Age: 45 years old

Gender: Female

Occupation: Office Worker

Improper Body mechanics

Overstretching of the back

Suddenly caused injury

Muscle responds to the injury

by contraction

Tearing and elongation of

muscles on ligaments

Ligaments are torn form their

attachments

Lumbar spine strained/sprained

Soft tissues become inflamed

Pain in the back

Muscle Spams

Affects the facet joint

It is now innervated and

contains free encapsulated
nerve endings

Local pressure occur

Activates the C fiber and Adelta fibers

Increase the level of the basic
fibroblast growth factor

Promotes the repair of the

affected site

Slowly gradually resolves

NSAIDS: Ibuprofen
Analgesic:
Paracetamol
Proper use of body
Mechanics
Massage
Neuroreflexotherapy

1. Acute pain related

to sprained spine
Encourage patient to assume
position of comfort if indicated.
Provide backrub massage, as
necessary
Demonstrate and encourage
use
of
relaxation
skills like deep
breathing,
visualization.
Administer analgesics and
NSAIDS, as indicated to
relieve pain.
Instruct to use proper body
mechanics to avoid further
injury.

2. Ineffective Role
Performance related to
acute pain
Involve client in planning care and
scheduling activities. This is to
enhance feelings of competency
and self-worth and encourages
independence and participation in
therapy.
Give positive reinforcement for
accomplishments. Allows client to
feel good about self. Reinforces
positive
behavior.
Enhances
confidence.
Set limits on maladaptive behavior.
Assist client to identify positive
behaviors that will aid in coping.
It helps client maintain self-control,
enhancing self-esteem.

3. Deficient knowledge
related to proper body
mechanics to protect
the back
Discuss return to activities,
stressing
importance
of
increasing as tolerated.
Encourage development of
regular
exercise
program
(walking, stretching).
Discuss importance of good
posture and avoidance of
prolonged standing and sitting.
Recommend sitting in straightbacked chair with feet on a
footstool or flat on the floor.
Encourage lying-down rest
periods, balanced with activity

Joan is a 45-year old office worker who re-presents to you with persistent lower back pain. She initially
presented 3 weeks ago with acute onset of severe pain after lifting a heavy weight box. Her pain has
improved but not resolved. Sitting for long periods and household exacerbate her pain. Joan is worried
that her back pain might get any worse. Sought consultation and upon assessment there were no spinal
deformity noted, straight legs is normal and no neurologic abnormalities noted but there was diffuse
tenderness of her lower back. Given NSAIDS and advised to take rest for a week. Proper body
mechanics was recommended.

Nursing Diagnosis
Disease Process
Signs and Symptoms

Legends
Medical Management
Predisposing
Precipitating