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  • Health Info 健康資訊
    • Headaches
      • Cervical headaches
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    • Neck
      • Neck pain by Gwen Jull, Part I
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      • Neck pain position statement
      • Neck Pain
      • Neck, Dizziness and Vertigo
    • Back
      • Thoracic extension (upper back backward bending) and chest expansion
    • Low back
      • Acute, treat early for best results
      • Education for low back pain
      • Management of acute to prevent chronic LBP
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      • Sciatica, 1
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      • Mobility to maintain lumbar lordosis
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      • Common hip joint exercises
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      • Limp & Wasting From Lumbar, 76 yr
      • Sciatica
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      • Acute shoulder pain
      • Acute thoracic pain
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      • Hip strain
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      • Calf stretches for cramp, swollen-aching leg
      • Exercises for OA
      • Fitness exercise advice, postural to sporting
      • Karate training
      • Marathon Prerequiite
      • Postural Exercises, Flexion Exercises Cause Injury
      • Scoliosis Screening, Exercise Program
      • Stretches for RSI, tendinitis
      • Stretch to prevent injury
      • Stretching exercises, the challenge
      • Swimming, To swim or not to swim?
      • Therapeutic Exercises, Importance of Different Type
      • To exercise or not to exercise?
      • To stretch or not to stretch?
      • Wii as an Exerise Device
      • Wii, Exer-gaming, More Evidence
      • Work athlete, marathon workers
      • XBOX 360 Kinect
    • General Advice
      • Back pain, more than a clinical symptom
      • Common sayings or Heuristics for patients
      • Cost effectiveness of physiotherapy
    • Posutre
      • Core awareness belt
      • Core stabilization for sports & ADL
      • Core stabilization, motor control
      • Dental saddle stool
      • Dr Mandal, balanced sitting posture on forward sloping seat #1
      • Dr Mandal, balanced sitting posture on forward sloping seat #2
      • Evolution figures for postural advice
      • Kyphosis, more common, need of early detection
      • Need of postural training for patients with neck pain
      • Olympic athletes, lifting with lordosis & bracing
      • Postural muscle training I
      • Postural muscle training II
      • Treadmill desk
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  • Home 主頁
  • B-Free Products 必飛產品
    • B-Free Ranger (Wired model) 必飛越野號 (原創有線版)
    • B-Free Ranger (Remote control model) 必飛越野號(創新遙控版)
    • B-Free Flash (Wired model) 必飛閃電號 (原創有線版)
    • B-Free Flash (Remote control model) 必飛閃電號(創新遙控版)
    • B-Free Double Flash (latest model) 必飛閃電號升級版 (創新遙控版)
    • FAQ about Stair-Climbing Wheelchairs, 常見問題
    • Our Growing Path 我們成長之路
      • 2014
        • 2014-09, Wheelchair Users' Joy Ride 輪椅使用者之興奮
        • 2014-10, MTR Onsite Test 通過地鐵公司的嚴格測試
        • 2014-12, Wheelchair Users' Joy Ride 輪椅使用者之興奮
      • 2015
        • 2015-02, 頭條日報
        • 2015-04, 東張西望
        • 2015-04, Geneva Inventions Gold Awards 瑞士日內瓦發明金獎
        • 2015-04, Celebrity congratulates 名人祝賀
        • 2015-05, Celebrity congratulates 名人祝賀
        • 2015-06, Celebrity congratulates 名人祝賀
        • 2015-10, 威爾斯醫院
        • 2015-10, at Nursing Home 在安老院當義工
        • 2015-10, Celebrity congratulates 名人祝賀
        • 2015-11, TVB, 貿發局廣告
        • 2015-11, Fedex Grant contest FedEx中小企拓展業務大賽勝出得到大獎
        • 2015-12, Elderly Joy Ride 長者之興奮
        • 2015-12, HK Chamber of Commerce Award ​香港工商業科技獎
      • 2016
        • 2016-02, TVB, 敢創, 香港
        • 2016-03, TVB, 學是學非
        • 2016-04, Mediazone Award 媒體大獎
        • 2016-05, 人大委員長張德江到科學園
        • 2016-08, B-Free Ranger Pilot Run 必飛越野號試航
        • 2016-09, SCMP 香港精神奬
        • 2016-10, Cybathlon, Switzerland 瑞士殘疾人士科技競賽
      • 2017
        • 2017-03, B-Free in Birmingham 必飛被邀請到英國伯明翰參展
        • 2017-05, B-Free in New York 必飛被邀請到美國紐約參展
        • 2017-07, B-Free in Shanghai 必飛被邀請到中國上海參展
        • 2017-07, B-Free in Toyko 必飛被邀請到日本東京參展
        • 2017-10, B-Free in Vienna 必飛被邀請到奧地利維也納參展
        • 2017-12, 諾貝爾學人卓越科技獎
      • 2018
  • Health Info 健康資訊
    • Headaches
      • Cervical headaches
      • Headaches & Manipulative
    • Neck
      • Neck pain by Gwen Jull, Part I
      • Neck pain by Gwen Jull, Part II
      • Neck pain by Gwen Jull, Part III
      • Neck pain position statement
      • Neck Pain
      • Neck, Dizziness and Vertigo
    • Back
      • Thoracic extension (upper back backward bending) and chest expansion
    • Low back
      • Acute, treat early for best results
      • Education for low back pain
      • Management of acute to prevent chronic LBP
      • Non-specific low back pain
      • Sciatica, 1
      • Sciatica, 2
      • Mobility to maintain lumbar lordosis
    • Hip
      • Common hip joint exercises
      • Other hip joint exercises
    • Case study series
      • Limp & Wasting From Lumbar, 76 yr
      • Sciatica
    • Crisis Plan Series
      • Acute shoulder pain
      • Acute thoracic pain
      • Ankle sprain
      • Carpal tunnel syndrome
      • FHP, Neck pain
      • Hip strain
      • lumbar lordosis
      • PF Joint
      • Plantar fasciitis
      • Subacute shoulder pain
      • Tennis elbow
    • Exercise
      • Calf stretches for cramp, swollen-aching leg
      • Exercises for OA
      • Fitness exercise advice, postural to sporting
      • Karate training
      • Marathon Prerequiite
      • Postural Exercises, Flexion Exercises Cause Injury
      • Scoliosis Screening, Exercise Program
      • Stretches for RSI, tendinitis
      • Stretch to prevent injury
      • Stretching exercises, the challenge
      • Swimming, To swim or not to swim?
      • Therapeutic Exercises, Importance of Different Type
      • To exercise or not to exercise?
      • To stretch or not to stretch?
      • Wii as an Exerise Device
      • Wii, Exer-gaming, More Evidence
      • Work athlete, marathon workers
      • XBOX 360 Kinect
    • General Advice
      • Back pain, more than a clinical symptom
      • Common sayings or Heuristics for patients
      • Cost effectiveness of physiotherapy
    • Posutre
      • Core awareness belt
      • Core stabilization for sports & ADL
      • Core stabilization, motor control
      • Dental saddle stool
      • Dr Mandal, balanced sitting posture on forward sloping seat #1
      • Dr Mandal, balanced sitting posture on forward sloping seat #2
      • Evolution figures for postural advice
      • Kyphosis, more common, need of early detection
      • Need of postural training for patients with neck pain
      • Olympic athletes, lifting with lordosis & bracing
      • Postural muscle training I
      • Postural muscle training II
      • Treadmill desk
  • About Us 關於我們
    • Found's Profile
  • Contact Us 聯絡我們
  • Announcement 通告
    • 2018-05-31
  • Subsidiaries 子公司
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Tel: 2899 2893

Low back pain, Sciatica, 1​

This is a continuation of the previous low back pain case report of a patient with low back pain and sciatica with pain radiating down the leg to very briefly explain my view on the implication of the clinical findings and the rationale for the treatment approach.
Central low back pain suggested an injury to a central structure of the back, most likely to be the disc as indicated in the patient's history and confirmed by the CT scan. Radiating leg pain indicated more severe injury, a peripheralization phenomenon as well as the possibility of a nerve root irritation. Recent evidence as provided by the 'Australian Physiotherapy Association Low Back Pain Position Statement' supports the effectiveness of spinal manipulative therapy and specially designed exercises on the treatment of acute and chronic low back pain. In contrast, rest-in-bed, traction, electrotherapy and generalized back exercises give no evidence of promoting better recovery. The patient therefore responded well to chiropractic treatment instead of traditional physiotherapy. As an allied health profession, musculoskeletal physiotherapists certainly do not endorse chiropractic theory and approach. Nevertheless, their willingness of applying hands-on treatment, if used appropriately, could certainly help spinal injuries of mechanical origin. As a general rule, quick thrust manipulations are not indicated for disc conditions. Many other more gentle and multi-directional mobilizations/manipulations can be used instead.
Despite settling from acute symptoms, the patient's back and leg pain persisted. The acute disc protrusion could have settled but the effect of such protrusion on the surrounding soft tissues could have persisted. It is hypothesized that the surrounding soft tissues were irritated and inflamed as a result of the disc protrusion. Scar tissues/adhesions/thickenings gradually developed despite healing of the disc itself. Muscle spasms could also develop into muscle tension/tightness. Such complicated soft tissue pathology gradually stiffened up the spine, hence restricting spinal movements. Lumbar lordosis (low back S-curve) and extension (backward bending) are often reduced in such disc pathology. As scar tissues could have developed at close vicinity to or adhered to the nerve root, neural (nerve) mobility was also restricted and leg symptoms persisted. Immediate aim of treatment should be minimizing such soft tissue and muscular tension and restoring neural and joint mobility. Manipulative/mobilization technique should therefore be more specific. Centralization phenomenon when peripheral (limb) symptoms recede more centrally often indicates good prognosis or recovery. The long-term goal should be preventing recurrence of the problem.



Luck LI
Musculoskeletal Physiotherapist

Location

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Professional and dedicated. The Health Information is truly amazing, helping me to recover from my low back pain. I’m sure Dr. Motion is going to help a lot more people."

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  • Home 主頁
  • B-Free Products 必飛產品
    • B-Free Ranger (Wired model) 必飛越野號 (原創有線版)
    • B-Free Ranger (Remote control model) 必飛越野號(創新遙控版)
    • B-Free Flash (Wired model) 必飛閃電號 (原創有線版)
    • B-Free Flash (Remote control model) 必飛閃電號(創新遙控版)
    • B-Free Double Flash (latest model) 必飛閃電號升級版 (創新遙控版)
    • FAQ about Stair-Climbing Wheelchairs, 常見問題
    • Our Growing Path 我們成長之路
      • 2014
        • 2014-09, Wheelchair Users' Joy Ride 輪椅使用者之興奮
        • 2014-10, MTR Onsite Test 通過地鐵公司的嚴格測試
        • 2014-12, Wheelchair Users' Joy Ride 輪椅使用者之興奮
      • 2015
        • 2015-02, 頭條日報
        • 2015-04, 東張西望
        • 2015-04, Geneva Inventions Gold Awards 瑞士日內瓦發明金獎
        • 2015-04, Celebrity congratulates 名人祝賀
        • 2015-05, Celebrity congratulates 名人祝賀
        • 2015-06, Celebrity congratulates 名人祝賀
        • 2015-10, 威爾斯醫院
        • 2015-10, at Nursing Home 在安老院當義工
        • 2015-10, Celebrity congratulates 名人祝賀
        • 2015-11, TVB, 貿發局廣告
        • 2015-11, Fedex Grant contest FedEx中小企拓展業務大賽勝出得到大獎
        • 2015-12, Elderly Joy Ride 長者之興奮
        • 2015-12, HK Chamber of Commerce Award ​香港工商業科技獎
      • 2016
        • 2016-02, TVB, 敢創, 香港
        • 2016-03, TVB, 學是學非
        • 2016-04, Mediazone Award 媒體大獎
        • 2016-05, 人大委員長張德江到科學園
        • 2016-08, B-Free Ranger Pilot Run 必飛越野號試航
        • 2016-09, SCMP 香港精神奬
        • 2016-10, Cybathlon, Switzerland 瑞士殘疾人士科技競賽
      • 2017
        • 2017-03, B-Free in Birmingham 必飛被邀請到英國伯明翰參展
        • 2017-05, B-Free in New York 必飛被邀請到美國紐約參展
        • 2017-07, B-Free in Shanghai 必飛被邀請到中國上海參展
        • 2017-07, B-Free in Toyko 必飛被邀請到日本東京參展
        • 2017-10, B-Free in Vienna 必飛被邀請到奧地利維也納參展
        • 2017-12, 諾貝爾學人卓越科技獎
      • 2018
  • Health Info 健康資訊
    • Headaches
      • Cervical headaches
      • Headaches & Manipulative
    • Neck
      • Neck pain by Gwen Jull, Part I
      • Neck pain by Gwen Jull, Part II
      • Neck pain by Gwen Jull, Part III
      • Neck pain position statement
      • Neck Pain
      • Neck, Dizziness and Vertigo
    • Back
      • Thoracic extension (upper back backward bending) and chest expansion
    • Low back
      • Acute, treat early for best results
      • Education for low back pain
      • Management of acute to prevent chronic LBP
      • Non-specific low back pain
      • Sciatica, 1
      • Sciatica, 2
      • Mobility to maintain lumbar lordosis
    • Hip
      • Common hip joint exercises
      • Other hip joint exercises
    • Case study series
      • Limp & Wasting From Lumbar, 76 yr
      • Sciatica
    • Crisis Plan Series
      • Acute shoulder pain
      • Acute thoracic pain
      • Ankle sprain
      • Carpal tunnel syndrome
      • FHP, Neck pain
      • Hip strain
      • lumbar lordosis
      • PF Joint
      • Plantar fasciitis
      • Subacute shoulder pain
      • Tennis elbow
    • Exercise
      • Calf stretches for cramp, swollen-aching leg
      • Exercises for OA
      • Fitness exercise advice, postural to sporting
      • Karate training
      • Marathon Prerequiite
      • Postural Exercises, Flexion Exercises Cause Injury
      • Scoliosis Screening, Exercise Program
      • Stretches for RSI, tendinitis
      • Stretch to prevent injury
      • Stretching exercises, the challenge
      • Swimming, To swim or not to swim?
      • Therapeutic Exercises, Importance of Different Type
      • To exercise or not to exercise?
      • To stretch or not to stretch?
      • Wii as an Exerise Device
      • Wii, Exer-gaming, More Evidence
      • Work athlete, marathon workers
      • XBOX 360 Kinect
    • General Advice
      • Back pain, more than a clinical symptom
      • Common sayings or Heuristics for patients
      • Cost effectiveness of physiotherapy
    • Posutre
      • Core awareness belt
      • Core stabilization for sports & ADL
      • Core stabilization, motor control
      • Dental saddle stool
      • Dr Mandal, balanced sitting posture on forward sloping seat #1
      • Dr Mandal, balanced sitting posture on forward sloping seat #2
      • Evolution figures for postural advice
      • Kyphosis, more common, need of early detection
      • Need of postural training for patients with neck pain
      • Olympic athletes, lifting with lordosis & bracing
      • Postural muscle training I
      • Postural muscle training II
      • Treadmill desk
  • About Us 關於我們
    • Found's Profile
  • Contact Us 聯絡我們
  • Announcement 通告
    • 2018-05-31
  • Subsidiaries 子公司
    • Smart-Office
    • Beauty & Health