Low Back Pain

Low Back Pain

1. anatomy of back

   • muscles
     • superficial muscles
       • lattismus dorsii
       • serratus anterior
     • intermediate muscles
     • deep muscles muscles
       • Splenius muscle
         • splenius capitis
         • splenius cervicis
       • Erector spinae group of muscles
         • Iliocostocervicalis group
         • Longissimus group
         • Spinalis group
       • Transversospinalis group
         • semispinalis
         • multifidus
         • rotators.
       • Interspinales and intertransversarii
   • VERTEBRAL COLUMN
     • 7 cervical vertebra
     • 12 thoracic
       • 5 lumbar
     • 4 fused coccygeal
     • 5 fused sacral
     • vertebrae
       • body
       • vertebral arch
       • two transverse processes
       • spinous process
       • spinal nerves
       • anterior & posterior articular processes
       • intervertebral disc
         • nucleus pulposus.
         • annulus fibrosus.
     • Ligaments
       • Anterior Longitudinal Ligament
       • Posterior Longitudinal Ligament
       • Ligamentum Flavum
       • Intertransverse Ligament
       • Interspinal Ligament
       • Supraspinal Ligament
     • joints
       • Atlanto-Occipital Joints
       • Atlantoaxial Joints
       • cartilaginous joints between their bodies
       • synovial joints between their articular processes
   • Arterial Supply & Venous Drainage
     • Arterial Supply rich arterial supply because their marrow is a site of erythropoesis.:
     • venous drainage
       • internal vertebral venous plexus
       • external vertebral venous plexus

2. causes

   • mechanical
   • non-mechanical: malignancy,infection..etc
   • inflammatory
   • other cuases: prolapse intervertebral disc

3. Examination of The Spine

   • Inspection:Observe : front, side & behind for normal posture, gait & alignment
   • Palpation:Skin temperature & any abnormalities e.g. Swelling
   • Movement: Observe the patient’s ACTIVE range of motion
   • Special tests : Straight leg raising,Lasegue &Femoral nerve stretch test

4. sciatica

   • causes
     • Disc herniation
     • Spinal stenosis
     • Spondylolisthesis
     • other causes include irritation of the nerve from adjacent bone, tumors, muscle, internal bleeding
   • signs & symptoms
     • pain
     • Walking difficult
     • Fatigue
     • Soreness
     • Diminish reflex
   • complications
     • Partial or Complete Loss of Leg Movement
     • Partial or Complete Loss of Sensation in the Leg
     • Loss of Bowel or Bladder Function

5. treatment

   • pharma.
   • non-pharma.
     • physiotherapy
     • alternative therapies
       • Acupuncture,Chiropracti, Yoga,Massage,Devil's Claw (herbal medication) , Exercise and Physical Therapy