Acute back Pain Patient Advice

[junior_physiotherapist]

Stretching: The goal of stretching exercises, as their name suggests, is to stretch and improve the extension of muscles and other soft tissues of the back. This can reduce back stiffness and improve range of motion.
Aerobic: Aerobic exercise is the type that gets your heart pumping faster and keeps your heart rate elevated for a while. For fitness, it is important to get at least 30 minutes of aerobic (also called cardiovascular) exercise three times a week. Aerobic exercises work the large muscles of the body and include brisk walking, jogging, and swimming.

[junior_physiotherapist]

For back problems, you should avoid exercise that requires twisting or vigorous forward flexion, such as aerobic dancing and rowing, because these actions may raise pressure in the discs and actually do more harm than good. In addition, avoid high-impact activities if you have disc disease. If back pain or your fitness level makes it impossible to exercise 30 minutes at a time, try three 10-minute sessions to start with and work up to your goal. But first, speak with your doctor or physical therapist about the safest aerobic exercise for you.
Medications: A wide range of medications are used to treat chronic back pain. Some you can try on your own. Others are available only with a doctor’s prescription.

[C1086]

Thank you very much for your message. My question is really what sort of things do you advise a patient in acute pain to do so they don't get worse. For instance you have just treated them and they go home, then what do they do ?? Contrast bathing is fine, but what else would you recommend ? Eg it is generally agreed not to spend ages in bed, but supposing the patient is really acute, all they want is to get better and fast, what would you recommend they do to speed up there recovery and get better quicker.
Anyone else out there have any pearls that they find really helpful in this type of situation.
C1086

[sdkashif]

There has been already a lot of discussion on the topic of back pain with general over view for planning effective treatment strategies. When a patient comes to you to get help from physiotherapist, it is the resposnsibility of the physiotherapist to assess him properly to find out the possible cause for pt's back pain or spinal pain. In however, majority of the cases it is not possible to find the exact cause of low back pain. In other words after ruling out the red flags and yellow flags for Spinal pain or ruling out the serious causes of spinal pain, it is always clinician responsibility to find a possible cause for pt's pain. But as I have already mentioned that a possible cause is not found in majority of cases and patient back pain is labelled as acute non specific Back pain in acute cases. The acute non specific Back pain accounts for almost 80% cases of back pain. There are many empirical rules to treat this non specific back pain. The rest of 20% cases of Back may have other causes to be indentified and labelled in pt's treatment plan, so here you will be able to plan any suitable physiotherapy management plan. The best plan here is to use the evidence based guidelines of physiotherapy that you may use effectively. For you as a beginner, it is better to have a look over Danish Health and technology Guidelines which are very empirical and effective. You may have a look over them at Danish Health Technology Assessment 1999; 1(1) Low Back Pain

Another effective source of information for you is EUROPEAN GUIDELINES FOR THE MANAGEMENT OF ACUTE NONSPECIFIC LOW BACK PAIN IN PRIMARY CARE

Another good review is the norwegian Guidelines and you may have a look over that Acute low back pain-Interdisciplinary clinical guidelines developed by The Norwegian Back Pain Network

You may also have a look over the Gudelines developed in the USA at USA - Department of Health and Human Services, Agency for Health Care Policy and Research, Acute Low Back Problems in Adults; AHCPR Publication No. 95-0642

In my opinion this will help you to start as a beginner to get a better idea.

[C1086]

Thank you very much for those references. They are excellent and will be usefull. But what I really want to know is what do you tell your acutely painful patient while in your treatment room, what to do after his treatment when he gets home.
European Guidelines are not much immidiate help to him at this moment in time, all he wants is to be out of pain, as much as possible for as long as possible. Should he do exercises (which ones ?), should he go for a swim, should he go home and do nothing etc etc

Happy New Year

C1086

[junior_physiotherapist]

Hi colleague:

i'll give u this link and i think it'll help u ,really it's very interisting link


www.spine-health.com/topics

hope to be useful

all best