Low Back Pain

BY
DR. RAVI SHANKAR REDDY, PHD,PT
Assistant Professor
Dept. of Medical Rehabilitation
College of Applied Medical Sciences
King Khalid University
 ‫ﻣﻘدﻣﺔ‬

Introduction
.‫أرﺑﻌﺔ ﻣن ﻛل ﺧﻣﺳﺔ أﺷﺧﺎص ﻓﻲ اﻟﻌﺎﻟم ﺷﮭدوا آﻻم أﺳﻔل اﻟظﮭر ﻓﻲ ﻣرﺣﻠﺔ ﻣﺎ ﻣن ﺣﯾﺎﺗﮭم‬

• Four out of Five people in the world will

experience low back pain at some point in
their lives.
.‫وھو واﺣد ﻣن أﻛﺛر اﻷﺳﺑﺎب ﺷﯾوﻋﺎ ﺑﯾن اﻟﻧﺎس اﻟذﯾن ﯾﻔﻘدوا اﻟﻌﻣل أو اﻟذھﺎب إﻟﻰ اﻟطﺑﯾب‬

• It is one of the most common reasons people

miss work or go to the doctor for.
‫ وﻧﺎدرا ﻣﺎ ﺗﺣﺗﺎج إﻟﻰ ﺟراﺣﺔ ﻛﻌﻼج‬.‫ ﯾﻣﻛﻧك ﻣﻧﻊ أﻛﺛر اﻷﻟم اﻟﺧﻠﻔﻲ‬،‫ﻟﺣﺳن اﻟﺣظ‬

• Fortunately, you can prevent most back pain.

Surgery is rarely needed as a treatment.
Dr. Ravi Shankar Reddy. PhD, PT 2
 ‫اﻷﺳﺑﺎب‬

Causes
‫ واﻟﻔﻘرات‬،‫ ﺑﻣﺎ ﻓﻲ ذﻟك اﻟﻌظﺎم واﻟﻌﺿﻼت واﻷرﺑطﺔ واﻷوﺗﺎر‬،‫آﻻم اﻟظﮭر ﯾﻣﻛن أن ﺗﻧﺷﺄ ﻣن ﻣﺷﺎﻛل ﺗﺗﻌﻠق ﺑﺄي ﻣن ﻣﻛوﻧﺎت ذﻟك‬
.(‫)وﺳﺎﺋد ﺗﺷﺑﮫ اﻟﻐﺿﺎرﯾف اﻟﺗﻲ ﺗﺧﻔف ﻣن ﺷراﺋﺢ ﻋﻣودك اﻟﻔﻘري‬

• Back pain can arise from problems related to

any of it’s components, including bones,
muscles, ligaments, tendons, and disks (the
cartilage-like pads that cushion the segments
of your spine).

Dr. Ravi Shankar Reddy. PhD, PT 3

 ‫اﻷﺳﺑﺎب‬

Causes cont..
.‫ﻓﻲ ﺑﻌض اﻷﺣﯾﺎن ﻻ ﯾوﺟد ﺳﺑب ﻣﺣدد وﯾﻣﻛن اراﺟﺎع ﻵﻻم اﻟظﮭر ﻟﮫ‬

• Sometimes no specific cause can be found for

back.‫اﻟظﮭر‬pain.
‫إﺟﮭﺎدات اﻷرﺑطﺔ أو اﻟﻌﺿﻼت ھﻲ اﻟﺳﺑب اﻷﻛﺛر ﺷﯾوﻋﺎ ﻵﻻم‬

• Strains in the ligaments or muscles are the

most common cause for back pain.
‫ أو ﺑﻌد ﺣرﻛﺔ ﻣرﺑﻛﺔ ﻣﻔﺎﺟﺋﺔ‬،‫ﻋﺎدة ﻣﺎ ﯾﺣدث ﻣن رﻓﻊ ﻏﯾر ﺻﺣﯾﺢ ﻟﺛﻘل‬
• It usually occurs from improper or heavy
lifting, or after a sudden awkward movement.

Dr. Ravi Shankar Reddy. PhD, PT 4

 ‫ﻗد ﺗﺳﺑب اﻟﻣﺷﺎﻛل اﻟﮭﯾﻛﻠﯾﺔ أﯾﺿﺎ آﻻم اﻟظﮭر‬

Structural problems may also cause

back pain
.‫اﻧﺗﻔﺎخ أو ﺗﻣزق اﻷﻗراص ﺑﯾن اﻟﻔﻘرات‬

• Bulging‫اﻟﻧﺳﺎ‬or ruptured disks.

‫ أﻟم‬.‫ﻗد ﯾﺿﻐط اﻷﻗراص ﻋﻠﻰ اﻷﻋﺻﺎب ﻧﺗﯾﺟﺔ اﻧﺗﻔﺎخ أو ﺗﻣزق‬
• Discs may press on nerves if they bulge or
rupture. Sciatica.

Dr. Ravi Shankar Reddy. PhD, PT 5

 ‫ ﻓﺈﻧﮫ ﯾﻣﻛن أن ﯾﺳﺑب أﻟم ﺣﺎد ﻣﻊ‬،‫إذا ﻛﺎن اﻧﺗﻔﺎخ اﻟﻘرص اﻟﻐﺿروﻓﻲ ﺿﺎﻏط ﻋﻠﻰ اﻟﻌﺻب اﻟرﺋﯾﺳﻲ اﻟذي ﯾﻧﺗﻘل أﺳﻔل اﻟﺳﺎق‬
‫ﺣرارة ﺷدﯾدة ﻋن طرﯾق اﻷرداف واﻟظﮭر ﻣن ﻧﺎﺣﯾﺔ اﻟﺳﺎق‬
• If a bulging or herniated disk presses on the
main nerve that travels down your leg, it can
cause a sharp, shooting pain through the
buttock and back of the leg.

Dr. Ravi Shankar Reddy. PhD, PT 6

 ‫اﻟﺗﮭﺎب اﻟﻣﻔﺎﺻل‬

Arthritis
.‫ وأﺳﻔل اﻟظﮭر‬،‫ واﻟرﻛﺑﺗﯾن‬،‫اﻟﺗﮭﺎب ﯾﺻﯾب اﻟورﻛﯾن واﻟﯾدﯾن‬

• Osteoarthritis affects the hips, hands, knees,

and lower back.
.‫ ﯾﻣﻛن أن اﻟﺗﮭﺎب اﻟﻣﻔﺎﺻل ﺣول اﻟﻌﻣود اﻟﻔﻘري ﯾﺳﺑب ﺿﯾﻘﺎ ﻓﻲ اﻟﺣﯾز ﺣول اﻟﻧﺧﺎع اﻟﺷوﻛﻲ‬،‫ﻓﻲ ﺑﻌض اﻟﺣﺎﻻت‬
• In some instances, arthritis around the spine
can cause a narrowing of the space around
the spinal cord.

Dr. Ravi Shankar Reddy. PhD, PT 7

 ‫ﻋدم اﻧﺗظﺎم اﻟﮭﯾﻛل اﻟﻌظﻣﻲ‬

Skeletal irregularities
.‫ ﯾﻣﻛن أن ﺗﺣدث آﻻم اﻟظﮭر‬، ‫إذا وﺟدت اﻧﺣﻧﺎءات ﻏﯾر طﺑﯾﻌﯾﺔ ﻓﻲ اﻟﻌﻣود اﻟﻔﻘري‬

• If your spine curves in an abnormal way, back

pain can occur.

Dr. Ravi Shankar Reddy. PhD, PT 8

 ‫ھﺷﺎﺷﺔ اﻟﻌظﺎم‬

Osteoporosis
.‫ﻓﻘرات ﻓﻲ اﻟﻌﻣود اﻟﻔﻘري اﻟﺧﺎص ﺑك ﻗد ﺗواﺟﮫ ﻛﺳور ﺿﻐط إذا أﺻﺑﺣت اﻟﻌظﺎم ﻣﺳﺎﻣﯾﺔ وھﺷﺔ‬

• The vertebrae on your spine may experience

compression fractures if your bones become
porous and brittle.

Dr. Ravi Shankar Reddy. PhD, PT 9

 ‫ﻋواﻣل اﻟﺧطر‬

Risk factors
:‫اﻟﻌواﻣل اﻟﺗﺎﻟﯾﺔ ﻗد ﺗزﯾد ﻣن ﺧطر إﺻﺎﺑﺗك ﺑﺂﻻم أﺳﻔل اﻟظﮭر‬

• The following factors may increase your risk of

developing low back pain:
• Smoking ‫اﻟﺗدﺧﯾن‬
• Obesity ‫اﻟﺳﻣﻧﺔ‬
• Older age ‫اﻟﺗﻘدم ﻓﻲ اﻟﺳن‬
• Gender ‫اﻟﺟﻧس‬
• Physically strenuous work ‫اﻟﻌﻣل اﻟﺷﺎق ﺟﺳدﯾﺎ‬

Dr. Ravi Shankar Reddy. PhD, PT 10

 ‫ﻋواﻣل اﻟﺧطر‬

Risk factors cont..

‫اﻟﻌﻣل اﻟﺛﺎﺑت ﻛﺛﯾر اﻟﺟﻠوس‬

• Sedentary work
‫اﻟوظﯾﻔﺔ ﻣرھﻘﺔ‬
• Stressful job
‫اﻟﻘﻠق‬
• Anxiety
‫ﻛﺂﺑﺔ‬
• Depression

Dr. Ravi Shankar Reddy. PhD, PT 11

 ‫ﻣﺗﻰ ﯾطﻠب اﻟﻣﺷورة اﻟطﺑﯾﺔ‬

When to seek medical advice

‫ ﻓﺈﻧﮫ ﻗد ﯾﺳﺗﻐرق ﻓﺗرة ﺗﺻل إﻟﻰ ﻋدة أﺳﺎﺑﯾﻊ‬،‫ﻋﻠﻰ اﻟرﻏم ﻣن أن ﻣﻌظم آﻻم اﻟظﮭر ﺗﺗﺣﺳن ﻣﻊ اﻟﻌﻼج اﻟﻣﻧزﻟﻲ واﻟرﻋﺎﯾﺔ اﻟذاﺗﯾﺔ‬
.‫ﻟﺗﺧﺗﻔﻲ ﺗﻣﺎﻣﺎ‬

• Although most back pain improves with home

treatment and self-care, it may take up to
several weeks to completely disappear.
‫ اﺳﺗﺷر اﻟطﺑﯾب‬،‫ ﺳﺎﻋﺔ ﻣن اﻟرﻋﺎﯾﺔ اﻟذاﺗﯾﺔ‬72 ‫إذا ﻛﻧت ﻻ ﺗﻼﺣظ ﺑﻌض ﻋﻼﻣﺎت اﻟﺗﺣﺳن ﺧﻼل‬

• If you do not notice some signs of

improvement within 72 hours of self-care,
consult your physician.

Dr. Ravi Shankar Reddy. PhD, PT 12

 ‫ﻣﺗﻰ ﯾطﻠب اﻟﻣﺷورة اﻟطﺑﯾﺔ‬

When to seek medical advice cont..

.‫ ﯾﻣﻛن أن ﯾﻛون آﻻم اﻟظﮭردﻟﯾل ﻋﻠﻰ وﺟود ﻣﺷﻛﻠﺔ طﺑﯾﺔ ﺧطﯾرة‬،‫ﻓﻲ ﺣﺎﻻت ﻧﺎدرة‬

• In rare cases, back pain can indicate a serious

medical problem.
‫اﻟﺑﺣث ﻋن اﻟرﻋﺎﯾﺔ اﻟطﺑﯾﺔ ﻋﻠﻰ اﻟﻔور إذا ظﮭر آﻻم ظﮭرك‬
• Seek medical attention immediately if your
back pain ‫ ﺧﺻوﺻﺎ ﻓﻲ اﻟﻠﯾل ﻋﻧد اﻟﻧوم‬،‫وھو ﺛﺎﺑت أو ﻣﻛﺛف‬
– Is constant or intense, especially at night when
you lay down
‫ وﺧﺎﺻﺔ إذا ﻛﺎن اﻷﻟم ﯾذھب وﯾﻧﺗﺷر ﻓﻲ اﻟرﻛﺑﺔ‬،‫ﯾﻧﺗﺷر أﺳﻔل أﺣد أو ﻛﻼ اﻟﺳﺎﻗﯾن‬
– Spreads down one or both legs, especially if the
pain goes spreads the knee
– Causes weakness, numbness, or tingling in the
legs ‫ أو وﺧز ﻓﻲ اﻟﺳﺎﻗﯾن‬،‫ وﺗﺧدر‬،‫ﯾﺳﺑب ﺿﻌف‬

Dr. Ravi Shankar Reddy. PhD, PT 13

 ‫ﻣﺗﻰ ﯾطﻠب اﻟﻣﺷورة اﻟطﺑﯾﺔ‬

When to seek medical advice cont..

‫ﯾﺳﺑب ﻣﺷﺎﻛل ﺟدﯾدة ﻓﻲ اﻷﻣﻌﺎء أو اﻟﻣﺛﺎﻧﺔ‬

– Causes new bowel or bladder problems

‫ أو اﻟﺣﻣﻰ‬،‫ﯾرﺗﺑط اﻷﻟم أو اﻟﺧﻔﻘﺎن ﻓﻲ اﻟﺑطن‬
– Is associated with pain or throbbing in the
abdomen, or fever
‫ أو إﺻﺎﺑﺔ أﺧرى‬،‫ ﺿرﺑﺔ ﻟظﮭرك‬،‫ﯾﺗﺑﻊ ﺳﻘوط‬
– Follows a fall, blow to your back, or other injury
‫ﯾراﻓﻘﮫ ﻓﻘدان اﻟوزن ﻏﯾر اﻟﻣﺑرر‬
– Is accompanied by unexplained weight loss.

Dr. Ravi Shankar Reddy. PhD, PT 14

 ‫اﻟوﻗﺎﯾﺔ‬

Prevention
‫ ﺑﻌض‬.‫ ﺑﮭذا ﻗد ﺗﻛون ﻗﺎدرة ﻋﻠﻰ ﺗﺟﻧب آﻻم اﻟظﮭر‬،‫ﻣن ﺧﻼل ﺗﺣﺳﯾن ﺣﺎﻟﺗك اﻟﺑدﻧﯾﺔ وﻣﻣﺎرﺳﺔ ﻣﯾﻛﺎﻧﯾﻛﺎ اﻟﺟﺳم اﻟﺳﻠﯾم‬
-:‫اﻟﻧﺻﺎﺋﺢ ﻟﻠﺣﻔﺎظ ﻋﻠﻰ ظﮭرك ﺻﺣﻲ وﻗوي‬
• By improving your physical condition and
practicing proper body mechanics, you may be
able to avoid back pain. Some tips to keep
your back healthy and strong:

Dr. Ravi Shankar Reddy. PhD, PT 15

 ‫اﻟﺗﻣرﯾن‬

Exercise
‫ وﺗﻣﻛﯾﻧﮫ ﻣن‬،‫ وﻣﻧﺧﻔض اﻷﺛر ﻣﺛل اﻷﻧﺷطﺔ اﻟرﯾﺎﺿﯾﺔ اﻟﺗﻲ ﻟن ﺗﺟﮭد أو ﺗﮭز ظﮭرك ﺑﮭﺎ ﯾﻣﻛن زﯾﺎدة اﻟﻘوة واﻟﺗﺣﻣل ﻓﻲ ظﮭرك‬،‫ﻣﻧﺗظم‬
.‫اﻟﻌﻣل ﺑﺷﻛل أﻓﺿل‬

• Regular, low-impact aerobic activities that

won’t strain or jolt your back can increase
strength and endurance in your back and
allow them to function better.
‫ﻣن اﻷﻣﺛﻠﺔ ﻋﻠﻰ ذﻟك اﻟﻣﺷﻲ واﻟﺳﺑﺎﺣﺔ‬
• Examples include walking and swimming.

Dr. Ravi Shankar Reddy. PhD, PT 16

 ‫ﺑﻧﺎء اﻟﻘوة اﻟﻌﺿﻠﯾﺔ واﻟﻣروﻧﺔ‬

Build muscle strength and flexibility

‫اﻷﺳﺎﺳﻲ ﺗﻌزﯾز )اﻟﺑطن وﻋﺿﻼت اﻟظﮭر( ﺑﺎﻟﺗﻣﺎرﯾن اﻟﺗﻲ ﺗﺳﺎﻋد ﺣﺎﻟﺔ ﻋﺿﻼت ظﮭرك ﺑﺣﯾث ﺗﻌﻣل ﻣﻌﺎ ﻟﺗﺣﺳﯾن اﻟﺷﻌور‬
‫ﺑﻌﻣودك اﻟﻔﻘري‬
• Core-strengthening (abdominal and back
muscles) exercises help condition your back
muscles so they work together to improve
how your back feels.

Dr. Ravi Shankar Reddy. PhD, PT 17

 ‫اﻻﻗﻼع ﻋن اﻟﺗدﺧﯾن‬

Quit smoking
.‫ واﻟﺗﻲ ﯾﻣﻛن أن ﺗؤﺛر ﺳﻠﺑﺎ ﻋﻠﻰ ﻋﻣﻠﯾﺔ اﻟﺷﻔﺎء‬،‫اﻟﻣدﺧﻧون ﻣﻌرﺿون ﻻﻧﺧﻔﺎض ﻣﺳﺗوﯾﺎت اﻷوﻛﺳﺟﯾن ﻓﻲ أﻧﺳﺟﺗﺔ اﻟﻌﻣود اﻟﻔﻘري‬

• Smokers have lower oxygen levels in their

spinal tissues, which can compromise the
healing process.

Dr. Ravi Shankar Reddy. PhD, PT 18

 ‫اﻟﺣﻔﺎظ ﻋﻠﻰ وزن ﺻﺣﻲ‬

Maintain a healthy weight

.‫زﯾﺎدة اﻟوزن ﯾﺿﻊ ﺿﻐطﺎ ﻋﻠﻰ ﻋﺿﻼت اﻟظﮭر‬

• Being overweight puts strain on your back

muscles.

Dr. Ravi Shankar Reddy. PhD, PT 19

 ‫اﻟوﻗوف اﻟذﻛﻲ‬

Stand smart
.‫اﻟﺣﻔﺎظ ﻋﻠﻰ ﻣوﻗف ﺣﯾﺎدي ﻟﻠﺣوض‬
• Maintain a neutral pelvic position.
.‫ ﺗﺗﻧﺎوب وﺿﻊ ﻗدﻣﯾك ﻋﻠﻰ ﻣوطﺊ ادﻧﻰ ﻣﻣﺎ ﯾﺧﻔف اﻟﺿﻐط ﻋﻠﻰ أﺳﻔل اﻟظﮭر اﻟﺧﺎﺻﺔ ﺑك‬،‫إذا ﻛﺎن ﯾﺟب اﻟوﻗوف ﻟﻔﺗرة طوﯾﻠﺔ‬

• If you must stand for a long time, alternate

placing your feet on a low footstool to take
the pressure off your lower back.

Dr. Ravi Shankar Reddy. PhD, PT 20

 ‫اﻟﺟﻠوس اﻟذﻛﻲ‬

Sit smart
.‫ وذات ﻗﺎﻋدة دوارة‬،‫ ﻣﺳﺎﻧد اﻷذرع‬،‫اﺧﺗﯾﺎر ﻣﻘﻌد ﻣﻊ دﻋم ﺟﯾد أﺳﻔل اﻟظﮭر‬
• Choose a seat with good lower back support,
arm rests, and a swivel base.
‫ إﺑﻘﺎء اﻟورﻛﯾن واﻟرﻛﺑﺗﯾن ﻓﻲ وﺿﻊ‬.‫ﻗد ﺗﻔﻛر ﻓﻲ وﺿﻊ وﺳﺎدة أو ﻣﻧﺷﻔﺔ ﻣﻠﻔوﻓﺔ ﺻﻐﯾرة ﺣول ظﮭرك ﻟﻠﺣﻔﺎظ ﻋﻠﻰ اﻟﻣﻧﺣﻧﻰ اﻟطﺑﯾﻌﻲ‬
‫ﻣﺳﺗوى‬

• You may consider placing a pillow or rolled

towel in the small of your back to maintain a
normal curve. Keep your hips and knees level.

Dr. Ravi Shankar Reddy. PhD, PT 21

 ‫اﻟرﻓﻊ اﻟذﻛﻲ‬

Lift smart
.‫رﻓﻊ ﺳﺎﻗﯾك‬

• Lift with your legs.

.‫ﺗﺗﺣرك ﻣﺑﺎﺷرة ﺻﻌودا وھﺑوطﺎ‬
• .‫ﻟﺟﺳﻣك‬
Move straight up and down.
‫ اﺟراء وﺛﯾق ﻟﺗﺣﻣﯾل‬.‫ﺣﺎﻓظ ﻋﻠﻰ اﺳﺗﻘﺎﻣﺔ ظﮭرك وﺛﻧﻲ ﻓﻘط اﻟرﻛﺑﺗﯾن‬
• Keep your back straight and bend only at the
knees. Hold the load close to your body.
.‫اﺑﺣث ﻋن ﺷرﯾك ﻟﻠﻣﺳﺎﻋدة ﻓﻲ اﻟرﻓﻊ‬،‫ إذا ﻛﺎن اﻟﺣﻣل ﺛﻘﯾﻼ ﺟدا‬.‫ﺗﺟﻧب رﻓﻊ واﻟﺗواء ﻓﻲ وﻗت واﺣد‬
• Avoid lifting and twisting simultaneously. If
the load is too heavy, seek a lifting partner to
help.

Dr. Ravi Shankar Reddy. PhD, PT 22

Dr. Ravi Shankar Reddy. PhD, PT 23