Low back pain, Sciatica, 2
To prevent future aggravations of low back pain and sciatica with pain radiating down the leg, the source and cause of the problem and the type of treatment that is effective in alleviating the signs and symptoms must be identified. The source of injury of could be a postero-laterally (backward but towards the side) protruded disc caused by slipping and falling on his buttock, i.e. a traumatic compression and forward bending action. The initial effective treatment was hands-on manipulations to settle most symptoms but the residual signs and symptoms were caused by lack of specific techniques to restore his soft tissue, muscle, joint and neural function.
The most simplistic solution is to avoid falling again. Unfortunately, once such damage has occurred, recurrence could simply be caused by many 'normal' daily activities such as prolong sitting, bending, lifting and other poor postures. Postural and ergonomic advice is therefore crucial in the rehabilitation and prevention of such problem to avoid further protrusion or degeneration of the disc. Since scar tissues/adhesions/thickenings have a tendency to contract, treatment techniques aiming at reducing soft tissue thickening, restoring lumbar extension (low back backward bending) and neural (nerve) mobility must be maintained by the patient even long after discharge. Specific self-mobilizing, mobility and stretching exercises must therefore be given. Muscle weakness is unavoidable in any injury. Strengthening and stability exercises are therefore important to ensure muscle balance in strength, length and endurance in the pelvic and lumbar (low back) region. Since many patients do not wish to go to the gymnasium or have time to do such exercises, their design should be emphasized in incorporating into the functional activities and postural exercises which are in fact most important and practical. Only when patients could grasp the art of the above specific exercises should they be encouraged to return to their sporting activities such as swimming, walking, running, golf etc.
The most common mistake patients make is that they often forget their specific exercises once they return to their sporting activities! Without proper warm up, interruption and cool down with the specific exercises, their sporting activities could become hazardous to their injuries. The same applies to their daily activities that they should 'exercise' early, during and at the end of the day. High risks activities such as prolong sitting, bending, lifting should be avoided or at least interrupted with their exercises. Patients must be reminded of the importance of continuing their own self-treatment.
Luck LI
Musculoskeletal Physiotherapist
The most simplistic solution is to avoid falling again. Unfortunately, once such damage has occurred, recurrence could simply be caused by many 'normal' daily activities such as prolong sitting, bending, lifting and other poor postures. Postural and ergonomic advice is therefore crucial in the rehabilitation and prevention of such problem to avoid further protrusion or degeneration of the disc. Since scar tissues/adhesions/thickenings have a tendency to contract, treatment techniques aiming at reducing soft tissue thickening, restoring lumbar extension (low back backward bending) and neural (nerve) mobility must be maintained by the patient even long after discharge. Specific self-mobilizing, mobility and stretching exercises must therefore be given. Muscle weakness is unavoidable in any injury. Strengthening and stability exercises are therefore important to ensure muscle balance in strength, length and endurance in the pelvic and lumbar (low back) region. Since many patients do not wish to go to the gymnasium or have time to do such exercises, their design should be emphasized in incorporating into the functional activities and postural exercises which are in fact most important and practical. Only when patients could grasp the art of the above specific exercises should they be encouraged to return to their sporting activities such as swimming, walking, running, golf etc.
The most common mistake patients make is that they often forget their specific exercises once they return to their sporting activities! Without proper warm up, interruption and cool down with the specific exercises, their sporting activities could become hazardous to their injuries. The same applies to their daily activities that they should 'exercise' early, during and at the end of the day. High risks activities such as prolong sitting, bending, lifting should be avoided or at least interrupted with their exercises. Patients must be reminded of the importance of continuing their own self-treatment.
Luck LI
Musculoskeletal Physiotherapist