Nyeri Punggung Bawah

EVOLUSI DARI QUADRIPEDAL KE BIPEDAL ANIMAL

LBP ?
LBP :
1. The most common musculoskeletal complaint and a
leading cause of work disability
2. 80% of the population will experience LBP during their
lifetime
3. 95% originally is mechanical  MECHANICAL LBP/
POSTURAL LBP : due to an anatomic or functional
abnormality without underlying inflammatory or
neoplastic disease ( mostly due to degenerative change )
THE MAIN FUNCTIONS OF HUMAN SPINE :

1.UPRIGHT POSITION
2.PROTECTION
3.STABILIZATION
4.MOVEMENT
 THE UPRIGHT POSITION :
VERY SPECIFIC FOR HUMAN
THE ONLY PILLAR
THE POSITION IS AT THE BACK
OF THE BODY MASS
IT IS VERY STRONG, YET VERY
MOBILE AND FLEXIBLE
IT IS BEAUTIFULLY CURVED

VERY PRONE TO INJURY

 PATOLOGI PADA SPINE
• Spondylosis
• Spondyloathrosis
• Spondylitis
• Spondylolisthesis
• Scoliosis
• Hyperkyphotic/hyperlordotic
• Fraktur
• Destruksi
THE SPINAL STABILIZERS:

1. The vertebrae
2. The intervertebral discs
3. The ligaments
4. The muscles
 WHICH IS
STRONGER ?
THE SPINAL CURVATURES
MAKE THE SPINE 16 x
STRONGER
THE CENTER OF GRAVITY
THE LONG AND SHORT LIGAMENTS
OF THE SPINE
THE BACK MUSCLES
hyperlordosis
Muscle spasm
SLR TEST
THOMAS TEST
PATRICK FABERE TEST
OBER TEST
GAENSLEN TEST
 Bagaimana penanganannya?
• Penanganan nyeri dengan obat-obatan.
• Modalitas terapi fisik untuk mengurangi nyeri
dan ketegangan/rasa kaku pada punggung
bawah dan betis.
• Perubahan posisi dan cara bekerja yang baik
(profer back mechanism)
• Latihan untuk koreksi postur tubuh.
• Program latihan fisik untuk mengoreksi
panjang, kekakuan dan kekuatan otot.
Posisi Kerja Ergonomis
TO REDUCE LUMBAR LORDOSIS
TO STRETCH BACK EXTENSOR
MUSCLES
TO STRENGTHEN ABDOMINAL MUSCLES
TO STRENGTHEN GLUTEUS MAXIMUS
MUSCLE
TO STRENGTHEN
GLUTEI MUSCLES
TO STRETCH
HAMSTRING
TO STRETCH HIP FLEXORS
TO STRENGTHEN THE
BACK MUSCLES
TO CORRECT POSTURE
TO CORRECT POSTURE
EMG BIOFEEDBACK
EXERCISE
EMG BIOFEEDBACK EXERCISE
EMG BIOFEEDBACK
EXERCISE
Koreksi Postur
LUMBO-SACRAL CORSET
TLSO
E control
 LSO,
E-F-L controls

KNIGHT BRACE
LSO,
E-F-L controls
No R control
KNIGHT-TAYLOR BRACE

TLSO,
E-F-L controls
JEWETT BRACE

TLSO,
F control
 BOSTON BRACE

TLSO,
Lat.-Deviation control
BOSTON BRACE
 MILWAUKEE BRACE

CTLSO,
Lateral-deviation control