Acute Low Back Pain

Acute Low Back Pain


Acute low back pain treatment requires the practitioner to determine which motion or position decreases the patient’s symptoms.

Lumbar radiculopathies are commonly due to nerve impingement by facet joint dysfunction, spasm of the piriformis muscle, and degenerative pathologies such as spinal stenosis. These symptoms often lessen when the patient is in a more flexed position, also called a flexion bias. When symptoms are due to lumbar disc dysfunction and protrusion, the patient’s symptoms improve when they lean backward and extend the spine. This is called an extension bias.

The muscles involved in maintaining the lower back’s stability include the psoas, quadratus lumborum, abdominal muscles, latissimus dorsi, paraspinal and oblique muscles (Figure 10-1). These muscles, often called “the core,” contract to help stabilize the spine. When these muscles are appropriately engaged, they dissipate the stresses on the spine.

Figure 10-1 • Muscles involved in the lower back’s stability. (Reprinted from Moore KL, Agur AM, Dalley F. Essential Clinical Anatomy. 5th ed. Baltimore: Wolters Kluwer; 2014 with permission.)

Figure 10-2 • Muscles of the hip that can contribute to back pain. (Reprinted from Archer PA, Nelson LA. Applied Anatomy & Physiology for Manual Therapists. Baltimore: Wolters Kluwer; 2012 with permission.)

Improving range of motion of these muscles and the joints they serve is referred to as joint mobilization. Providing manual techniques to joints with limited movement promotes joint mobilization, decreases pain, and improves range of motion.

Dysfunction of other muscle groups that contribute to supporting the back can also lead to back pain. Tightness of the muscles of the hip (iliacus, piriformis, rectus femoris) can cause back pain and sciatica (Figure 10-2). Weakness of the core muscles, such as the abdominal muscles and obliques, may cause instability around the spine and lead to pain symptoms.

The goal of treating acute low back pain is to move the patient to a posture that reduces their pain and helps regain conscious control of their core muscles.

Oct 19, 2020 | Posted by in MEDICAL ASSISSTANT | Comments Off on Acute Low Back Pain

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