is almost equal among men andwomen (10.1 vs 8.7%) and is highest in WesternEurope.

Occurs most frequently between ages 30 and 50.


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Statistics

Back pain treatments cost the NHS around 1billionper year

Lost production as a result of LBP is estimated tocost at least 3.5 billion per year.

90% of acute back pain resolves in 6 weeks

More than 13,000 back pack-related injurieswere reported amongst US school children in2000.


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Symptoms

Depending on the cause, symptoms canvary

Dull, sharp or burning

Felt at a single point or over a broad area

Occurs suddenly or comes on gradually

Occurs with spasms or stiffness

Associated leg symptoms such as pain,

numbness or tingling


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Low Back Pain (Lumbago)

Back pain is a common problem thataffects most people at some point intheir life. It usually feels like an ache,tension or stiffness in your back.

Classifications:

Acuteless than 6 weeksSub-Acute6 to 12 weeks

Chronicmore than 12 weeks


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Red Flag Symptoms

History of cancer

Progressive motor or sensory deficit

Prolonged steroid use, IV drug use

Major trauma

Numbness in groin/saddle

Bilateral leg weakness

Fever and chills Unrelenting severe pain with rest

Loss of bowel or bladder function


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Cauda Equina

A serious problem that can occur if thenerves at the end of the spinal cord aresqueezed

Seek emergency treatment if youexperience any red flag Symptoms


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Causes of Back Injuries

Most back injuries can be attributed toone of these five causes

Poor posture Improper body mechanics/work habits

Stressful living

Loss of flexibility

Poor conditioning/overweight


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Your back went out because

your front went out.


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Obesity

World Health Organization (WHO)

Overweight: BMI 25-29

Obese: BMI 30 and above

By 2015: 700 million will be obese

Overweight and obesity lead to serioushealth consequence

Cardiovascular disease

Diabetes

Musculoskeletal disorders

Some cancers


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Diagnostic Testing

Physicians will not generally orderdiagnostic tests in the first six weeks of

low back painMost of the time, the causes for back

pain cannot be found by x-ray, CT scanor MRI


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The intensityof the pain

does not equal theseverityof the injury


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Potential Disk Problems

Degenerated disks

Thinning disks

Bulging disks

Herniated disks

Osteophyte (bone

spur) formation


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Why does back pain seem

to always come back?

The disks between our vertebrae act likeshock absorbers

When disks are injured from either wearand tear or a sudden force, they areunable to repair themselves very wellbecause they lack the rich blood supply

needed for healing


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Sciatica

Set of symptoms - not a disease in itself

When the sciatic nerve is irritated or

compressedCauses shock like or burning low back

pain that can extend down to the foot

Extreme cases can cause loss of motor

control


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Sciatica


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Sciatica Treatment

Self care under a doctors care

Chiropractic

Prescription medications

Epidural steroid injections

Physical therapy program


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Piriformis Syndrome

Muscle that runsabove the sciaticnerve.

When the musclebecomes tight,causes sciatica likepain down the leg

Prolonged sitting,car accidents, falls


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Piriformis Syndrome

Treatment Stretching- #1 treatment

Physical therapy

Massage therapy

Anti-inflammatory medications

Temperature treatments


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Spinal Stenosis

Congenital or age related narrowing of the spinalcanal


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Spinal Stenosis

Risk of developing increases after 50years of age, severity can increase with

age Treatments include

Pilates or yoga to stretch and strengthen thespine.

Physical therapy

Epidural steroid Injections


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Spondylosis

Spinal arthritis

Can allow for a forward

slippage of the vertebraeonto the vertebrae belowit


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Helping prevent spinal

osteoarthritis Stay ahead of the

game!

Get up and go!

Cut the fat!

Sit smart

Stand smart too!

Save those joints

Only eat the goodstuff

Kick the habit, dont

smoke!

No pain, all gain!

Be good to yourself


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Muscle Strains

The majority of back pain is caused by musclestrains

Usually heals with conservative treatments andtime

Muscles in the lower back have an excellentblood supply bringing it the necessary nutrientsfor healing to occur


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Medications

Over the counter

Acetaminophen, ibuprofen, aspirin

Narcotic pain relievers Not recommended for long term use

Tramadol, Oxycodone, Hydrocodone,Codeine

Muscle relaxants Treats muscle spasms

Tizanidine, Lorazepam, Baclofen, Dantrolene


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Treatment Options

Exercise

Temperature treatments

Physical therapy

Chiropractic

Acupuncture

Massage therapyWater therapy


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Did you notice surgery was not included?


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Exercise and Low Back Pain

The natural stimulus for healing process is activeexercise

The majority of people do not get enoughexercise from daily activities to support theirlower back muscles.

While some of these muscles are used ineveryday life, a complete exercise program foroptimal lower back health is needed


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The doctor said he needed moreactivity. So I hide his TV remote

three times a week


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Healthy Living

Exercise regularly

Maintain or achieve a healthy weight

Regular core strengthening exercises

Eat healthy, drink plenty of water

Practice good body mechanics

Good quality sleep


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Body Mechanics


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Sleeping Easier with Back

Pain No perfect position for everyoneListen

to your body

Pillow between your legs Firmer mattress

Egg crate or pillow top if it helps

Good sleep routine


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Easing back pain during

sleep


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Four things to take away

Chances are you will experience backpain at some point in your life

Expensive diagnostic tests cannotalways identify the cause of your pain

There is no quick fix

Establish a healthy lifestyle

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Oh my back