haldemann (1977) 26 causes whyke (1976) 20 categories introduction
TRANSCRIPT
![Page 1: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/1.jpg)
![Page 2: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/2.jpg)
![Page 3: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/3.jpg)
![Page 4: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/4.jpg)
Haldemann (1977) 26 causes
Whyke (1976) 20 categories
IntroductionIntroduction
![Page 5: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/5.jpg)
BACK ACHE BACK ACHE
DR.BHARAT PATEL M.S.(Ortho)
SAMVED HOSPITAL
DR.BHARAT PATEL M.S.(Ortho)
SAMVED HOSPITAL
![Page 6: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/6.jpg)
IntroductionIntroduction
Hazleman and Bulgar (1979)
Disc prolapse over diagnosed
![Page 7: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/7.jpg)
IntroductionIntroduction
Moorey and Robertson
Benign lumbar pain syndromes
![Page 8: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/8.jpg)
Classification of low back pain
Classification of low back pain
Spondylogenic back pain
Neurogenic back pain
Viserogenic back pain
Vascular back pain
Psychogenic back pain
![Page 9: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/9.jpg)
CAUSES OF BACK PAINCAUSES OF BACK PAIN
![Page 11: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/11.jpg)
![Page 12: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/12.jpg)
![Page 13: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/13.jpg)
![Page 14: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/14.jpg)
![Page 15: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/15.jpg)
Causes of back painCauses of back pain
Poor Posture
Disturbed normal
“natural S” shape of
spine leads to back
pain.
![Page 16: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/16.jpg)
Causes of back painCauses of back pain
Out of Shape
Your overall physical condition can affect your back.
![Page 17: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/17.jpg)
Causes of back painCauses of back pain
Tension and Stress
![Page 18: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/18.jpg)
Causes of back painCauses of back pain
Aging and Disease
Loss of muscle strength with aging.
“slip disc”
Osteoarthritis, a form of aging arthritis, can cause back pain.
![Page 19: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/19.jpg)
Causes of back painCauses of back pain
Impact Trauma
![Page 20: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/20.jpg)
Causes of back painCauses of back pain
Obesity
![Page 21: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/21.jpg)
Causes of back pain
![Page 22: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/22.jpg)
Adolescent acute backAdolescent acute back
12 to 14 yrs in girls
14 to 16 in boys
Disc space infection
Herniated lumbar disc
Spondylolysis or lysthesis
![Page 23: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/23.jpg)
Lumbar InstabilityLumbar Instability
The tall young man
House wife
Post surgical patient
The keep-fit enthusiast
Young man in his 20’s with undetected lumbar
osteochondrosis.
Mature woman between 40-50 with degenerative
spondylolisthesis.
![Page 24: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/24.jpg)
The man fearful of his backThe man fearful of his back
Over 40 and in past years suffered probably a
minor episode of back pain.
Because of this temperament, combined at the
time with a strongly worded caution from his
doctor to take care, the patient has lost all
confidence in the health and durability of the
low back.
![Page 25: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/25.jpg)
Time dependent back acheTime dependent back ache
Particular movement aggravates the pain.
Particular time aggravates pain – rising in the morning.
![Page 26: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/26.jpg)
Over stressed labourers backOver stressed labourers back
Strong solidly built man
Farmer
No sciatica
Insidious onset
![Page 27: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/27.jpg)
The Equinox SyndromeThe Equinox Syndrome
Severe leg pain limb cold
Feel of numbness
Unless the neurological involvement is
multiradicular, normal muscle power regained
in 10 wks.
![Page 28: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/28.jpg)
Spinal stenosisSpinal stenosis
Congenital stenosis.
Acquired stenosis – facet joint arthrosis,
ligamentum flavum thickening, disc trespass,
posterior vertebral lipping, spondylolisthesis,
venous congestion, isolated disc resorption,
degenerative stenosis, disc prolapse.
![Page 29: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/29.jpg)
Chair bound back acheChair bound back ache
40 year old physically active in the past, but
risen professionally to assume
responsibility which entail much
administrative work.
Obese.
Lumbar stiffness on rising in the morning.
![Page 30: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/30.jpg)
Low back pain in pregnant womenLow back pain in pregnant women
50% of the pregnant women.
Sweden is the highest 70% (9 wks of sick leave).
Common with multiparus women.
Mechanism :
Increased lumbar lordosis.
Hormone relaxing.
![Page 31: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/31.jpg)
How to prevent by exercise programmeHow to prevent by
exercise programme
Before pregnancy & during 1st trimester.
Can be continued in 2nd and 3rd trimester.
![Page 32: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/32.jpg)
Low back pain in childrenLow back pain in children
Rare complaint.
Often illusive – Delayed diagnosis because of rarity.
Must be investigated.
Causes :Mechanical DevelopmentalInflammatoryNeoplasticTethered cordPsychogenic
![Page 33: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/33.jpg)
Sports related low back ache
![Page 34: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/34.jpg)
Collapsed back with kissing spineCollapsed back with kissing spine
Women in late middle age
Lumbar ache on standing
Degenerated all joints
![Page 35: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/35.jpg)
DISORDERS OF IV DISCDISORDERS OF IV DISC
![Page 36: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/36.jpg)
![Page 37: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/37.jpg)
Backache Leads To……
Pain
Disability to pursue activities of daily leaving
Absenteeism
Sexual dysfunction
Financial and psychological set back
![Page 38: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/38.jpg)
Diagnosis of back painDiagnosis of back pain
Physical Examination&
Investigations
![Page 39: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/39.jpg)
Diagnosis of back painDiagnosis of back pain
Physical Examination
![Page 40: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/40.jpg)
Diagnosis of back painDiagnosis of back pain
Investigation :• Blood Ix
• Radiological Ix
- Plain X-ray- Myelography- CT scan- MRI
![Page 41: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/41.jpg)
Management of back painManagement of back pain
Conservative Treatment
Operative Treatment
Preventive Treatment
![Page 42: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/42.jpg)
Conservative treatmentConservative treatment
Medicines
Pain killers
Muscle
relaxants
Vitamins
![Page 43: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/43.jpg)
Conservative treatmentConservative treatment
Bed rest
![Page 44: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/44.jpg)
Conservative treatmentConservative treatment
Physiotherapy
Activity modification
![Page 45: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/45.jpg)
Conservative treatmentConservative treatment
Manipulation of back
![Page 46: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/46.jpg)
Conservative treatmentConservative treatment
–Orthosis- (belts)
![Page 47: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/47.jpg)
Conservative treatmentConservative treatment
Weight reduction
![Page 48: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/48.jpg)
Conservative treatmentConservative treatment
Injection therapy( epidural steroids)
![Page 49: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/49.jpg)
Operative treatmentOperative treatment
![Page 50: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/50.jpg)
Operative treatmentOperative treatment
WHY
WHEN? ?
WHERE
?
![Page 51: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/51.jpg)
Preventive TreatmentPreventive Treatment
DO’S & DON’TSDO’S & DON’TS
![Page 52: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/52.jpg)
Preventive treatmentPreventive treatment
While working in standing position, use a small stool under one foot to avoid back strain.
![Page 53: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/53.jpg)
Preventive treatmentPreventive treatment
While carrying weights, divide the load into two equal halves
![Page 54: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/54.jpg)
Preventive treatmentPreventive treatment
Always climb up to bring heavy object from height. Avoid stretching your back.
![Page 55: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/55.jpg)
Preventive treatmentPreventive treatment
Sit with back straight & well supported while doing work. Avoid stooping.
![Page 56: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/56.jpg)
Preventive treatmentPreventive treatment
Reduce weight keep slim &
active
![Page 57: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/57.jpg)
Preventive treatmentPreventive treatment
Always carry weight near the body.
![Page 58: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/58.jpg)
Preventive treatmentPreventive treatment
After a heavy day at work A good way to rest your back
Correct sleeping posture
A firm mattress, A small pillow under head & neckA small bolster under the knees
![Page 59: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/59.jpg)
Preventive treatmentPreventive treatment
Simple exercises to keep the back fit
![Page 60: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/60.jpg)
Preventive treatmentPreventive treatment
Follow this posture & avoid back, neck & shoulder pain
Reduce brightness to avoid strain
Elbow support
Back support
Low back support
Correct distance between table and chair
Foot support
Correct table height
![Page 61: Haldemann (1977) 26 causes Whyke (1976) 20 categories Introduction](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649db15503460f94aa0c24/html5/thumbnails/61.jpg)
THANK YOUTHANK YOU