RESEARCH

Research on Low back and neck pain -

Low back and neck pain is the second largest recurrent disorder to common cold and fever.
Only 1-2 % of low back patients need surgical intervention and 1-2 % have non-mechanical back pain (Deyo et al 1992)
Up to 50% of chronic and 70% of acute low back pain are rapidly reversible using simple symptom specific exercises that the patient can do by themselves (Long 1995, Sufka 1998,Werneke 1999, Aina 2004).
Many conditions previously thought to have an inflammatory pathology, such as tendonitis, are now known to have a degenerative or mechanical cause that is best treated by specific exercises (Jozsa and Kannus 1991, Khan 1999).
Passive modalities such as heat, TENS, and ultrasound have not been found effective in treating or preventing musculoskeletal problems (van der Windt 1999, Nordin and Campello 1999).
Passive care promotes patient dependency and does not reduce the recurrence rate of spinal pain. (Waddell 1987; Croft 1997)
An active treatment approach that involves empowering the patients to participate in their own recovery shows superior results to treatment where the patient adopts a dependent role (Lorig 1989, Lorig 1997)
Up to 50% of chronic and 70% of acute low back pain are rapidly reversible using simple symptom specific exercises that the patient can do by themselves (Long 1995, Sufka 1998,Werneke 1999, Aina 2004).
The McKenzie system has its philosophies of patient self management which is crucial in preventing the recurrences. The McKenzie Method is the most well researched physiotherapy assessment and treatment system. Many musculoskeletal problems can be rapidly reversed if they are properly assessed.
Rapid responders using the Mckenzie concept often include patients who have not benefited from other treatments. They can be identified in 1-2 visits.
Research has shown that the McKenzie assessment is as reliable as CT scans and MRI’s in determining the source of the patient’s pain and the potential for recovery but only when a properly trained clinician performs it. (Donelson et al., 1997)
A systematic assessement by a Diplomated McKenzie therapist prior to surgeries improves the outcomes of surgeries (Wetzal and Donelson 2003)

What are the risk factors in back, neck pain ?

During the course of their lives 70–85% of individuals will experience low back pain (LBP) (Andersson, 1999; Deyo and Weinstein, 2001; Goodwin and Goodwin, 2000; van Tulder, 2001)

Over 80% of such patients report recurrent episodes (Waddell, 1998, p. 103–117).

It is estimated that 80–90% of patients will have recovered within 6 weeks, regardless of treatment (Bronfort et al., 1996; CSAG, 1994; Indahl et al., 1995; Jackson, 2001; Klaber Moffett et al., 1986; Lahad et al., 1994; van Tulder et al., 1997).

What about extensive investigations done for such conditions?

Pathoanatomical findings correlate poorly with levels of pain and disability (Nachemson, 1999).

The association between symptoms and imaging results has been consistently weak, and up to 85% of patients with low back pain cannot be given a precise pathoanatomical diagnosis using these methods Deyo RA, Weinstein JN, 2001

Only a small proportion (<15%) will have an underlying nerve-root compromise secondary to a herniated disc. (Deyo et al 1987)

Hence activity and exercises play a very important role for the health of the spine as age advances. All that is required of you is to self manage, exercise in your directional preference to abolish your present symptoms and take preventive care to prevent recurrences. There is no need what so ever to take long prolonged exercise regimes to prevent recurrences. It is all in your hands.

Prolonged bedrest has no role in the treatment of low back or neck pain and its resulting referred or radiating symptoms to the extremities.

What should you do?

Overall, 25% of women over the age of 65 years and 40% of women over the age of 80 years have a vertebral compression fracture.(Langdon 2011, Melton et a 1989).

The aetiology of postural neck pain remains uncertain but is generally considered to be associated with poor postural awareness and habitual postures which result in greater load on the supporting structures (Farfan, 2000, Neumann, 2002).

It is increasingly recognized that timely resumption of physical activity is critical to successful rehabilitation (van Tulder MW, Koes B, Malmivaara A. 2006).

Greater decrease in pain, early return to work. (Long 1995)

Better functional outcomes (Sufka 1998)

Non-centralization 6 times more likely to undergo surgery. In other words, centralization is a very good predictor of a nonsurgical outcome (Skytte 2005).

MDT assessment improves the selection process of surgical patients. (Wetzel & Donelson 2003)

Predicts number of visits, functional status at discharge, pain status at discharge. That is, we can let you know how many sessions you may require to reach complete functional status. (Werneke, 2008)

Directional preference, predictor of outcome. That is, if exercises are prescribed to you based on your directional preference, the outcomes to your treatment will be better (Long et al , 2004, 2008)

Shrigiridhari Physiotherapy Center

"Back Neck and Joints"

India's Only Certified Mckenzie Clinic

Research