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TREATMENT OF LOW BACK PAIN BY PHYSIOTHERAPY

Now a day’s low back pain is one of the most common health problems of Bangladesh. Physiotherapy treatment is the best effective treatment for low back pain without any side effect or any surgery.
Physiotherapy treatment for low back pain can be done by the combined application of electrotherapy modalities and manual therapy .Patient education and posture correction is also a part of treatment.
Electrotherapy modalities which can be used for treating LBP includes SWD(SAHORT Wave Diathermy), MWD(Micro Wave Diathermy) , TENS(Transcuteneous Electric Nerve Stimulation), IRR(Infra Red Radiation), Pelvic Traction etc.

Physiotherapy programs that are designed to treat low back pain and some radicular pain (pain radiating down the leg) includes a combination of the following types of exercises:

Stretching:
Proper stretching of the muscles along with active exercise will help maintain normal range of motion and provide relief for muscles that are often suffering disuse atrophy (shrinking muscles from lack of use) or in spasm from inappropriate posture or nerve irritation. For many patients it is best to follow a stretching routine that has been individually designed for them by a physical therapist or a spine physician. As a general rule, low back pain patients should focus on stretching the lower back muscles, abdominal muscles, hips and legs. The patient should never bounce during stretching, and all stretches should be slow and gradual.

Dynamic stabilization exercises:
These exercises involve the use of a variety of exercises and may include use of exercise balls, balancing machines or specific stabilizing exercises. The point of dynamic stabilization exercise is to strengthen the secondary muscles of the spine and help support the spine through various ranges of motion.

Core strengthening exercises:
These are specific exercises to strengthen the abdominal muscles and low back muscles (erector spinae) to provide the aforementioned ‘belt of muscle’ around the spine. These exercises typically include:

• Specific abdominal strengthening, such as sit-ups, crunches, abdominal machines, and leg raises.
• Low back exercises (hyperextensions), which can be performed on machines or by simply lying on the stomach and slowly raising the chest off the ground. This exercise utilizes the lower back muscles to ‘hyperextend’ the spine.
• ‘Good-mornings’ are also an exercise to strengthen the lower back muscles. This exercise requires the patient to stand with legs straight and shoulder width apart, with a broom-stick or weighted bar across the shoulders. The patient then slowly bends forward until the face is parallel to the floor and then raises back up. Very similar to just bending to
touch the toes except there is weight across the shoulders.
Some patients with low back pain are successfully treated with physiotherapy but then return a year or two later with the exact low back problem. Most often the patient strengthens the abdominal muscles and low back muscles during physiotherapy and subsequently takes the stress off the low back. After physiotherapy, the patient does not maintain the abdominal and low back exercise program at home, leading to a slow loss of fitness in the trained muscles and possibly eventual low back problems. Thus, it is highly recommended that once a patient is treated successfully with physiotherapy, he/she develops an exercise maintenance program at home to help sustain the strength and muscle mass that was developed by physiotherapy treatment.BACK PAIN

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