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POSTURAL PAIN SYNDROME. Definition. Postural pain syndrome is pain that develops in the cervical, thoracic or the lumbar area due to poor posture maintained over a long period of time. Excessive tension is placed on these areas. Pain is relieved with activity. Postural pain syndrome. - PowerPoint PPT Presentation
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POSTURAL PAIN SYNDROME
DefinitionPostural pain syndrome is pain that develops
in the cervical, thoracic or the lumbar area due to poor posture maintained over a long period of time. Excessive tension is placed on these areas.
Pain is relieved with activity.
Postural pain syndromeIncludes:
Postural overload Causes unbalanced mechanical load.
Postural overexertion Intensity and duration of work is higher than the
capacity of the muscles.Vibration syndrome
Situations where continual compression is exerted on the structures.
Postural pain Bad posture in static positions.
PathophysiologyThere is no significant damage or trauma to
tissue.Pain is only experienced during activities
where constant stress is placed on normal tissue.
When working at a desk, the sustained posture results in reduced circulation to the neck and upper back muscles, which then become tired and fatigued.
These muscles fail to support good upright posture and eventually become overstretched and weak.
Causes and Risk factorsSome of the most common causes:
Slouching in chairsDriving in hunched positionsStanding badlyLifting incorrectlySleeping on sagging mattressesBeing unfitInactivity and the wrong sort of movementHead and neck strain
Causes and Risk factorsMusculoskeletal problemsWork-related back problemsLower back painRepetitive strain injuryCarpal tunnel syndrome
Causes and Risk factorsCommon risk factors:
Being unfitBeing overweightJobs involving lifting, bending or moving heavy
objectsBeing seated in one place for long periods of
timeFrequent use of a telephone without a headsetHigh levels of stress, anxiety and tension
DiagnosisDifficult for doctors to find the exact causePain usually starts a day or two after the
injury has occurred or only after several years.
Signs and symptomsUsually patients with postural pain syndrome
have normal and pain-free movement.When poor posture is maintained for a long
time, pain is experienced.
TreatmentPhysiotherapy may include:
Soft tissue massageElectrotherapy e.g. ultrasoundPostural tappingThe use of posture support e.g. bracesMobilisationDry needlingExercises to improve strength of weak muscles.Improve postureStretch short and strong muscles.
TreatmentTeach patient about kinetic handling.Correct biomechanics.Clinical Pilates
Do’s and Don’tsDo’s: (sitting)
Sit in a chair that supports your back in a slightly extended position.
Hips and knees in 90° .Shoulders in retraction
and chin tucked in to minimise postural strain.
Feet should be firmly placed on the ground.
Do’s and Don’tsDon’ts: (sitting)
Slump sitLean forward and
downward to reach your work.
Sit with your neck forward for an extended period of time(move around every 20 minutes).
Do’s and Don’tsDo’s: (standing)
Put one foot up and change position often.Work at a comfortable height.
Don’ts: (Standing)Wear high-heel, hard heeled or platform shoes for
long periods of time.Stand in one position for too long.Stand with knees locked.Stand bent forward at your waist with your work in
a low position.
X-Rays
Evidence based article
Getting your back back to work: pain relief- where to start?
Evidence based articleFocus is on dental health care workers poor
posture due to their job leading to back and shoulder pain.
Presents a classification system for the treatment of spinal pain created by physical therapist Robin McKenzie.
The approach has had favourable clinical acceptance among therapists and patients and offers a conservative alternative to treating back and neck pain.
Evidence based articleMcKenzie characterized mechanical pain as;
Pain that can be constant or intermittentLimited range of motion of the back or neck
that improves as symptoms diminishMovements in certain “incorrect,” or
exacerbating directions increases the pain while simultaneously decreasing range of motion in the opposite direction.
Evidence based articleHe proposed three nonspecific mechanical
syndromes;Postural pain syndromeDysfunction syndromeDerangement syndrome
Evidence based articleDental workers usually work in a slouched
position.Slouched sitting causes the spinal
musculature to diminish its activity and place increasing stress on the posterior ligamentous structures of the spine resulting in increased length or “creep”
Bogduk defines creep as a constant force, that if left applied for a prolonged period to collagen tissue will result in further movement or length of the ligamentous tissue.
Evidence based articleWe often see significant weakness of the back
extensor and post. scapula musculature.Tightness of the ant. chest and shoulder
musculature in individuals having back and neck pain.
Evidence based articleEg. of an exercise;
Slouch-overcorrect From an extreme, slouched position to an
exaggerated, lordotic posture.
Evidence based articleIndications
Periods in the day when no pain is experiencedPain is confined to areas above the kneeSymptoms are worse when sitting and
generally better with standing or walkingSymptoms are worse when bending and with
inactivityIf symptoms are better when in supineSeveral episodes of back pain have been
experienced over the past few years.
Evidence based articleContra indications
A first episode of back pain that persists for more than ten days
Bowel and bladder symptoms associated with back pain
Back or neck pain caused by traumaLeg pain below the knee including numbness,
tingling or weaknessMalaisePain that disturbs sleep
Feeding an individual a fish takes care of their hunger, while teaching them to fish allows them to survive for life.(unknown)
References Caruso, T.J. and Pleva, D.J. 2006. Getting your back back to work: pain
relief—where to start? International Journal of Mechanical Diagnosis and Therapy. 1(1): 18-28. http://www.mdt-japan.org/therapist/2006IJMDT_1%20(1).pdf#page=19
Retrieved on 4 June 2012.
http://ebookbrowse.com/postural-pain-syndrome-jan08-pdf-d79305710
http://www.bbc.co.uk/health/physical_health/conditions/in_depth/back_pain/causesback_types.shtml#top
http://www.physicaltherapy.zoomshare.com/5.html
http://www.physioadvisor.com.au/8390250/postural-syndrome-posture-pain-poor-posture-.htm
Referenceshttp://www.google.co.za/imgres?
q=postural+pain+syndrome&um=1&hl=en&sa=N&biw=691&bih=352&tbm=isch&tbnid=Tfs1jZ5TgN9n-M:&imgrefurl=http://www.back-in-action.co.uk/Pages/BackPain.htm&docid=T3pa1ZZ_UITSVM&imgurl=http://www.back-in-action.co.uk/Images/Pages/Back_Pain/image003.jpg&w=315&h=400&ei=eRjGT9azDYyYhQe17-XaBQ&zoom=1
http://www.the-good-doctor.net/posture-and-forms-of-middle-back-pain/
Referenceshttp://www.google.co.za/imgres?
q=postural+pain+syndrome&start=82&um=1&hl=en&sa=N&biw=1117&bih=703&tbm=isch&tbnid=wVGjb5CM624Y3M:&imgrefurl=http://erikdalton.com/media/published-articles/forward-head-posture/&docid=xJOUvc0XqBE0KM&imgurl=http://erikdalton.com/images/Fig3_disk_W.jpg&w=300&h=394&ei=HhfGT6usEo-4hAf3nuC9BQ&zoom=1&iact=hc&vpx=877&vpy=312&dur=4188&hovh=257&hovw=196&tx=137&ty=165&sig=112601856111257986843&page=5&tbnh=154&tbnw=118&ndsp=21&ved=1t:429,r:10,s:82,i:26