Essential Back Care - Dorling Kindersley

Here is a summary of the key points about back and neck anatomy:

• The spine is made up of 33 vertebrae, divided into cervical (neck), thoracic (midback), lumbar (low back), sacrum, and coccyx (tailbone) regions.

• Each vertebra has a cylindrical body and several protrusions (processes) that provide attachment points for muscles and ligaments. A hole in each vertebra forms the spinal canal to protect the spinal cord.

• Discs between the vertebrae act as shock absorbers and allow the spine to bend and twist. Each disc has a tough outer layer (annulus fibrosus) and a gel-like center (nucleus pulposus).

• Facet joints connect vertebrae and guide their movement. synovial joints contain fluid to lubricate the joints.

• Muscles and ligaments surround and support the spine. Core muscles in the abdomen and back play an important role in stabilizing the spine.

• The spine protects the spinal cord, which transmits signals between the brain and the rest of the body. Spinal nerves exit the spine through intervertebral foramina on each side.

• Good posture, exercise, and lifestyle habits help keep the spine healthy and flexible. Excess weight, injury, aging, and some diseases can contribute to back and neck problems.

• Diagnosis and treatment options for spine problems include physical exams, imaging tests, medication, physical therapy, braces, injections, and surgery as a last resort. The prognosis depends on the underlying condition.

That covers the key highlights about anatomy, function, problems, diagnosis, and treatment of the back and neck. Let me know if you would like me to explain anything in the summary in more detail.

ated with prolonged periods of inactivity (»p.72), which can

• Facet joints: The articular processes of a facet joint are lined with protective cartilage. The synovial membrane surrounding the joint secretes a lubricating fluid that assists movement.

lead to muscle wastage and increased mechanical strain.

• Disks: Disks contain an outer annulus fibrosus, which is composed of layers of concentric fibers and an inner nucleus pulposus, made of a pulpy gelatinous substance.

There is also a risk of secondary injuries owing to impaired

• Spinous process: The spinous processes of the thoracic vertebrae are much larger than those of the cervical or lumbar vertebrae.

posture and coordination. Left untreated, chronic neck pain

• Transverse process: The transverse processes of the thoracic vertebrae are larger and project posteriorly and laterally.

can progressively worsen over time and lead to chronic neck

• The bones, nerves, muscles, and ligaments of your back and neck build up a full anatomical profile.

Pain and stiffness are common, especially first thing sy

syndrome and spinal degeneration. Rare complications

• Detailed breakdowns of the structures in your back and neck help illustrate the individual elements.

joint muscles stretches (»p.173).

in the morning or after long periods of rest. Prolonged include cervical myelopathy (»p.65), due to spinal cord

Your therapist will:

compression, and radiculopathy (»

▶ monitor your progress:

p.63), in which nerve- • Once your doctor has referred you, your therapist will perform a thorough assessment. The therapist may perform manual therapy, educate you about posture, ergonomics, and relaxation techniques.

sitting, using mobile devices, or performing repetitive tasks. root compression causes pain, numbness, and weakness. You will do active and passive exercises.

Pain tends to worsen with neck movements and postures

• You should now experience diminished pain and an improved range of movement. You continue active and passive exercises, stretches, and conditioning exercises. You should continue postural advice, stretch daily, and alter sports technique. You may use advanced conditioning and invest in better chairs and get eye exams.

31

• Consulting your primary care doctor: If this is your first attack of back pain, see your doctor. They will examine you, ask about your symptoms, and may order tests to determine the cause. Treatment will depend on the diagnosis.

• Describing your pain: Use adjectives to describe the severity, quality, and location of your pain. This helps determine the cause.

• Diagnosis and treatment: Most back pain is mechanical. Your doctor will examine you and may order tests like blood tests, X-rays or MRIs. Treatment options include rest, medication, physical therapy, etc.

• Where to find help: See your doctor for diagnosis and treatment. You can also see physical therapists, massage therapists, acupuncturists, chiropractors or surgeons if needed.

• Eating for health: Eat a balanced diet with protein, carbohydrates, fat, fruits and vegetables. Stay hydrated. Losing excess weight can help.

• Calculating your energy needs: Your basic energy requirement depends on your age, sex, height, and activity level. Eat enough calories to maintain your weight and support your activity level.

• Reducing risk: Exercise regularly, practice good posture, sleep on a supportive mattress, minimize stress, don’t smoke, etc.

important that you both feel comfortable. Some suggestions: walking, so whenever possible, get up from your chair and horizontal (the level of your hips), with your arms supported.

the desk. Never cross your legs when sitting. Your chair

• Before engaging in any sexual activity, make sure you warm stretch. If your job requires you to sit for long periods, keep This helps prevent your shoulders from rotating forward and

should have good lumbar support; a curved backrest will •Further specialist investigation may be required to determine the exact cause of your pain.

up and stretch. Gentle massage or a warm bath can help the risks to a minimum by taking regular breaks to stand and relieves pressure and muscle strain. Change your position

support the natural curve of your spine. Adjust your chair to •Your doctor will perform a physical examination, including checking your spine and testing your reflexes and

A 1. Lying on your side. Place a

loosen tight muscles.

Bent knees

walk around. As a general rule, aim to stand up, move around, frequently—every 20 to 30 minutes if possible. When sitting,

fit your work surface so that your upper arms hang verti- flexibility. A slump test may also be done.

firm pillow between your knees

B 2. On your back with

• Find a comfortable position. Experiment with different

pillow under knees

and open up your hips.

cally at your sides, elbows at 90° and feet flat on the floor. •Your body weight and level of body fat will be determined. A healthy weight and an appropriate level of body fat are

positions to find one that puts the least amount of pressure or do some simple exercises for 2 to 3 minutes every hour. sit with your buttocks against the back of the chair, keep

This helps prevent fatigue and maintains good circulation. important for back health and avoiding pain.

on your back. Side lying, spooning, or rear entry positions Keeping physically active throughout the day will help your knees level with or slightly higher than your hips, have

•Change desk height and chair to allow thighs to remain

are often most comfortable.

backs. Stand with your knees slightly bent, feet apart by 6 to both feet flat on the floor, and maintain the natural arch in

•There are strategies you can employ to prevent and relieve back and neck pain, including:

horizontal, arms even with desk surface and minimal bend at

the width of your shoulders, hands relaxed at your sides, your lower back. Adjust the height of your chair so your

12 in (15 to 30 cm), and concentrate on breathing freely and

hips and keep weight off heels.

wrist. Typing tray and document holder at same level. Mouse sleep position, using proper support, and taking breaks when using electronic devices.

• Start slowly. Be gentle, go slowly, focus on pleasuring your using your diaphragm. Roll your shoulders slowly backwards hips are slightly higher than your knees. If your keyboard

within easy reach. Frequent short breaks suggested.

possible. Light stretching and exercise. Applying heat or ice to stiff or sore areas. Relaxation and deep breathing techniques.

partner, and avoid movements that cause pain.

and forwards a few times. This helps relieve muscular is much lower than your desktop, you may find it helpful to

•Investigations and diagnosis •Target and treat the underlying cause of pain where possible in addition to managing symptoms. This may include lifestyle changes, physiotherapy, medication, injections, surgery, pain management programs, or other therapies.

• Consider manual stimulation or oral sex as alternatives tension and improves flexibility in your neck. Include simple use a keyboard raiser or laptop riser to elevate it.

Here are the main points:

• Ensure correct alignment of your head and neck to avoid strain. You should only use one pillow if lying on your back.

• Use a supportive mattress and consider your sleeping position. Lying on your front or side with bent knees and a pillow between your legs can help.

• Sit with good posture in an ergonomic chair at the correct height. Your lower back should be supported and your feet flat on the floor.

• Raise the screen to eye level and keep your elbows close to your sides when typing.

• Explore gentle sexual positions like spooning that do not aggravate your pain. Communicate with your partner about your needs.

• Describe your pain clearly to your partner and reassure them you are still attracted to them. Set aside time to connect physically and emotionally.

• Use pain relief methods such as heat/ice and massage. See a doctor if needed for prescription medication or physical therapy.

The key points summarize advice for managing and alleviating back pain through positioning, movement, communication and self-care. The response highlights the importance of finding ways to maintain intimacy with a partner despite discomfort. Overall, a combination of medical and lifestyle approaches can help in coping with and overcoming back pain.

• The spine provides central support and allows movement. It consists of vertebrae in the cervical (neck), thoracic (midback), and lumbar (lower back) regions.

• The cervical spine is the most mobile. The thoracic spine connects to the rib cage. The lumbar spine bears most of the body’s weight.

• Vertebrae have processes that provide attachment for muscles and ligaments. Their facet joints connect vertebrae and allow movement.

• Discs between vertebrae act as shock absorbers and allow movement. Facet joints and discs together act as fulcrums and ball bearings, respectively.

• The spine, discs, muscles, and ligaments work together to support the body and enable movement while protecting the spinal cord.

• Exercises can help strengthen and mobilize the spine and surrounding structures. Rehabilitation aims to restore function and reduce pain.

The summary outlines the key points around spine anatomy, function, and care. The assistant extracted the essence from the diagrams, descriptions, and explanations in the provided text. Please let me know if you would like me to clarify or expand on any part of the summary.

The spine allows movement through a combination of vertebrae, disks, muscles and ligaments. Vertebrae are bones that stack up to form the spinal column. Disks are cartilaginous pads that separate the vertebrae, acting as shock absorbers. Pairs of muscles attach to the vertebrae, allowing the spine to bend, twist and stabilize. Ligaments are elastic bands that connect the vertebrae, providing stability.

The spinal canal runs through the vertebrae and contains the spinal cord, which transmits signals between the brain and the rest of the body. Spinal nerves emerge from the spinal cord through gaps in the vertebrae and innervate the body.

Smaller muscles near the vertebrae fine-tune posture and movement. Larger superficial muscles control bigger movements like bending over. Muscles usually work in pairs, with one contracting as the other relaxes.

The stabilizing muscles near the joints help control spinal positioning. The mobilizing muscles, like the erector spinae, produce movement. Abdominal muscles support the spine and maintain pressure in the abdomen.

The spine provides mobility and stability through an integrated system of bone, cartilage, muscles and ligaments. Proper functioning of this system is essential for movement, balance and health.

• The symptoms indicate the pain may have been caused by a muscle strain from twisting, bending over, or heavy lifting. The pain developed rather suddenly within a few hours.

• There is a possibility of a disk protrusion or tear that is pinching a nerve, causing pain to radiate down the leg. This would require medical diagnosis and possible imaging tests.

• Other possible causes for the lower back and leg pain include sciatica, stenosis of the spinal canal, spondylolisthesis, sacroiliac joint strain, or piriformis syndrome. These would also require a doctor’s diagnosis and appropriate treatment.

• Some symptoms point to poor circulation as a possible cause. The patient should see the doctor, especially if the pain interferes with walking or standing.

• There are some indications the pain may be caused or aggravated by prolonged sitting or inactivity. Improving mobility and core stability may help, but a doctor’s advice is still recommended.

• If the pain is accompanied by other symptoms like colitis, eye inflammation, rashes or discharge, there may be an underlying condition requiring diagnosis and treatment. The patient should consult their doctor.

In summary, while some symptoms point to strains, tears or pinched nerves as possible causes, and lifestyle changes may provide some relief, the variety and severity of symptoms described warrant a doctor’s diagnosis and advice regarding appropriate treatment. The best course of action is for the patient to consult their physician.

• The pain is likely inflammation of the neck joints or muscles (acute torticollis).
• See a doctor within 24 hours if pain is severe or accompanied by other symptoms.
• To relieve pain: — Rest in a comfortable position, use ice, and take an OTC painkiller
• After 3-5 days, perform gentle neck exercises and resume normal activities cautiously.
• See a doctor again if pain persists or worsens after 7-10 days. They may refer you to physical therapy for further treatment.
• To prevent recurrence, use good neck posture and strengthen your neck muscles through exercise in the long term.

Here is a summary of the stages of treatment for facet joint pain:

Immediate: Seek diagnosis and treatment from doctor. Rest, apply heat/ice, and take over-the-counter medication for pain relief.

Short term: Try physical therapy, massage therapy, acupuncture or osteopathy. Avoid aggravating activities. Use a soft collar for support if needed.

Medium term: Get corticosteroid injections to reduce inflammation. May have diagnostic medial branch blocks to determine if facet joints are source of pain.

Long term: If injections provide substantial but temporary relief, radiofrequency denervation may be recommended to reduce pain signals from facet joints. As a last resort, spinal fusion surgery may be considered.

Lifestyle changes and self-care are recommended at all stages to prevent recurrence.

▶ pace yourself.

as normal as possible.

epidural injections (»pp.86–87),

lp in learning to live

▶ relax your muscles.

▶ avoid activities that aggravate

or discectomy (»pp.88–89).

with pain.

▶ use medication wisely

your pain.

Disc surgery aims to release

▶ an operation such as a fusion and appropriately.

▶ get advice regarding specific

the irritated or compressed

of the neck vertebrae or

▶ return to normal activities

nerve or remove the damaged

cervical artificial disk replacement.

and work as soon as

disk material.

This aims to give stability

possible after consulting

to the spine and relieve pressure. your doctor.

exercises and activities from your doctor or specialist. EARLY STAGE

INTERMEDIATE STAGE

ADVANCED STAGE

■ Once your doctor has referred you,

■ Your pain should diminish gradually,

■ By this stage you should have been

your therapist will perform a thorough

and you should be able to return to your

pain-free for at least 3–6 months.

assessment to determine the location,

normal daily activities. However, you should: You may:

cause, and severity of your pain. He may:

▶ continue gentle isometric strengthening

▶ start more advanced conditioning

▶ suggest conservative treatment including exercises (»pp.163–65)

exercise such as swimming, aqua

manual therapy (»pp.94–95; 98–99), careful

▶ modify your weight training routine:

aerobics, jogging on soft ground, or use

and progressive rehabilitation exercises.

use light weights and higher reps.

gym equipment such as an elliptical

▶ advise against prolonged bed rest, as this ▶ maintain good posture awareness

trainer or cross-trainer for 30 minutes

can worsen your condition.

during all activities.

2–3 times a week, increasing duration

▶ educate you about posture

■ Your specialist may suggest:

and intensity gradually as pain allows.

(»pp.112–115), ergonomics, and

▶ acupuncture (»pp.100–01) or TENS

■ You should:

relaxation techniques (»pp.148–49).

(»pp.102–03) to relieve pain.

▶ continue gentle mobility and flexibility

▶ suggest certain gentle passive or

▶ an epidural (»pp.86–87) or facet

training as a maintenance program.

active spinal mobilizations and

joint injection (»pp.86–87) if your

▶ continue to maintain good workstation,

muscle-energy techniques (»p.92).

symptoms warrant.

sleeping, and sitting postures.

■ If your pain is not improving or

■ If your pain is not improving or

is getting worse, you should:

is getting worse, you should:

▶ return to your specialist for review.

▶ consult your doctor. Further

SICAL THERAP

PHY

imaging may be required and surgery may need to be considered.

Here is a summary of the suggestions for managing thoracic pain:

• Consult your doctor for diagnosis and to rule out any serious underlying conditions.

• Relieve pain by finding a comfortable position, using ice, and taking anti-inflammatories.

• Start gentle mobility and strengthening exercises as soon as pain allows.

• A physical therapist can provide manual therapy, advice on posture and exercise.

• Gradually return to normal activities and exercise as your pain and mobility improve.

• Seek follow up with your doctor if pain persists or worsens after 6-8 weeks of self-care.

• Maintain good back care, core stability, and an exercise routine to prevent recurrence.

relieve pain (»pp.158–59).

curls (»p.190), and bridges (»p.195).

resistance to rebuild fitness and stability.

• Find a comfortable position, such as lying down.

▶ teach you correct standing, sitting,

▶ hip-flexor stretches (»p.209),

▶ Be guided by your therapist or trainer,

• Apply ice for 15 minutes every 2 hours the first day.

and lifting postures (»pp.112–15).

hamstring stretches (»p.196), and calf

who will aim to strengthen your core and

• Take an over-the-counter pain reliever.

▶ show you basic mobility exercises

raises (»p.198).

back muscles through exercises that do

• See a doctor right away for diagnosis and prescription pain medicine.

such as pelvic tilts (»p.200) and

▶ low-intensity cardiovascular exercise

not compress your spine. Once you are

• Avoid prolonged sitting, driving, and bending for 3 to 7 days.

knees-to-chest stretches (»p.202).

such as fast walking (starting with

able to do these pain-free, and have full,

• Follow advice for gentle movement and exercise from a physical therapist.

▶ advise you to continue with acunpuncture 5 minutes), aquatic therapy, and use

free movement, you may return to normal

• See your doctor again in 7 to 10 days. You may need an MRI, steroid injection, or surgery.

(if appropriate), relative rest, and

of an elliptical trainer or bicycle.

daily and sporting activities, as guided

• Rebuild core strength and fitness over 6 to 8 weeks through recommended exercises.

posture correction.

Increase duration as your symptoms

by your therapist.

• Continue good back care and posture. See a doctor if pain continues over 3 months.

allow.

■ If your symptoms are worsening or not

improving, you should:

▶ return to your doctor for review.

▶ Return to normal activities gradually, over 6 to 8 weeks, as your symptoms improve.

▶ See your doctor if pain worsens or does not start improving in 3 months.

• Stay as active as possible while managing pain with medication as prescribed.
• For moderate to severe pain that does not improve with physical therapy, see a specialist. They may recommend:
• Rehabilitation to improve strength, flexibility and fitness
• Diagnostic blocks to identify pain source
• Prolotherapy or intradiskal injections to reduce inflammation
• If pain continues with no further treatment options, see a pain management specialist. They can provide a program including:
• Physical and psychological techniques for coping with chronic pain
• Help managing expectations and appropriate use of medication
• In severe cases, surgery such as spinal fusion or disk replacement may be recommended as a last resort.

The goals are to stay active, strengthen the body, manage pain, and learn coping strategies to improve quality of life despite ongoing pain. Surgery is only considered once all other options have been exhausted.

You have a disability relating to low back pain caused by spondylolysis (a stress fracture in the lumbar spine) or spondylolisthesis (slipping of one vertebra on another). Treatment focuses on strengthening your core and back muscles, improving your flexibility and posture, and modifying your activities to avoid further injury. You will work closely with a physical therapist on an exercise program tailored to your needs. If your pain does not improve with conservative treatment, your doctor may recommend spinal fusion surgery to stabilize the spine. The goal is for you to cope with your disability and continue with your daily activities as normally as possible.

If your sciatica pain is not improving or is getting worse, you should:

• Return to your doctor for review.

The key is to stay as active as possible, but to avoid pain-aggravating positions or activities. To help relieve sciatica pain, try:

• Ice packs or heating pads on your back
• Over-the-counter medication like ibuprofen to reduce inflammation
• Gentle stretching and exercise, as instructed by your doctor
• Elevate your legs while sitting

The underlying cause needs to be addressed. Your doctor may order an MRI or CT scan to determine the cause of your sciatica and the best treatment. Options include:

• Physical therapy and exercise for muscle spasms or piriformis syndrome
• Epidural steroid injections to reduce inflammation
• Surgery to remove portions of a damaged disk or to widen the spinal canal if other treatments are not effective

Most people recover from chronic sciatica, but it can take several months. Staying active, managing pain, and patience are key. See your doctor right away if your pain is severe or you have trouble controlling your bowels or bladder.

Chronic sciatica causes light touch or pressure sensation, as well as normal movement to cause pain. The skin may appear discolored, sweat more, or seem swollen, and be sensitive to temperature changes. These signs indicate changes to the affected nerve, its cells, and pathways in the spine and brain.

While there are no physical risks, living with chronic pain can lead to difficulty staying active and working, as well as psychological challenges.

Treatment focuses on managing pain, restoring mobility and strength, and learning to pace activities. Options include medication, physical therapy, injections, TENS, and in severe cases surgery. The pain often improves slowly over time. Patients should continue exercises, be realistic about abilities, and not overexert themselves.

For spinal stenosis, treatment also focuses on managing pain, restoring mobility and learning to avoid painful positions. Options include physical therapy, epidural injections, and in severe cases decompression surgery. Patients may use walking aids. Exercises, stretches and posture adjustments can help relieve pressure on the spinal canal.

In summary, the characteristics are light touch/pressure and normal movement causes pain. The risks are really related to living with chronic pain. And the treatment focuses on managing pain, restoring strength and mobility, learning to pace activities and in severe cases surgery. The prognosis is often slow improvement over time with self-management.

Coccydynia refers to pain in the coccyx or tailbone. It is usually caused by a fall or blow to the coccyx. Initial treatment focuses on relieving pressure on the coccyx, reducing inflammation and pain. Use of a coccyx cushion, ice, and medication can help. If pain persists for over a month, the doctor may order X-rays to check for fracture and may refer to a specialist. The specialist may try manual therapy, injections or in rare cases surgery.

Physical therapy aims to reduce pain and improve mobility and function. Treatment may include manual therapy for the coccyx, electrotherapy, stretching and strengthening exercises for the back, hips and legs. Activity modification, use of a coccyx cushion and relaxation techniques are also recommended. As pain improves, cardiovascular and higher impact exercises are gradually introduced.

In most cases, nearly normal function can be restored with conservative treatment over 3-6 months. However, coccydynia can sometimes become chronic, requiring long-term self-management to prevent or minimize flare-ups.

• Whole spine conditions can involve inflammatory diseases, osteoporosis, poor posture, scoliosis, or hypermobility syndrome.

• Symptoms may include pain, aching, loss of mobility, unstable joints, muscle tension, or changes in posture or spine shape.

• Causes depend on the specific condition but can include inflammation, osteoporosis leading to vertebral fractures, postural problems, scoliosis (curvature of the spine), or hypermobile joints.

• Risks and complications relate to the underlying condition but may include permanent disability, deformity, or even damage to the spinal cord.

• Inflammatory disease: Seek medical help immediately. Get diagnosed and treated promptly with anti-inflammatory meds and physical therapy. The treatment typically involves medications, exercise, lifestyle changes and physical therapy over the long run.

• Hypermobility syndrome: Get diagnosed and learn correct movement patterns and core strengthening. Treatment focuses on posture, balance, strength and stabilizing the joints. It often requires long term management of pain and psychological factors.

• Postural pain: Initially try OTC meds and rest. See a doctor for diagnosis and treatment with meds or therapy if pain persists. Treatment focuses on diagnosing and addressing the underlying cause, as well as pain management. Severe cases may require long term lifestyle changes and pain management.

The summary highlights the key steps in the diagnosis and treatment of various spine conditions like inflammatory disease, hypermobility syndrome and postural pain. The treatment typically spans the short term to long term, and addresses both medical as well as physical therapy/lifestyle components for effective management of the conditions.

To manage muscle inflammation or disease, you can:

▶ Take ibuprofen in recommended dosages regularly, not just when pain becomes unbearable.

▶ Get nutritional, hormone, and other tests to determine appropriate treatment.

▶ Take medications like low-dose antidepressants to relax muscles and improve sleep.

▶ Get injections to relax trigger points.

▶ Follow a functional rehabilitation program to improve strength, flexibility, movement, posture, and fitness.

▶ Use a pain management program including psychological help and appropriate medications.

To adapt, you should:

▶ Pace yourself

▶ Maintain good posture

▶ Use medication properly

▶ Stay active

▶ Listen to your body

▶ Don’t worry too much about minor symptoms

▶ See your doctor if pain persists

Early stage treatment may include soft tissue massage, posture education, biomechanical correction, and functional retraining. You’ll start gentle exercises.

Intermediate stage treatment adds core and high-level exercises, functional training, and cardio.

Advanced stage treatment intensifies exercises and may include swimming, t’ai chi, or Pilates. See your doctor if not improving or getting worse.

For scoliosis, see a specialist for diagnosis and appropriate treatment like exercise, bracing, or surgery. Treatment focuses on posture correction, core stability, and pain management.

For a vertebral compression fracture, get immediate medical help. Treatment focuses on rest, medication, support, and rehabilitation to relieve pain, improve movement and function. Vertebroplasty may provide relief if not recovered after 6 weeks.

Ongoing treatment for chronic conditions focus on stability, strength, flexibility, movement, and minimizing pain through appropriate exercise, lifestyle changes, and medication as needed. Follow up with your doctor regularly.

• Muscular tension: Caused by poor posture, injury, overexertion, leg length differences, scoliosis, etc. Leads to pain, muscle spasms, and strain on joints/ligaments. Treatment includes relaxation, improved posture, physical therapy.

• Ankylosing spondylitis: Autoimmune disease causing inflammation and calcification of spine ligaments. Usually occurs in young adults and more common in men. Causes stiffness, pain, and limited mobility. Increase risk of osteoporosis and heart problems. Treatment includes physical therapy, exercise, and medication.

• Spondylolysis and spondylolisthesis: Spondylolysis is a crack in a vertebrae, often from overuse or injury. Can lead to spondylolisthesis, where the vertebrae slips out of place. Causes pain, numbness. Treatment includes physical therapy, bracing, sometimes surgery. Monitor to prevent worsening.

• Vertebral compression fracture: Weakening of vertebrae, often from osteoporosis. Can lead to fractures from falls or activity. Causes pain, height loss, kyphosis. Treatment includes rest, bracing, pain management, and treating underlying osteoporosis. Surgery for severe pain or deformity.

In summary, these conditions are caused by a combination of overuse, injury, poor health, genetics, and aging. The treatments focus on relieving pain, stabilizing the spine, physical therapy, and managing any underlying conditions. Surgery may be needed in severe cases. Close monitoring is often required, especially for conditions that may worsen over time.

Osteoporosis is a condition that causes bones to become weak and fragile. It is usually caused by aging and hormonal changes, especially in women after menopause. However, other factors like smoking, alcohol use, lack of exercise, and low body weight can also contribute to osteoporosis.

The main symptom of osteoporosis is bone fractures, especially in the spine, hips, and wrists. These fractures can cause severe pain, mobility issues, and disability. Osteoporosis is diagnosed using bone density scans.

To prevent and treat osteoporosis, doctors recommend calcium and vitamin D supplements, exercise, quitting smoking, limiting alcohol, and medications like bisphosphonates. Making lifestyle changes and treating any underlying conditions can help manage symptoms and prevent fractures.

Injuries or abnormalities of the sacroiliac joints, such as strain from a sports injury, can cause the ligaments surrounding the joints to become inflamed. Inflamed ligaments lead to loosening of the joints, making them more mobile. It is common for pregnant women to suffer from hypermobile sacroiliac joints due to hormonal changes that soften the ligaments.

Symptoms include sharp pain in the upper inner buttock, dull pain radiating to the lower buttock and legs, restricted leg movement, and difficulty walking. Tests may be done to check for inflammation.

Recovery can take a long time. Ligaments heal slowly and may not heal completely. Sitting or lying still for a long time can lead to stiffness and immobility.

The sacroiliac joints connect the sacrum at the base of the spine to the two ilia, the largest pelvic bones. These joints support weight and the spine.

Osteoarthritis and spondylosis are age-related spinal degeneration that often start after age 50. They cause narrowing of the spinal canal due to bone spurs and disc degeneration. Symptoms include back pain, leg pain, numbness, and weakness. Risks include reduced mobility and pain. Treatment focuses on pain management and physical therapy.

Scoliosis is an abnormal curvature of the spine that often develops in children and adolescents. It can cause back pain, difficulty breathing or walking in severe cases. Bracing or surgery may be needed to prevent progression. Long-term risks include chronic back pain and joint degeneration.

Coccydynia is pain in the coccyx or tailbone, often caused by injury, prolonged sitting, or childbirth. Symptoms include pain while sitting, bowel movements, or sex. Cortisone injections or surgery may be needed for severe, persistent cases.

Piriformis syndrome occurs when the piriformis muscle irritates the sciatic nerve, causing pain, tingling, and numbness. It is often caused by muscle tightness or spasms and aggravated by sitting or activity. Stretching, physical therapy, and injections are often effective treatments.

Gluteus medius dysfunction refers to strains and tears in the gluteus medius muscle in the buttocks. It causes pain, stiffness, and difficulty walking. It is often caused by overuse or injury. Rest, physical therapy, and ice or heat can help relieve symptoms. Severe tears may require surgery.

In summary, many age-related changes and injuries can contribute to back and hip pain. A combination of diagnosis, imaging, physical therapy, medication, injections, and sometimes surgery may be needed to effectively manage symptoms. An active, healthy lifestyle with good core and leg strength can help prevent or minimize many of these conditions.

• Gluteus medius muscle becomes tight, shortened, and less flexible due to stress, tension, or overuse.
• This can cause hip and buttock pain, stiffness, instability, and difficulty moving the hip.
• Minor strains usually heal in a few weeks with rest, while chronic tightness needs rehabilitation to regain range of motion.
• See a doctor for diagnosis and treatment. They will examine the hip and may order tests like X-rays or MRIs.
• Treatment options include rest, medication, physical therapy, steroid injections, and in severe cases, surgery.
• If pain persists for over 6-8 weeks, see an orthopedic specialist. They may order more tests to determine the underlying cause.
• Tests include blood tests, X-rays, CT scans, MRIs, and nerve studies. These help rule out serious conditions and guide treatment.

The key points are that the gluteus medius can become tight and dysfunctional, causing pain and mobility issues. Diagnosis and treatment aim to determine the underlying cause, reduce pain, improve flexibility and function, and prevent recurrence. Rest, medication, physical therapy, and consulting doctors and specialists are all options for finding relief.

Benefits: MRI scanning is totally noninvasive and does not involve any potentially harmful radiation.

Process: MRI scanning of a section of your spine will usually take about 30 minutes to complete. You will lie in a narrow tunnel surrounded by magnets. It is often noisy, so you will be given ear plugs. It is important to tell your doctor if you feel claustrophobic. You may be offered a sedative or open scan.

Specialized X-rays:

• CT scans: Send out multiple X-ray beams to produce detailed images. Show calcification and bone damage clearly but involve radiation exposure.
• Bone scans: Inject radioactive material to detect areas of high tissue renewal, indicating infection, tumor or fracture. Safe and painless. Can detect problems 3 months earlier than X-rays.

Other tests:

• Discography: Identify source of discogenic pain. local anesthetic is used to insert needle into suspect disc(s) and dye is injected. If pain is reproduced and X-rays show dye spread, it indicates the disc is the source of pain. Surgery may be recommended.
• Electromyography: Monitors electrical activity of muscles to identify nerve damage. Involves inserting fine needles into muscles, which are wired to a monitor. Shows if nerves are functioning properly. No side effects, slight pricking sensation. Not definitively diagnostic alone.
• Moiré fringe analysis: Uses polarized light to detect posture and leg length problems. Limited usefulness.

Medications for back and neck pain:

• Simple painkillers (e.g. aspirin, ibuprofen, acetaminophen): Relieve mild to moderate pain. Available OTC.

• Combination drugs (e.g. codeine, oxycodone with aspirin/ibuprofen/acetaminophen): Relieve mild to moderate pain. Available with prescription.

• Stronger painkillers (e.g. narcotics like morphine, hydrocodone, oxycodone; non-narcotics like tramadol): Relieve moderate to severe pain. Available with prescription.

• Muscle relaxants (e.g. diazepam, methocarbamol): Provide sedation and muscle relaxation. Available with prescription.

• Anti-inflammatory drugs (e.g. NSAIDs like celecoxib, diclofenac, ibuprofen): Reduce pain by inhibiting inflammation. Some available OTC, some require prescription.

• Steroids (e.g. betamethasone, prednisolone): Counteract inflammation. Require prescription.

• Low-dose tricyclic antidepressants (e.g. amitriptyline): Suppress nerve pain, relieve muscle tension and insomnia. Require prescription.

• Anticonvulsants (e.g. carbamazepine, gabapentin): Soothe chronic nerve pain. Require prescription.

• Gabapentin, pregabalin, and bamazepine are anticonvulsant medications used to treat neuropathic pain. They work by reducing pain signals in the brain and spinal cord.

• Injections can provide rapid relief from back and neck pain. They deliver medication directly to the source of pain, allowing for lower doses and fewer side effects. Common types of injections include trigger point injections, ligament injections, facet joint injections, epidural injections, and nerve blocks.

• Spinal surgery may be recommended if other treatments are not providing relief or for emergency conditions. Common surgeries for back and neck pain include:

› Discectomy: Removes pressure on nerve roots caused by a herniated disc. Used for sciatica pain.

› Decompression: Removes pressure on the spinal cord or nerve roots caused by spinal stenosis. Relieves nerve pain.

› Spinal fusion: Fuses two or more vertebrae together to stabilize the spine. Used for severe, ongoing pain.

› Disk replacement: Replaces a diseased or degenerated intervertebral disc with an artificial one.

• Most people benefit from spinal surgery, with relief from symptoms for at least 10 years. Surgery may not completely cure pain but can reduce severity and frequency.

• Surgery may be offered as a last resort except for emergency conditions like cauda equina syndrome, in which case immediate surgery is required.

Does this summary cover the key highlights from the material on treatment options? Let me know if you would like me to clarify or expand on any part of the summary.

• Discogenic or facet joint pain that does not improve with other treatments may require spinal fusion surgery to stabilize the spine. Fusion stops all movement in the affected area, leaving it rigid. It is only done when other treatments have failed.

• An alternative to fusion is disc replacement, which restores disc height and allows some mobility. This reduces stress on adjacent segments and slows their degeneration.

• Severe scoliosis may require surgery to straighten the spine, usually in adolescence when curvature is progressing rapidly.

• Surgery for coccydynia relieves chronic tailbone pain when other treatments have failed. The coccyx is partially or completely removed.

• Preparing for spinal surgery includes optimizing health and fitness. Losing excess weight, quitting smoking, and exercising all promote better outcomes. Knowing what to expect from the procedure reduces anxiety and leads to faster recovery.

• Results vary depending on the procedure but often include dramatic pain relief, restored mobility and function, and improved quality of life. Recovery times range from weeks to years.

• Physical therapists use mobilization, manipulation, exercise, and education to reduce pain, improve mobility and function. Treatment is tailored to each patient’s needs and condition.

• The McKenzie method helps patients actively manage pain through repeated movements. The Schroth method uses targeted exercises to correct spinal curvature from scoliosis.

• Soft tissue mobilization techniques address tendons, muscles, fascia and other non-bony tissues to reduce pain and improve mobility.

Does this summary accurately reflect the key points about spinal surgery and physical therapy options? Let me know if you would like me to clarify or expand the summary in any way.

Myofascial trigger point therapy involves applying pressure to painful muscle knots to relieve pain. A physical therapist locates these trigger points and applies deep pressure and massage to deactivate them. The techniques used include myofascial release, muscle energy technique, and proprioceptive neuromuscular facilitation. These techniques stretch, mobilize, and correct movement patterns. They aim to improve flexibility, coordination, stability, and mobility.

Acupuncture may be used along with physical therapy. It releases natural pain relieving chemicals to reduce pain, improve sleep, and enhance well-being. As pain decreases, the physical therapist introduces other treatments and exercises.

Therapeutic ultrasound uses sound waves to increase blood flow, reduce muscle spasm, loosen connective tissue, and heal damaged cells. The physical therapist applies gel to the skin and moves an ultrasound head over the area for several minutes.

Hydrotherapy or aquatic therapy allows exercising in water which supports the body and reduces stress on the joints. The physical therapist guides the patient through exercises tailored to their needs.

Functional training uses weight-bearing activities to target core muscles. The physical therapist designs exercises that mimic everyday movements to build strength, improve mobility, and prevent injury. The training can improve sports performance and prevent sports injuries.

Sensorimotor training focuses on balance, coordination, and posture. The physical therapist guides the patient through static, dynamic, and functional exercises using tools like wobble boards, resistance bands, and foam pads. The training aims to restore communication between the brain and muscles.

Strapping or taping techniques provide support for muscles and joints. The physical therapist applies tape which may need to be changed every few days. The tape helps improve posture, take strain off the neck and back, and encourage healing.

Osteopathic manipulation aims to loosen stiff joints and restore mobility. An osteopath uses rhythmic movements to mobilize joints and may massage muscles to relax them before manipulation. Treatment focuses on correcting problems with muscles and joints to relieve pain. An osteopath also provides advice on posture, diet, and exercise.

Your chiropractor will apply gentle downward pressure and manipulation to your spine to relieve back pain and improve mobility.

Treatment focuses on correcting misalignments in the vertebrae of your spine that can pinch nerves.

Your chiropractor will take a medical history and may order x-rays. Treatment may require multiple sessions and follow-up with exercises.

Some discomfort is possible but treatment aims to be gentle. Chiropractors focus on the musculoskeletal system and how it affects nerve function and health.

A referral from your doctor is not required but can be helpful. Initial consultations last around 30 minutes, follow-ups 15-20 minutes.

X-rays and physical exams help diagnose problems. Treatment uses a special table that can be adjusted for proper positioning.

Your chiropractor will feel your spine for problems, check flexibility and range of motion. Precise hand movements are used to manipulate the spine.

Relief may not be immediate but should improve over multiple sessions. Treatment, exercises and posture advice can help provide ongoing benefits.

Acupuncture is a traditional Chinese treatment that involves inserting thin needles into specific points on the body. It is based on the idea that energy flows through the body in channels called meridians. Blockages in these meridians can lead to illness. Acupuncture aims to restore the flow of energy and balance in the body.

Acupuncture may help relieve back pain by:

• Reducing pain, which can enable other treatments like physical therapy to work better. However, results vary between individuals and there is no guarantee it will provide relief.

• Treating trigger points which can help relieve long-standing pain and improve mobility.

Reasons for choosing acupuncture include:

• Conventional treatments are not helping.
• You want to try an alternative therapy.
• You prefer natural remedies.

During treatment:

• The acupuncturist will take a detailed medical history and assess your pulse, tongue, and complexion.
• Sterilized needles are inserted into specific points on the body. This may cause a brief stinging sensation.
• You relax for 10-15 minutes while the needles are in place.
• Moxa (a Chinese remedy) may be used to help clear energy blockages.

The overall goals are to restore energy flow, relieve pain, and balance the body. Acupuncture may need to be combined with other therapies for the best results. The treatment can be used for both acute and chronic back pain, but you should get a medical diagnosis first before pursuing acupuncture.

• Relaxation techniques such as meditation, hypnosis, and autogenic training can help reduce chronic back pain by lowering stress and tension. They teach you to recognize and release muscular tension.

• Meditation aims to calm the mind and reduce stressful thoughts. There are many types, including transcendental meditation, Buddhist meditation, and yoga. Meditation may help reduce recurrent back pain caused by tension. It is best learned from a teacher.

• Hypnosis alters your perception of pain. Under hypnosis, your conscious mind is suspended so a hypnotist can suggest ways to reframe your experience of pain. Hypnosis may provide lasting pain relief for some people. It is best done with a trained hypnotist, at least initially.

• Autogenic training involves silently repeating phrases to stimulate relaxation and calm thoughts. It helps shift your mind from daily stresses to a relaxed state, easing tension and pain.

• How well and how quickly you respond depends on factors like the severity of your pain, your ability to relax, and how diligently you practice the techniques. Patience and persistence are required. Some pain relief may be lasting, but relaxation techniques often require ongoing practice.

• Most relaxation techniques can be self-taught but are best learned from a skilled teacher, at least initially. A teacher can give you personalized guidance and help you master the techniques.

• No single approach works for everyone. You may need to try different techniques to find what works best for you. But with regular practice of proven relaxation methods, many people are able to reduce their back pain and improve their quality of life.

The summary is: The release of pent-up tension through relaxation techniques.

• The human spine provides support and allows movement. It is divided into three sections: cervical (neck), thoracic (midback), and lumbar (lower back).

• The cervical spine is the most flexible and supports the head. It allows neck movement and helps maintain balance.

• The thoracic spine is the least flexible and protects the chest organs. It primarily allows rotation and limited flexion/extension.

• The lumbar spine is flexible and involved in many movements like bending, walking, and running. It connects to the pelvis and is where most back strains occur.

• There are many factors that increase the risk of back problems like age, gender, posture, fitness, occupation, and genetics. Back pain is most common between ages 30 and 50.

• Disk degeneration occurs with age as disks dry out and lose fluid. This can lead to disk protrusions, narrowed spinal canals, and facet joint problems.

• Insufficient exercise, heavy lifting, awkward postures, repetitive movements, vibration, and static positions can contribute to back problems.

• Back pain can often be prevented or reduced through regular moderate exercise and physical activity like yoga or walking.

• Practice good posture to avoid back strain and injury. Good posture distributes weight evenly and minimizes stress on your back.

• Office workers, drivers, and other sedentary occupations are at high risk of back pain due to prolonged sitting with poor posture. Stretching and taking breaks can help.

• When standing, keep your head level, shoulders back, chest open, spine gently curved, pelvis in neutral alignment, and knees slightly bent. Engage your core muscles.

• When sitting, use a supportive chair and cushion, keep your head level, chest open, and spine curved. Take regular standing breaks.

• Be aware of your posture and make a habit of correcting yourself when you start to slouch. It takes practice and consistency.

• Exercises like yoga and Pilates help build strength and flexibility for good posture. Walking, swimming and other gentle activities also help.

• Orthotics like shoe inserts can help correct posture problems caused by flat feet or imbalance. See a podiatrist for custom orthotics.

• Maintaining a healthy weight takes pressure off your back and makes good posture easier. Focus on diet and exercise.

• If you have a chronic back condition, avoid activities that aggravate your pain. Talk to your doctor about safe exercises and lifestyle changes.

• Pregnancy changes your posture and center of gravity. Follow the same principles of good posture and see a physical therapist if needed.

Good posture:

• Straight back with gentle S-curve

• Feet flat on the floor

• Good alignment of bones and joints

• Decreases stress on spine

Bad posture:

• Slouching

• Leads to backache, joint pain, tension headaches

• Restricts breathing

Exercise benefits:

• Keeps joints supple and strengthens muscles

• Improves fitness, stamina, and endurance

• Lowers heart rate and blood pressure

• Reduces stress and back/neck pain risk

Warm-up:

• Low-impact cardio • Static stretching • Dynamic stretching • Sport-specific exercises

Cool-down:

• Gentle walking • Gentle loosening exercises • Static stretching

Avoid injury by:

• Using proper equipment • Warming up • Not overtraining • Maintaining good technique • Taking safety precautions • Addressing muscle imbalance or weakness • Improving flexibility and range of motion

• Eating a healthy, balanced diet and staying hydrated contribute to back health.

• Being overweight puts extra stress on the spine. Cutting down on unhealthy foods and exercising regularly can help lose weight and relieve back stress.

• Calorie intake determines weight gain or loss. Consuming more calories than burned leads to weight gain; burning more calories than consumed leads to weight loss.

• Foods high in fat (9 calories/gram) and alcohol (7 calories/gram) are energy dense, providing many calories for their weight. Carbohydrates and protein (4 calories/gram each) are less energy dense.

• For most adults, a daily calorie intake of around 2,000 is typical for weight maintenance. Increase or decrease by 500 calories per day for 1 pound of weight loss or gain per week.

• Staying hydrated is important for back health. Most experts recommend 6-8 glasses of water per day.

• Key nutrients for bone and muscle health include calcium, vitamin D, protein, and magnesium. These nutrients are found in foods like dairy, fish, leafy greens, nuts, and beans.

• Limiting processed foods, sugar, salt, red meat, and saturated fat benefits back health. A balanced diet with lots of fruits and vegetables, lean proteins, and whole grains is best.

• Consider consulting a doctor or dietitian for specific dietary recommendations tailored to your needs. General guidelines provide a starting point, but individual factors like age, sex, weight, and activity level determine optimal calorie and nutrient intake for each person.

▶ To maintain a healthy weight, you need to balance the calories you eat with the energy you use each day. The typical recommended intake is:

• Carbohydrates: 60% of total calories
• Fat: 25% of total calories
• Protein: 15% of total calories

▶ Your basic energy requirement (BER) depends on factors like your age, weight, height, and activity level. Sedentary people need fewer calories while active people need more.

▶ Body mass index (BMI) measures if you are at a healthy weight. A BMI under 18.5 is underweight, 18.6-24.9 is normal, 25-29.9 is overweight, and over 30 is obese. However, BMI does not account for muscle mass and may be inaccurate for some people.

▶ To prevent back and neck pain, maintain good posture, especially if sitting for long periods. Use an ergonomic chair and desk setup, keep your spine aligned, take regular breaks, and avoid tension in your shoulders and neck.

▶ When using a computer, place the monitor directly in front of you, use a wrist rest, set the monitor an arm’s length away and at eye level, keep your elbows close to your body, and take frequent breaks.

▶ For good posture, keep your head level, avoid dropping your chin, and make sure your ears are over your shoulders, your shoulders are over your hips, and your hips are over your knees and ankles. Engage in exercises like neck retraction to relieve tension.

▶ Stay physically active outside of work to maintain flexibility and strength. Exercise, stretch, and vary your positions and movements as much as possible.

Here are some key tips for lifting and carrying safely:

back straight

with your spine

and pelvis

neutral

Use your leg muscles, not your back, to lift the load. Bend at your knees and hips, not your waist. Keep the weight close to your body. Don’t twist while lifting. Maintain a neutral spine with your back straight, chest open, and pelvis level. Engage your core muscles. Check the weight and dimensions of the load before lifting to make sure it’s in a safe range for you. Get help for heavier loads. Ensure a clear walking path before lifting and carrying the load. Take small steps when walking. When carrying in front, keep the load balanced and don’t lean back. When carrying on your back, avoid bending forward at the waist. Put the load down the way you picked it up, with control and a neutral spine. Bend at the knees and hips. Ask for help if a load causes pain or if you don’t feel in control when lifting or carrying it. Don’t overload yourself.

Good posture

Bad posture

Lift with your legs by bending at the knees and keeping your back straight. Balance the load in front of Keeping your back straight, bend at the hips with knees and hips your body and walk carefully. Do not twist sideways or lean back. soft while lifting. Do not arch your back. Use your arm muscles to lift and balance the load in front of you. Walk upright with core engaged.

Lifting with a rounded back puts strain on your spine. Do not lift a load by bending over at the waist with your back folded. Do not lock your knees or walk with an exaggerated swayback. Get help for heavy loads.

Your back is supporting too much weight in these positions. Find a neutral spine and engage your core before lifting. Get help for any load that causes pain or imbalance.

• Assess the weight of objects before lifting

• Keep your back straight and abdomen engaged when lifting

• Bend at your hips and knees, not your back

• Keep the load close to your body

• Use your leg muscles to lift, not your back

• Distribute weight evenly between hands and lift smoothly

• Vary positions and take breaks to avoid repetitive strain

• Stand close to your work surface with one foot forward and one back for stability

• Use long-handled tools to avoid overreaching

• Kneel or sit while working at low levels

• Ask for help if tasks are too difficult

• Make adaptations like raised beds or stools if needed

To reduce back strain while gardening:

• Use long-handled tools and kneepads to avoid bending and kneeling.

• Face the direction you are moving when mowing and push rather than pull.

• Take regular breaks and avoid working when conditions are difficult.

• Use a spade with levers and handles to make tasks easier. Digging:

• Bend at knees and hips, not waist. Keep back straight and do not twist.

• Cut around spadeful before lifting and leverage spade to raise soil.

• Move feet rather than twisting back when turning.

• Shoveling: Same principles as digging. Crouch low and slide shovel along ground.

Leverage shovel against thigh and throw soil sideways without lifting.

To reduce strain while driving:

• Ensure a good driving position with properly adjusted seat, wheel, and mirrors.

• Relax neck, shoulders, and grip. Take breaks on long drives.

• When exiting car, turn to face door, bend knees, and slide forward. Use armrest and door frame for support. Straighten legs gradually.

To reduce pain during pregnancy:

• Expect changes in posture and center of gravity. Consider wearing a support belt.

• Exercise regularly to strengthen core muscles. Walking, swimming, and yoga are good options.

• Practice good posture. Stand up straight but don’t lock knees. Keep shoulders back.

• When sitting, use a lumbar support. Keep knees higher than hips.

• Get enough rest. Ask for help with physically demanding tasks.

• Use heat/ice, massage, and over-the-counter pain medication as recommended by your doctor.

Here are some key strategies for coping with pain:

• Stay active and exercise regularly. Gentle exercise releases endorphins that improve your mood and act as natural painkillers. While rest is also important, too much inactivity can make pain feel worse.

• Apply heat or ice. Ice can reduce inflammation while heat relaxes tense muscles. Use them alternately for 10-15 minutes several times a day.

• Practice relaxation techniques. Deep breathing, meditation, yoga, and massage can help you relax, ease pain, and improve your mood.

• Get enough sleep. Aim for 7 to 8 hours of sleep per night. Lack of sleep can intensify the perception of pain.

• Eat a healthy diet. Focus on whole foods like fruits and vegetables, whole grains, and lean protein. Stay hydrated and avoid excess sugar or caffeine.

• Seek counseling or join a support group. Speaking to others with chronic pain can help you feel less isolated and pick up useful coping tips. Counseling can also help address any depression or anxiety related to your pain.

• Use over-the-counter or prescription medication as directed. Medication in combination with self-care and lifestyle changes is often the most effective approach. But avoid excess medication or dependence on drugs alone.

• Ask about other treatment options. For chronic back pain, complementary therapies, physical therapy, massage therapy, acupuncture, and chiropractic adjustments may provide relief.

• Practice positive thinking. Focus on things you can do and accomplish each day rather than limitations. Staying optimistic and distraction techniques can help take your mind off the pain.

• Seek professional support if needed. For severe or persistent pain, consult pain specialists, physiatrists, psychiatrists or psychologists for in-depth treatment. Interventional treatments or surgery may sometimes provide lasting relief when more conservative methods have failed.

• Psychological factors such as mood, anxiety, and fear can affect how intense you perceive your pain and your ability to tolerate it.

• There are complementary therapies (e.g. acupuncture, massage) and psychological techniques (e.g. meditation, relaxation) that can help reduce pain in addition to conventional medical treatments (e.g. drugs, surgery).

• Pain perception depends on both physical and mental factors. Your psychological state, thoughts, and focus can either increase or decrease your experience of pain. For example, being distracted can reduce your awareness of pain. Chronic pain in particular has a psychological impact and is difficult to diagnose and treat.

• There are two main types of pain: acute nociceptive pain from an injury and chronic neuropathic pain from changes in the nervous system. Acute pain usually gets better as injuries heal, but sometimes becomes chronic.

• Your mindset and level of control over pain can influence how much pain and disability you experience. Having a positive attitude can help reduce pain perception and the activity in pain-processing parts of the brain. Factors like anxiety, fear, and arousal can increase pain perception.

• Pain is hard to measure objectively. Doctors rely on patients’ descriptions of their pain to assess it, and patients’ interpretations of diagnoses and treatments also affect how well those treatments work.

So in summary, psychological and mental factors have a significant impact on the intensity and tolerability of pain. Complementary and psychological techniques are often used alongside medical treatments to help reduce pain by influencing mindset and perception.

Factors that increase pain:

• Anxiety, stress, fear and negative emotions: These psychological states focus your attention on the pain, causing you to perceive it as more intense.

• Negative thoughts and beliefs: Expecting the pain to be severe or worrying excessively about it can make it seem worse.

• Depression or low mood: Feeling down can reduce your motivation and tolerance for pain.

• Lack of coping skills: Not knowing how to effectively manage stress or adversity can worsen your experience of pain.

Factors that decrease pain:

• Remaining calm and relaxed: Practicing relaxation, meditation, deep breathing, etc. helps shift your focus away from the pain.

• Positive attitude and beliefs: Believing you can cope with and overcome the pain gives you a sense of control and makes the pain feel less threatening.

• Getting enough sleep: Sleep helps your body and mind rest, renew and heal. Lack of sleep can intensify the perception of pain.

• Using coping strategies: Learning skills to better manage stress, life difficulties and your reaction to pain helps reduce its severity. Some options include counseling, mindfulness, lifestyle changes, etc.

• Distraction: Focusing your mind on something other than the pain, such as an engaging activity, helps prevent you from perceiving the pain as strongly.

In summary, a person’s mental and emotional state has a significant influence over their experience of pain. Adopting a positive and proactive approach to coping with difficulties in life, including illness and injury, can help minimize the severity and impact of pain. The mind-body connection is powerful, and gaining awareness and mastery over your thoughts and reactions gives you an ability to modulate your pain levels.

tacks:Do you take responsibility for yourself or depend on others? It’s a balance. Some cope well, others struggle. You can change behaviors. Experience pain in context of life.Interruptions affect you.

while: if sole breadwinner, huge impact. Work type determines return.Too little sleep, more sensitive nerves, lower pain threshold.Lack of sleep gets you down, reduces ability to heal and cope.

Here are some summarizing points:

• Use a McKenzie night roll or pillows to support your waist and align your spine. This can relieve back pain when lying down.

• Place a pillow between your knees when lying on your side. This helps support your lower back and hips.

• Use extra pillows to support your knees when lying on your back. This helps reduce strain on your lower back.

• Use a neck support pillow for your head and neck. This keeps your spine aligned and prevents neck strain.

• Turn over slowly by first moving your upper arm and head. Then bring your knees up and gradually roll your body. Move carefully to avoid straining your back.

• Establish a regular sleeping pattern to avoid insomnia. Go to bed only when sleepy and get up at the same time each day. Limit screen time and stimulation before bed.

• To get in and out of bed, sit on the edge of the bed and lower yourself down. Raise your legs onto the bed. To get up, bring your feet to the floor, push up with your arms, and stand. Move slowly and carefully.

• When washing and dressing, sit on a chair or stool as much as possible. Bend at your knees and keep your back straight when reaching down. Use mobility aids like grab bars, non-slip mats, and long-handled tools. Take your time and avoid sudden movements.

• Communicate with your partner about your pain and modify sex positions to minimize discomfort. Try gentle positions like spooning or woman on top. Explore other intimate activities beyond just intercourse. Reassurance and openness can help reduce relationship stress.

Does this summary cover the main points regarding positions and strategies to help relieve back pain when sleeping, resting and being intimate with your partner? Let me know if you would like me to clarify or expand on any part of the summary.

• Consult your doctor or physical therapist before starting an exercise program, especially if you have an existing injury or health condition.

• Start slowly and build up gently. Do not rush the exercises or push through pain.

• Warm up first and stretch thoroughly to prepare your muscles. Stay hydrated and never exercise on an empty stomach.

• Focus on controlled movements. Move slowly and avoid any jerking motions. Breathe steadily as you exercise.

• Strengthening exercises should be done 2–3 times a week. Build up resistance gradually as your muscles strengthen.

• Stretching and flexibility exercises can be done daily to improve your range of motion and mobility. Hold each stretch for 15–30 seconds without bouncing.

• Improve your posture and core stability with exercises that target your back, abdominal, and pelvic floor muscles. Practice good posture throughout the day.

• Low-impact aerobic exercise 2–3 times a week will improve your stamina and general fitness. Walking, swimming or water aerobics are good options.

• Ice or heat sore areas as needed. Apply ice for 10–15 minutes several times a day to reduce inflammation. Use heat to relax tense muscles.

• Review and progress your exercises regularly with the guidance of your physical therapist. An exercise program should be tailored to your needs and abilities.

The chapters provide illustrations and advice on performing the exercises correctly and safely to maximize the benefits. The key is to start slowly, listen to your body, and build up your strength and range of motion over time. With regular exercise and practice, you can significantly improve your flexibility, balance, and muscle tone which will help strengthen your back and reduce chronic pain.

Consult an or and physical therapist before beginning any exercise program, and follow the general safety guidelines.

Some key points:

• Improving neck and back mobility and strength can help reduce pain, prevent problems, and aid recovery.

• Start gently and build up gradually. Don’t push into discomfort.

• Keep your core engaged and don’t lock your joints.

• Move slowly and breathe steadily.

• The exercises cover neck rotation, flexion and extension; shoulder rotation; upper back stretch; chest stretch; trunk rotation; and the cat stretch.

• Use your hands for initial resistance with neck exercises. You can progress to bands or pulleys.

• Rotate your trunk gently and feel the stretch in your upper back. Don’t force the movement.

• With lying trunk rotation, keep your hips stacked and rotate your upper body.

• The cat stretch promotes spine flexibility and core strength. Move slowly and breathe deeply.

Here is a summary of the instructions:

Raise your shoulders above your hands Bring your hips back over your knees Raise your upper body
Start levelling out your buttocks Straighten your arms Continue lifting yourself up, gradually straightening your elbows and back. Keep your head level with your back. Continue the movement until you return to the start position. Repeat the exercise for the required number of reps.

Sit up straight with good posture. Place your hands behind your head and look up diagonally. Stretch your elbows out to the sides while keeping your chest lifted. Tuck your chin in and slowly roll your head down toward your chest. Hold, then roll back up to the starting position.

Repeat looking in the opposite diagonal direction. This helps stretch your neck, upper back, chest, and shoulders. For variation, you can adjust the position of your arms higher or lower.

The key points are:

• Sit with good posture • Place hands behind head and look up • Stretch elbows out • Keep chest lifted • Tuck chin in • Slowly roll head down • Hold, then roll back up • Repeat on opposite side • Vary arm position for different stretch

This is a gentle exercise to help relieve tension and improve flexibility in your upper back and shoulders. Be sure to move slowly and stop if you feel pain.

Here is a summary of the steps:

LIFT

This exercise helps to strengthen your core muscles while also improving

your balance and stability. Going slowly and controlling the movement is key.

Lie face down with arms extended overhead and legs straight. Bend your left elbow and place your left hand under your forehead.

Bend your right knee and lift your right leg off the floor.

Simultaneously lift your right arm off the floor. Keep your nonmoving arm and leg extended. Focus on keeping your lower back straight and avoid twisting your torso. Use your core muscles to lift your arm and leg. Hold for 5 to 10 seconds and slowly lower back down. Repeat on the other side, then continue alternating. Aim for 3 sets of 10 to 15 repetitions on each side.

Here is a summary of the curl-up exercise:

Lie on your back with one leg straight and the other bent at a 90-degree angle, and your hands under your lower back. Use your abdominal muscles to lift your chest, shoulders and head off the floor while breathing out. Hold and then lower back down. Repeat for several reps, then switch leg positions.

There are 5 progressions to make the exercise more difficult:

Level 2: Perform with elbows off the floor.

Level 3: Place hands across chest instead of behind back. Lift chest, shoulders and head while keeping one leg straight and bending the other leg.

Level 4: Place a wobble board under lower back and perform as in Level 3.

Level 5: Place lower back on a Swiss ball and perform with knees bent and feet on floor.

The curl-up strengthens the abdominal muscles which help stabilize the pelvis. It can be part of a rehab program, with increasing difficulty as strength and endurance improve.

Lift your chest, shoulders and head, hold for 8 seconds. Return to start position for 2 seconds. Repeat for required number of reps.
Switch leg positions.

Small correction: It should be “Then lift your chest…” The then is missing in the original.

Lie on your back, arms by sides, feet on floor, hips and knees bent.

Lift hips, squeezing glutes and core, until body forms straight line from knees to shoulders.

Pause, lower back down. reps.

For single-leg bridge: Lift one leg, keeping hips level, and extend hips as above. Switch legs, reps each.

To vary: Bend knees more or feet on Swiss ball. Engage core.

Stand facing support. Grip support, bend knees and lean back. Push legs, pull arms to stretch upper back.

For quad stretch: Stand one foot on table, legs parallel. Tilt pelvis back to feel front-thigh stretch. Switch legs.

For hamstring stretch : Lie on back, grasp one leg just below knee and straighten leg up and overhead. Switch legs.

Alternatively: Lie on back, bend one knee and grasp that leg with both hands. Straighten knee and lift leg up, keeping other leg straight. Switch legs.

Here is a summary of the exercises:

82 Single-Leg Stand: Stand on one leg, tighten your buttocks and thighs. Aim to improve your balance and strengthen your core and legs.

83 Wall-Supported Foot Lift: Place feet against a wall and lift your toes and front of feet off the floor. Strengthens feet and lower legs.

84 Supine Pelvic Tilt: Lie on your back with knees bent and feet flat. Arch your back and pull in abdominals, tilting your hips. Releases back pressure and strengthens core.

85 Kneeling Pelvic Tilt: Kneel with hands under shoulders and knees under hips. Pull in abdominals and tilt hips forward. Strengthens core and improves posture.

86 Seated Pelvic Tilt: Sit on a Swiss ball with feet parallel. Pull in abdominals and tilt hips forward, rolling ball slightly. Challenges core strength and balance.

87 Prone Back Extension: Lie face down with towel under forehead. Lift head and shoulders, arching back slightly. Strengthens lower back muscles.

The summary outlines some key exercises to strengthen your core, back and legs by improving balance, flexibility and range of motion. The pelvic tilt variations are useful for releasing back pressure and aligning your posture. The single-leg stand and wall lift help build leg strength and the prone back extension maintains back muscle strength.

Here is a summary of the stationary lunge exercise:

1. Stand with feet shoulder-width apart, arms at sides.
2. Step one leg forward and lower your body until both knees are bent at about 90 degrees, with your back straight and abdominal muscles engaged. The front thigh should be parallel to the floor and the back knee should nearly touch the ground.
3. Push back to the starting position.
4. Repeat with the other leg and continue alternating.
5. Keep your core engaged and don’t let your front knee move forward of your ankle.
6. Start with 2-3 sets of 10-15 reps on each leg, 3 times a week. Build up slowly.

The key points are:

•Stand with feet shoulder-width apart and core engaged •Step one leg forward and lower into a lunge position with 90 degree bends in both knees •Push back to the starting position •Alternate legs and repeat •Keep your front knee behind your ankle and core engaged •Start with 2-3 sets of 10-15 reps on each leg, 3 times a week. Build up slowly.

The exercise works your buttocks, thighs and helps prevent lower back problems. While you may feel it in your thighs first, it is also working your buttocks. Start slowly and build up the intensity over time as your strength improves.

The child’s pose gently stretches your back, hips, and ankles. To perform it, kneel on the floor with your knees apart and big toes touching. Sit on your heels and fold forward, bringing your forehead toward the floor. Extend your arms in front of you. Relax your body and breathe slowly and deeply.

The Swiss ball roll-out works your core muscles. To do it, kneel behind a Swiss ball and place your hands on top of it, keeping your back straight. Slowly roll the ball forward by straightening your legs and sliding your body forward, while keeping your legs and hips in line. Roll out as far as you can while maintaining a flat back, then use your core muscles to roll back to the starting position. Ensure you engage your core and move in a slow, controlled manner.

Keep your pelvis neutral and your core engaged. Extend your arms forward. Feel the stretch in your hips, thighs and middle back. Roll the ball forward by extending your arms. Use your abs to pull the ball back. You can also stretch your side back muscles by extending your arms diagonally. Keep your back flat and only go as far as you can while maintaining control.

For a higher challenge, you can do this with a barbell instead of a ball once you build up strength and control. Kneel with hands shoulder-width apart and keep your back flat as you roll forward and back.

This helps build control and flexibility in your back, hips and core. Start with a stability ball and work your way up to a barbell as your control and strength improve.

Here is a summary of the principal back and joint problems covered in this section:

• Ankylosing spondylitis: A chronic inflammatory disease affecting the spine and sacroiliac joints. Causes pain, stiffness and decreased mobility.

• Sciatica: Pain along the sciatic nerve in the buttocks and legs caused by a herniated disk or spinal stenosis compressing nerve roots in the lumbar spine.

• Vertebral compression fractures: Collapse of vertebral bodies leading to pain, height loss and kyphosis. Usually due to osteoporosis.

• Piriformis syndrome: Irritation of the sciatic nerve by the piriformis muscle causing pain in the buttocks and legs.

• Sacroiliac joint dysfunction: Sacroiliac joint inflammation or instability causing pain in the low back and buttocks. Difficulty walking or sitting.

• Coccydynia: Pain in the coccyx (tailbone) usually caused by direct injury or childbirth. Pain when sitting.

• Hypermobility syndrome: Loose or unstable joints leading to pain, subluxations and early joint arthritis. Commonly affects the spine, knees, shoulders and fingers.

• Facet joint strain: Inflammation of facet joints in the spine causing pain and difficulty moving. Especially affects the neck and lower back.

• Whiplash: Soft tissue injury of the neck from acceleration-deceleration force. Causes neck pain, stiffness and headaches.

• Torticollis: Acute stiff neck caused by sleeping in an awkward position. Painful to turn the head. Muscle spasm on one side of the neck.

• Scoliosis: Abnormal lateral curvature of the spine. Can cause back pain, muscle spasm, difficulty walking and in severe cases affects heart and lung function.

• Disk herniation: Rupture of an intervertebral disk causing pressure on spinal nerves. Can lead to pain, numbness and weakness in the limbs. Most common in the lumbar spine.

Does this cover the key points? Let me know if you would like me to explain anything in more detail.

Here is a summary of the terms:

Acute: disk herniation, fracture, torticollis Back pain: low-back, chronic, acute, buttock, coccyx Causes: aging, trauma, poor diet, hypermobility syndrome, inflammatory disease, muscular tension Diagnosis: blood tests, bone scan, CT scan, DEXA scan, discography, EMG, hormone tests, injection, Moire fringe analysis, myelogram, PET scan, X-ray Instability: causes and symptoms Injury: whiplash, facet joint strain, sacroiliac strain Pain management: analgesics, antidepressants, anticonvulsants, anti-inflammatories, cortisone injections, epidural injections Posture: ergonomics, sitting posture Risk factors: body fat levels, fitness levels, gardening, gender, housework Spine conditions: ankylosing spondylitis, arthritis, scoliosis, spondylolisthesis, spondylolysis, stenosis Stretches and exercises: adductor lift, arm and hand, back rotation, balance, bending, bridge, calf, cat and camel, cat stretch, chest, clam, coccyx, contracting exercises, curl-up, dead bug, hip, hip abductor, hip flexor, hip-hitcher, Jacboson technique, kneeling hip flexor stretch, knees to chest, lat stretch, leg raise, lunge, neural glide, pelvic tilt, piriformis, prone, sacroiliac joint, side glide, single leg, spinal, Swiss ball, twisting, wall supported Symptoms: arm and hand pain, blurred vision, bowel movement changes, brachialgia, breathing problems, circulation problems, clicking joints, coordination problems, coughing, depression, ear ringing, facial pain, groin pain, headaches, hormonal changes, inflammation, insomnia, muscle spasms, nausea, neck pain, nerve pain, numbness, pins and needles, poor concentration, sensitivity, swallowing problems, trouble walking, urinary changes, vertigo, vision problems, vomiting, weakness
Therapies: acupuncture, Alexander technique, aromatherapy, autogenic training, cardio, chiropractic, cryotherapy, electrothermal treatment, hydrotherapy, hypnotherapy, massage, physiotherapy, pilates, traction, ultrasound, yoga Treatment: anticonvulsants, anti-inflammatories, cortisone injections, decompression surgery, discectomy, disk replacement, drug treatment, epidural injections, ergonomics, injection treatment, manual therapy, pain management, physiotherapy, rest, traction

• Dylosis refers to pain in the spine caused by abnormal motion or instability in the joints. • Spondylolysis refers to a defect or crack in the neural arch of the vertebrae, most commonly in the lower lumbar spine. It can lead to instability and pain. • Sacroiliac strain refers to inflammation or damage to the ligaments of the sacroiliac joint, causing pain and instability. • Sciatica refers to pain in the sciatic nerve, often caused by a herniated disc compressing the nerve. • Spondylolisthesis refers to the forward slippage of one vertebra over another, often causing pain and instability. • Scoliosis refers to an abnormal lateral curvature of the spine. • Myofascial pain syndrome refers to pain arising from trigger points and tightness in muscles and connective tissue. • Joint mobilization refers to gentle movements applied to joints to reduce pain and improve mobility. • Nerve root pain refers to pain arising from compression or inflammation of the nerve roots in the spine. • Piriformis syndrome refers to pain caused by compression of the sciatic nerve by the piriformis muscle.

In summary, these terms refer to a range of conditions causing back, pelvic and leg pain arising from problems with the joints, muscles, nerves and connective tissue of the spine and pelvis.

• Stenosis refers to narrowing of the spinal canal or nerve root canals in the spine. It can cause pain, numbness, and weakness.

• Acute means sudden or severe. This describes a sudden onset of pain or a severe pain.

• Spondylolysis and spondylolisthesis refer to conditions involving a break or slippage in the vertebrae, typically in the lower back. They can cause back and leg pain.

• Prone knee bend and hip flexor stretch are exercises that can help relieve lower back pain.

• Pelvic stability and strength are important for low back health. Exercises like bridges, pelvic tilts, and plank help build pelvic stability.

• Inflammatory diseases like ankylosing spondylitis can cause back pain and stiffness. Anti-inflammatory medications and exercise are used to manage pain.

• Discogenic pain refers to pain arising from the intervertebral discs in the spine. It is a source of chronic low back pain.

• Treatment options for back pain include exercise, manual therapy, medications, injections, lifestyle changes, and in severe cases, surgery. A multidisciplinary approach is often most effective.

• The spine is made up of 24 vertebrae plus the sacrum and coccyx. The vertebrae are stacked on top of each other and provide support for the back. Nerves exit the spine through openings between the vertebrae.

• The spinal cord runs through the spine and sends nerve signals throughout the body. Compression or injury of the spinal cord can cause pain, numbness or weakness.

• Torticollis refers to a stiff neck associated with muscle spasms and pain. It causes the head to tilt to one side. Treatment includes rest, heat, massage, and medication.

Does this help summarize some of the key points? Let me know if you would like me to explain or expand on any part of the summary.

• Swiss ball pelvic tilt: Exercise for gluteus medius dysfunction and lumbar dysfunction. Gently tilts pelvis to stretch lower back muscles.

• Traction: Gentle manual traction or traction using belt/harness system. Provides relief from compression by gently stretching spine. Used for various conditions like disk herniations, spinal stenosis, etc.

• Walking lunge: Exercise for gluteus medius dysfunction, piriformis syndrome, and hip flexor tightness. Alternating lunge steps help strengthen glutes and hips.

• Squat: Exercise for gluteus medius dysfunction, hip flexor tightness, and knee pain. Helps strengthen glutes, quadriceps, and hamstrings. Should be performed cautiously in some conditions like spondylolisthesis or acute back pain.

• Facet joint pain: Can cause pain in neck, midback or low back. Treated with medications, physical therapy, injections, etc. Aggravated by extension and rotation.

• Disk-related pain: Caused by disk herniations or degeneration. Can compress spinal nerve roots or spinal cord. Treated similarly to facet joint pain. Aggravated by flexion, sitting, and coughing.

• Spondylolysis and spondylolisthesis: Conditions where vertebra in lower back slips forward or backward. Can cause back pain, leg pain and muscle spasms. Treated with physical therapy, bracing, and sometimes surgery. Aggravated by extension.

• Torticollis: Acute neck pain and muscle spasm causing neck to tilt to one side. Treated with physical therapy, medications, massage, etc. Aggravated by neck movement in all directions.

• Lumbar dysfunction: Nonspecific low back pain. Treated with physical therapy, medications, lifestyle changes, etc. Aggravated by prolonged positions, flexion, and rotation.

• Footwear: Proper, well-cushioned footwear important for preventing and managing various causes of back pain. High heels and poor arch support can contribute to back pain.

• Traction, manual: Gentle manual traction applied by physical therapist. Used to relieve compression on vertebrae and spinal nerves. Can provide relief from acute flare-ups of back pain.