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" A Taxi Driver"

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" A Taxi Driver"

Anatomy of Spine and Back
- Segments of vertebral column
- Features of cervical, thoracic, and lumbar vertebrae
- Intervertebral disc - secondary fibrocartilage joint
- Ligaments of vertebral column
- Intrinsic muscles of the back
- Spinal nerve distribution
  - Sciatic nerve
  - Course
  - Dermatome
Normal and abnormal Curvatures of the Back
- Normal curvature
- Abnormal curvature
- Types of scoliosis
Physiology of Muscle Contractions & Action Potential
- How the muscle contracts? (Excitation)
- How the muscle contracts? (Contraction)
- Why coughing & sneezing affects the pain?
  - In order to generate a cough, your breathing system builds up pressure within the thorax.
    - = Increase the pressure in the abdomen & spinal discs
      - = A disc bulge = compress the nerve root = terrible sciatic nerve pain.
Causes, Alleviating, and Aggravating Factors of Lower Back Pain
- Specific
  - Discogenic
  - Structural defect
  - Direct Trauma
  - Lumbar strain
- Non-specific
  - Mechanical
- Causes of Lower Back Pain
  - Spondylolisthesis
  - Spinal stenosis
  - Herniation
  - Spondylitis
- What is Sciatica and Conditions That Could Cause Compression?
  - pain that radiates down the route of the sciatic nerve.
  - Epidemiology
    - a lifetime incidence ranging from 13% to 40%
    - Common in women
    - Herniated disc = 90% of cases
  - Risk factors
    - Age
    - Obesity
    - Diabetes
  - Scoliosis, Trauma, Tumor
  - Investigations
    - Current medical history
    - Past medical history
    - Physical Examination
      - Look
        Posture deformity
      - Move
        Flexion, extension, rotation
      - Special tests
        Straight leg raising test
      - Imaging
  - Treatment and Management of Sciatica
    - self-care
      - rest
      - Gentle stretches
    - Health-care
      - Prescribed drugs
      - Physical therapy
        Physiotherapy and Exercises for Sciatica
        What are the goals of physical therapy?
        Centralization of pain.
        Restoring Lumbar Curvature.
        Restoring Functional abilities
        Physical Therapy Modalities:
        Transcutaneous Electrical Nerve Stimulators (TENS).
        Muscle Re-education Biofeedback (Using EMG).
        Diathermy.
        Cryotherapy
        Thermotherapy
        Exercises for Sciatica
        Knee-to-chest exercise
        Pelvic Tilt Exercise
        A health profession aiming to develop, maintain, and restore maximum movement and functional ability throughout the lifespan.
    - Surgery
      - Laminectomy
      - Microdiscectomy
What is Radiculopathy?
- a range of symptoms produced by the pinching of a nerve root in the spinal column
  - Lumbar Radiculopathy
  - Cervical Radiculopathy
  - Thoracic Radiculopathy
  - Causes:
    - Herniated discs
    - Bone spurs