Dr. Mahindra Singh Baansal

A Typical Physiotherapy (Manual) Treatment for Locked Back

A TYPICAL TREATMENT FOR ACUTE FACET JOINT (Locked Back) ARTHROPATHY 

Purpose: 

To disperse joint swelling and inflammation, relieve muscle spasm

Rocking knees to the chest (60 seconds)

• Rest (30 seconds)
• Rocking knees to the chest
• Rest
• Rocking knees to the chest
• Rest
• Rocking knees to the chest
• Rest
• Reverse curl ups (five times)
• Rest
• Reverse curl ups
• Rest
• Reverse curl ups
• Rest
• Rest in bed and use medication under the direction of your doctor. NSAIDS are particularly effective in reducing the pain from the inflamed joint so painkillers are not usually necessary. 
• Repeat exercises every 2 hours throughout the day. 

When resting, you may be more comfortable in the foetal position with a pillow between the knees to decompress the joint.

For how long? 

You can progress to the sub-acute regimen when there is no flooding pins and needles pain down the leg, either when standing up from sitting or when taking weight on the leg. This can take a week to ten days, though it may be sooner.

A TYPICAL TREATMENT FOR SUB-ACUTE FACET JOINT ARTHROPATHY

Purpose: 

To disperse inflammation, relieve muscle spasm,disengage the jamming of the segments.

• Rocking knees to the chest (for 60 seconds)
• Rolling along the spine (15-30 seconds)
• Curl ups (five times)
• Rest
• Rocking knees to the chest
• Rolling along the spine (pivoting on sore spot)
• Curl ups
• Rest
• Rocking knees to the chest
• Rolling along the spine
• Curl ups
• Rest
• Rocking knees to the chest
• Rolling along the spine
• Curl ups
• Rest
• Repeat the regimen three times daily. After each session,rest on the floor for ten minutes with your lower ,legs supported on a sofa or soft chair, and a pillow under your head.

 Do not be alarmed if pivoting on the problem level causes a sharp pain in the back, or even leg pain. When up and about, avoid sitting in one position, or standing for too long. (this will usually bring on the pain down the leg). 

Have two brief walks per day (less than fifteen minutes): you should walk tall and light and let your hips  swing freely so the low back twists from left to right.

For how long? 

You should progress to the chronic treatment regimen when there is no leg pain. This usually takes a week to ten days but it may be much sooner.

Whilst pain itself does not need to be diagnosed by a doctor, the underlying reason(s) why we experience back pain may be more difficult to pinpoint. In the vast majority of cases,your doctor will try to work out what’s wrong with you by asking you to describe what your back pain feels like. It may help you to think about how you would answer the following questions before you visit your doctor.

·        Where is your pain?

·        Does it stay in the same place?

·        What sort of pain is it?

·        How long does it last for?

·        When did your back pain start?

·        What were you doing when it started?

·        Have you had any back problems in the past?

·        Do you have any other symptoms elsewhere in your body?

·        Does your back pain restrict your movement? 

To understand how severe pain is, doctors sometimes use a scale of zero(none) to ten (severe) or may ask you to classify the pain as mild, moderate,severe or excruciating. It may also help to use a visual analogue scale to try to quantity how bad your pain is. 

These scales are usually 10 cm horizontal or vertical lines with word anchor at each end, such as no pain and severe pain.By marking on the line where you think your pain lies, you are giving your PHYSIO a better idea of its intensity.

For children, drawing of faces in a series-from smiling to frowning and crying-can be used to determine the severity of pain.

Your PHYSIO may also examine you, and will also refer back to your medical history to work out if there are any other health conditions that might be contributing to your pain. They may also:

·        Perform a pinprick test to check that your sense of touch is working properly

·        Test the strength of your muscles by asking you to push against their hands

·        Test the reflexes in your knees and ankles by gently tapping just below your kneecaps and above your heels with a special hammer

·        Perform the “straight leg test” in which you lie on your back and raise your leg without bending your knee.