Recovering From Acute Low Back Pain. General Instructions

You have recovered from the acute episode because of your ability to master the exercises which relieved your pain. These exercises must be repeated whenever situations arise which have previously caused pain. You must perform the corrective movements before the onset of pain. This is essential.

If you carry out the following instruction, you can resume your normal activities without the fear of recurrence.

SITTING

  • When sitting for prolonged periods the maintenance of the lordosis is essential. It does not matter if you maintain this with your own muscles or with the help of a supportive roll, placed in the small of your back.
  • In addition to sitting correctly with a lumbar support, you should interrupt prolonged sitting at regular intervals. On extended car journeys you should get out of the car every hour or two, stand upright, bend backwards five or six times, and walk around for a few minutes.
READ:   Spine Health. PROCEDURE 8 — EXTENSION MANIPULATION

BENDING FORWARDS

  • When engaged in activities which require prolonged forward bending or stooping — for example, gardening, vacuuming, concreting — you must stand upright, restore the lordosis and bend backwards five or six times before pain commences.
  • Frequent interruption of prolonged bending by reversing the curve in the low back should enable you to continue with most activities you enjoy, even with some you do not enjoy.

LIFTING

  • If the load to be lifted weighs over thirty pounds, the strain must be taken with the low back in lordosis and you must lift by straightening your legs.
  • If the object weighs under thirty pounds less care is required, unless you have been in a bent or sitting position for some time prior to lifting. In the latter case you must lift as if the weight exceeds thirty pounds.
  • In addition to correct lifting technique, you must stand upright and bend backwards five or six times after lifting.
READ:   PAIN AND ITS TREATMENT MODELS

RECURRENCE

  • At the first signs of recurrence of low back pain you should immediately start the exercises which previously led to recovery, and follow the instructions given for when in acute pain.
  • If this episode of low back pain seems to be different than on previous occasions, and if your pain persists despite following the instructions, you should contact a manipulative therapist.

REMEMBER

  • If you lose the lordosis for any length of time, you are risking recurrence of low back pain.
PAIN AND ITS TREATMENT MODELS Pain affects everyone at one time or another. Many diseases and disorders of the human body are accompanied by pain. It is feared by many people, as much as or more than the disease itself. What is pain? What purpose, if any, does it serve? What happens in the body when a person feels pain? How is pain assessed? What are the different types of pain? Can pain be treated? If so, how? These are some of the questions addressed in this chapter. Pain is an expanding science, and an increasing number of specialty clinics are emerging. The International Association for the Study of Pain (IASP) identifies the following four models for pain treatment: Single service clinics are normally outpatient clinics providing specific pain treatment with the goal to reduce pain. These do not provide comprehensive assessment or management. Examples include a nerve block clinic and a biofeedback clinic. Pain clinics also are outpatient, but their focus is mainly on diagnosis and management of indivi...
ASSESSMENT OF PAIN Pain gives the body warning and often is accompanied by anxiety and the need to relieve the pain. Pain is both sensation and emotion. As noted earlier, it can be acute or chronic. Health-care professionals may find the following mnemonic tool useful for assessing a client in pain: P = place (client points with one finger to the location of the pain) A = amount (client rates pain on a scale from 0 to 10 ) I = interactions (client describes what worsens the pain) N = neutralizers (client describes what lessens the pain) The scale of 0 to 10, as described in the mnemonic, is a useful method of assessing pain. Further pain assessment skills include observing the client’s appearance and activity. Monitoring the client’s vital signs may be of value in assessing acute pain but not necessarily chronic pain. To assess the pain of children or those with some cognitive dysfunction or dementia, a “smiley face” model often proves beneficial. The first smiley face shows a happy face...
Spine Health. PROCEDURE 13 — FLEXION IN LYING The patient lies supine with the knees and hips flexed to about forty-five degrees and the feet flat on the couch. He bends the knees up towards the chest, firmly clasps the hands about them and applies overpressure to achieve maximum stress. The knees are then released and the feet placed back on the couch. The sequence is repeated about ten times. The first two or three flexion stresses are applied cautiously, but when the procedure is found to be safe the remaining pressures may become successively stronger, the last two or three being applied to the maximum possible. Fig. Flexion in lying. Effects: Flexion in lying causes a stretching of the posterior wall of the annulus, the posterior longitudinal ligament, the capsules of the facet joints, and other soft tissues. As the movement takes place from below upwards the lower lumbar and lumbo-sacral joints are placed on full stretch at the beginning of the exercise as soon as movement is initiated. Thus, the procedure is very i...
WHAT IS PAIN? Definition of Pain In dictionaries, pain (ICD-9: 780.96) is defined as a sensation of hurting or of strong discomfort in some part of the body, caused by an injury, a disease, or a functional disorder and transmitted through the nervous system. A nurse, Margo McCaffery, who worked for years with clients in pain and conducted extensive research in the field of pain, defines pain as whatever the experiencing person says it is, existing when he or she says it does. This definition is perhaps the most useful because it acknowledges the client’s complaint, recognizes the subjective nature of pain, and implicitly suggests that diverse measures may be undertaken to relieve pain. The IASP and the American Pain Society (APS) define pain as an unpleasant sensory and emotional experience arising from actual or potential tissue damage or described in terms of such damage. Again, this definition further confirms the multiple components of pain in a person’s psychological and physiological exist...
Spine Health. PROCEDURE 3 — EXTENSION IN LYING The patient, already lying prone, places the hands (palms down) near the shoulders as for the traditional press-up exercise. He now presses the top half of his body up by straightening the arms, while the bottom half, from the pelvis down is allowed to sag with gravity. The top half of the body is then lowered and the exercise is repeated about ten times. The first two or three movements should be carried out with some caution, but once these are found to be safe the remaining extension stresses may become successively stronger until the last movement is made to the maximum possible extension range. If the first series of exercises appears beneficial, then a second series may be indicated. More vigour can be applied and a better effect will be obtained if the last two or three extension stresses are sustained for a few seconds. It is essential to obtain the maximum elevation by the tenth excursion and once obtained the lumbar spine should be permitted to relax into the most extreme ...