DEFINITION

“Low back pain” (LBP) is a clinical syndrome

with main symptom as pain or other
discomfort in the low back area and
arounds.
PREFACE
Muskuloskeletal disorder :
 85%  Individu have experienced back pain in
their lifetime by the age of 60 years.
90%  Mechanical factors
10 % Medical diseases
 40 y.o : women.
after 50 y.o, : men.
 Children and adolescents are not immune from back
pain.
14% : adult
5% : children have a history of back pain
ANATOMY
ETIOLOGY
 Mechanical :

Obesity
Activity : prolong sitting or standing
High shoe heel
Leg lenghtdefferensiation
• Congenital
• Tumor
• Trauma
• Metal intoxication
• Metabolic disorder
• Inflammation diseases
• Degeneratif
• Chronic or acute infection
 Pathophysiology

Pain mechanism :
- Entrapment nerve root syndrome
- Chemical radiculitis
- Cell mediated reaction and demyelinisation
- Psychology
The pathophysiology of nonradicular LBP is usually
indeterminate.
Pain may arise from :
- vertebral column
- surrounding muscles
- tendons
- ligaments
- fascia.
 Diagnosis :
Anamnesis
• Location of the pain
• Characteristic
• Duration and frequency
• Onset
• Progressivity
 Diagnosis :
Physical Examination
• Standing :
posture,deformity, leg length, walk onheel and
walk on toe ability.
• Lying :
leg length measure, hip joint motion evaluation,
passive motion of the trunk, range of motion,
muscles strength, sensibility, reflex, low back
manouvers
Diagnosis :
Supporting Examination

• Radiologic :
X- ray, CT Scan, MRI,
• Laboratory :
Blood and urine analysis.
Treatment
Conservative

Rest
Analgetic and muscle relaxant regiment
Physical modality
Orthetic ( brace or corset )
Exercise
Preventive
 Surgery

Recommended on conditions :
No improvement after 4 or 6 weeks with
conservative therapy, and presenting severe
nerve root disorder, sensory deficit or bladder
and bowel disorder.
WF Exercise
WF Exercise

• Alternate Knee to
Chest

• Simultaneous Knee to
Chest
…WF Exercise
• Exaggerated
starter’s position
…WF Exercise
• Wall slides