Mckenzie approach to back pain Flashcards
What suggests worsening pain/pain getting better?
Back pain becomes leg pain- getting worse
Leg pain goes to back pain- getting better
Bulging disc
Disc starts to move towards nerve
Starts with back pain
Bulging disc on the nerve
The more it squeezes the nerve, the further down the leg symptoms go
If leg symptoms rise- suggests disc is receding back towards the centre
Herniated disc
Nucleus polposus pushed out of annulus
Can lead to severe neurological symptoms- foot drop, difficulty walking
Pattern
Constant bending forwards- 3500 ties per day
Getting up from bed, putting on makeup, shaving etc
Bending forwards squeezes the nucleus and causes disc to bulge backwards so can aggravate symptoms
What causes radiating leg pain
Displaced nucleus polposus stimulating annulus or nerve root
What is the nucleus polposus?
Soft jelly in centre portion of discs
What is the annulus?
Exterior of the disc surrounding the nucleus polposus
Other causes of sciatica
Growth, bone spurs
Candidate for surgery
Use of core strengthening in LBP
Involved trunk flexion exercises
Does help strengthen core muscles
But involves further flexing of the spine
Slouching and ligaments
When slouching, the ligaments in the back elongate which bulges the disc backwards
Direction of preference
Moving the spine in directions that puts joints in the back, back in place
E.g. If extension eases pain, promote more motions in this direction throughout the day
Should do this in theory until the pain eases- normally pain increases at first then starts to ease
Avoid combining multiple exercises
Example
Cut on knuckle
Not going to bend the finger as it will open the cut and cause pain
So stop bending it to prevent pain and let it heal
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