acute thoracic back pain

[Lachlan]

Often there are conditions which require time before physiotherapy exercises are effective.

From what you have described the patient would be too irritable to start moving around doing assessments. Pushing on their back or giving them exercises would most likely just aggravate their symptoms even more.

If i were to encounter that my advice would be:

-The patient should speak to doctor about more pain medications (anti inflams and muscle relaxants have evidence for acute back pain)

- Heat packs- May reduce some muscle spasm, unlikely to go deep enough to actually exacerbate any inflammation.

-Light soft tissue massage (if not too irritable and able to lay on their stomach, or even on their side if appropriate).

Im sure in a few days time the pain levels and irritibility would have settled to help you make an accurate diagnosis and treatment from there on out.

[thabiso]

Sometimes its difficult to go in and work on an area with cases of very bad pain. And I do agree, get a bit of reduction in the pain/irritability first. Cold (acute) or heat, IFT, or a gentle massage. That should allow you to get in and be more effective in your assessment and later treatment. The patient may benefit from a thoracolumbar support also (though I am not a fan for their continued use for too long-once they are over the initial bad pain curve I feel they should use it but rather develop good core stability)

all the best