Low Back Pain

Herniated nucleus pulpsus

Actual changes in the structure or mechanics of the lower part of the back may result in problems. Stress may tear fibers of the disk and result in an outward bulge of the enclosed nucleus pulposus. This bulge may press on spinal nerves and cause various symptoms, including nerve entrapment. What problem does this describe?

Spondylosis

Actual changes in the structure or mechanics of the lower part of the back may result in problems. What problem occurs from a stress fracture of the dorsal to the transverse process?

Spondylolisthesis

Actual changes in the structure or mechanics of the lower part of the back may result in problems. What problem occurs from one vertebrae slipping over another?

Sciatic (nerve root) pain

Actual changes in the structure or mechanics of the lower part of the back may result in problems. What problem occurs when the nerve is entrapped by a herniated disk?

Spinal stenosis

Actual changes in the structure or mechanics of the lower part of the back may result in problems. What problem occurs when there is narrowing of the intervertebral foramen which decreases the space where the spinal nerve exits or enters the spine?

Facet joint pain

Actual changes in the structure or mechanics of the lower part of the back may result in problems. What problems occurs from inflammation or changes in the spinal joint that cause pain?

Compression/stress fractures

Actual changes in the structure or mechanics of the lower part of the back may result in problems. What type of fractures are usually a result of osteoporosis and occur in the vertebrae?

Lower Back Pain

After the common cold, what condition is the most frequent cause of lost workdays in adults younger than 45 years.

It changes the lordosis, or curve of the lower part of the spine

How does movement of the pelvis affect the vertebral column?

A diagonal lift requires the lift to be performed with one foot in front of the other and one knee down on the ground. Keep the object close to the body and lift with the legs.

How should an individual with lower back pain perform an ergonomic and safe diagonal lift?

A golfer's lift requires bending at the waist while raising one leg behind to keep the spine in a neutral position.

How should an individual with lower back pain perform an ergonomic and safe golfer's lift?

While performing a squat, the client keeps the back straight while maintaining a neutral spine. Keep the object close to the body and lift with the legs. (The client's ability to perform a squat requires an absence of any knee or hip pathology)

How should an individual with lower back pain perform an ergonomic and safe squat lift?

Because repetitive loads applied to the lumbar intervertebral joint can lead to progressive tearing, fatigue, and ongoing disk prolapse. This balance helps to control the stresses involved in movement.

In regards to lower back pain, why is it important for the client to learn to balance muscular function and flexibility?

6 and 12

Lower back pain resolves within ______ weeks in 90% of clients. It resolves itself within ______ weeks in another 5%.

Relaxation techniques, deep breathing, meditation, prayer, guided imagery, avoiding frustration, managing angry feelings and negative thoughts, and participating in meaningful occupations that can help the client avoid stress that results in pain.

Stress can exacerbate lower back pain symptoms. What are examples of techniques to avoid or manage stress?

Five lumbar vertebrae

The lower back region is composed of which vertebraes?

* Education regarding normal back anatomy and the physiology of back movement as they relate to performance of occupations *Use of neutral-spine stabilization in occupational performance to reduce pain. *Education in basic body movements *Training in the use of adaptive equipment to modify tasks * Task analysis and use of ergonomic design to modify the environment. *Training in the use of energy conservation to maintain participation in occupation. *Use of occupations to increase strength and endurance *Education in strategies for pain management, stress reduction, and coping.

What are some examples of broad intervention plans to address lower back pain?

Reduction of pain, back stabilization techniques, use of adaptive equipment, and incorporation of body mechanics and ergonomics into client-specific areas of occupation, as well as the ability to adapt this learning to new occupations to prevent future problems.

What are some examples of client outcomes for an individual with lower back pain?

Poor conditioning, improper use of the back, obesity, smoking, age, and simple wear and tear over time

What are the common causes of lower back pain?

Long-handled sponges or brushes, reachers, long-handled shoehorns, sock aids, elevated toilet seats, hand-held adjustable shower heads, and footstools.

What are the most frequently recommended pieces of adaptive equipment for persons with lower back pain?

The squat, diagonal lift, and golfer's lift.

What are the safe and ergonomic lifting positions to teach clients with lower back issues?

Maintaining a straight back, bending from the the hip, avoiding twisting, maintaining good posture, carrying objects close to the body, lifting with the legs to promote safe performance, and using a wide base of support.

What concepts are addressed in a body mechanics client education session with regards to lower back pain?

Neutral position or neutral spine does not mean an absence of or no lordosis or curve of the lower part of the spine. It refers to the most comfortable spinal position for the client to complete movement patterns and then integrate this neutral position into daily occupations.

What is "neutral position" in reference to body mechanics and the vertebral column?

The structures act as shock absorbers and are relieved of pressure only when the body is supine

What is the function of the intervertebral disks of the vertebral column?

Impingement of the nerve as a result of narrowing of the foramen by arthritis or a disk problems

What lower back issue is associated with clients who prefer their "neutral position" in extension to relieve back pain?

Posterior spine problems such as facet pain

What lower back issue is associated with clients who prefer their "neutral position" in flexion to relieve back pain?

Movements such as bending, twisting, and reaching result in extension of the spine, and pressure on the disks may increase in one part of the back, whereas in another part of the back it may be under stretch.

What movements put forces on the vertebral column that could lead to lower back pain?

The abdominal muscles

What muscles act as a corset to support the lumbar area?

5%

What percentage of lower back pain is due to 'serious' spinal disease, inflammatory disease, and true nerve root pain

Planning ahead, pacing oneself, setting priorities, eliminating unnecessary tasks, balancing activity with rest, and learning one's limitations and activity tolerance.

What principles of energy conservation relate to individuals with lower back pain?

Vertebral body of the vertebrae

What structure is the weight-bearing component of the vertebral column?

Vertebrae and intervertebral disks

What structures make up the vertebral column?

Pedretti Pages: 1101 - 1108

What techniques should the client use to perform ADLs and IADLs when they have lower back pain?

Dynamic Lumbar Stabilization (DLS)

What therapy approach involves integration of the muscle groups that control movement of the spine and the abdominal muscles that support the back.

Anatomy, pathology, back stabilization, ergonomics, body mechanics, and pacing.

What topics should the therapist discuss with the client during a session for lower back education?

Between the vertebrae

Where are the intervertebral disks of the vertebral column located?