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NEUROREHABILITATION IN
LOW BACK PAIN SYNDROME
ISCHEMIA
SPASM PAIN
MANAGEMENT LOW
BACK PAIN
RECOMMENDATION
OF AMERICAN
COLLEGE OF 7 recommendations.
PHYSICIANS AND
THE AMERICAN PAIN Take a look the 7Th
Recommendation
SOCIETY
RECOMMENDATION OF AMERICAN COLLEGE OF PHYSICIANS AND
THE AMERICAN PAIN SOCIETY : TREATMENT OF LOW BACK PAIN
Exercise therapy
Manipulation/mobilisation
Physical modalities
Back schools and brief educational
nterventions/advice to promote self-care
Neuro- (Consider back schools where information given
is consistent with evidence-based
rehabilitation recommendations for short-term (<6 weeks)
technique
pain relief and improvements in functional status)
Cognitive-behavioural treatment for patients with
chronic low back Pain
Multidisciplinary biopsychosocial rehabilitation
with functional restoration for patients with
chronic low back pain who have failed
monodisciplinary treatment options.
Prevention Strategies
Exercise and
strengthening exercises
Weight loss?
Smoking cessation?
Improvement of
strenuous and stressful
working conditions
Back braces are
ineffective in prevention
14
Posture
BIOMECHANICS
PROPER BODY MECHANICS
REHABILITATION OF LOW
BACK PAIN
1. Haemodinamik effects
vasodilatation
improve tissue oxygenation
2. Metabolic effect
Improved enzym activity
3. Neuromuscular
decreased pain perception comfort feeling
4. Soft tissue
improved flexibility
Diathermy
Kisner Carolyn in
Therapeutic Exercise,
2002
Spine Exercise
• Core Stabilization
The primary functions of the muscle of the trunk are to provide
the stabilizing force ( core stability) against the effect of grafity so
that up right posture can be maintained
Kisner Carolyn in
Therapeutic Exercise,
2002
BACK EXERCISE
BACK EXERCISE
Low Back Flexion
Exercises
Hayden JA et al, 2005, systematic review:
◦ Exercise therapy that consists of individually
designed programs, including stretching or
strengthening, and is delivered with
supervision may improve pain and function in
chronic nonspecific low back pain.
Kisner Carolyn in
Therapeutic Exercise,
2002
FELDENKRAIS
FELDENKRAIS
FELDENKRAIS
FELDENKRAIS
FELDENKRAIS
FELDENKRAIS
FELDENKRAIS
Muscle Performance
Goal :
1. Activate and develop neuromuscular
control of spinal stabilization muscle
2. Develop strength and endurance in
the postural and stabilizing muscle.
Kisner Carolyn in
Therapeutic Exercise,
2002
BRACING
Short term:
◦ May enhance the patient’s feeling stability and
prevent joint motion to decrease the patient’s
pain
Long term:
◦ Deconditioning of the surrounding musculature,
contracture of the joint capsule and loss of
bone density
LUMBO-SACRAL ORTHOSE