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REHABILITATION OF COMMON PAIN SYNDROMES - Coggle Diagram
REHABILITATION OF COMMON PAIN SYNDROMES
LOW BACK PAIN
Common Causes
Postural – Most common
Trauma – Lumbosacral strain, # of lumbar vertebrae
Disc prolapse
Degenerative disease – Lumbar spondylosis
Structural lesions of spine – Spondylolisthesis, spondylolysis, spinal canal stenosis, Tumours
Inflammatory – Ankylosing spondylitis, Facetal joint arthritis
Metabolic – Osteoporosis
Others – Obesity, pregnancy occupational strain, etc.
Management
acute BP
absolute bed rest is essential.
Medical management
NSAIDs
Surgical:
Depending upon the cause of back pain
For example, in disc herniation percutaneous discectomy can be performed.
Postural advice
on sitting at work,
standing or
lifting.
PT management
acute BP
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NECK PAIN
Causes
Degenerative joint disease
Cervical muscle strain
Cervical spondylosis
Cervical disc prolapse
Cervical rib
Cervical Spondylolisthesis
Posture
cervical kyphosis
forward bent syndrome
double crush syndrome
Cervicobrachial neuralgia
Double crush syndrome:
This is a new term to signify radiating pain or pain at different locations along the course of a nerve due to an entrapment or irritation at two or more anatomical sites.
Cervicobrachial neuralgia:
The underlying pathology is often cervical spondylosis.
The symptoms are
neck stiffness,
pain radiating from neck down to the upper limb
segmental paresthesia of the neck, arm arm,fingers;
sometimes to the occipital region or the shoulder.
numbness or pin and needle sensation in the finger tips
deep tendon jerks slightly diminished.
Some patients find relief by placing the affected hands on their own head in an adducted and internally rotated position.
bakody's sign
Management
postural advise & neck care
soft cervical collar
butterfly pillow
work place modification
surgical
discectomy in cervical disk prolapse.
medical
NSAIDs
PT management
Electro modalities: cervical traction, IFT, SWD, US
Strengthening and stretching of the neck muscles.
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3.TENNIS ELBOW
Clinical Findings
tenderness at the common extensor origin from the lateral epicondyle
with pain also at the back of forearm.
Pain increases with resisted extension of the wrist in full elbow extension (Cozen Test)
Management
Conservative:
• Rest to the elbow (splinting may be used)
• Ultrasound to the common extensor origin.
• Local hydrocortisone infiltration.
• Stretching exercises to the wrist extensor at a later stage.
Surgical
In severe pain lasting more than 6 weeks and not responding to conservative treatment,
release of the attachment of muscles to the epicondyle may be indicated