What To Do About Lower Back Pain-Pain or other discomforts in the lower back, from under the ribs to the bottom of the buttocks, with or without pain radiating to the foot (Tudler, 2001; chioda, 2003). The occurrence of the pain will ultimately decrease lumbar mobility so that there will be limitations of movement, especially flexion movement (bending) or extension.
The cause of ‘back pain’
The cause of lower back pain varies, more than 90% is caused by mechanical factors; sprain and lumbar strains, degeneration processes, herniation (HNP), spondylolisthesis, spinal stenosis, osteoporotic compression fracture; while the rest due to non-mechanical factors; and nonspinal/visceral disease. Excessive daily activity, lifting heavy weights, standing too long or sitting in the wrong position (Borenstein & Wiesel, 1989; Meliala & Pinzon, 2004) are the leading triggers of lower back pain due to mechanical factors.
1.Condition of acute
do in a supine position on a hard base for about 2 days or more, this aims to reduce intradiscus pressure and reduce back muscle activity.
- Icing (cold compress)
do it right after the pain appears for 3-5 minutes in the pain area, can be repeated 3-6 times a day. It aims to reduce pain, inflammation of soft tissues, and increase tissue viscosity.
- Interferential therapy (TENS)
IF is used to reduce pain, an application can be directly in the pain and segmental requirement area.
(hurley et al., 2001)
- Iontophoresis ultrasound
USD benefits accelerate healing with early and late phase inflammation, circulation improvements that require collagen synthesis, increase tissue strength, and reduce pain. USD pulse wave 1 W / cm2 reduces pain. (Girardi et al, 1984)
- Brace (lumbar corset use)
will memfixsasi lumbar area during the activity that helps limit the movement of the lower back.
- Diathermy (SWD / MWD)
- It is useful to reduce pain and sedative effects of decreased tone and increased excitatory threshold increased tissue elasticity by decreasing the viscosity of the matrix of tissue, as well as reducing inflammation through increased venous blood circulation so that the transport of inflamed cells is enhanced. (low, 2000)
- Myofascial release technique
techniques decrease muscle tension manually through autogenic inhibition mechanisms in muscle spindles and Golgi tendon organs. This technique is done in `slow deep pressure` on the muscle.
(marshal, barnes, 2009)
useful in reducing pain and improving functional ability in chronic LBP (Paoloni et al, 2011)
-a technique of spinal mobilization that serves to reduce pain and restore spinal mobility (Descarreaux et al, 2003)
it is a specialized technique that is useful in reducing pervasive pain, improves the elasticity of the nervous system, improves and rebuilds the flow of neurodynamics axoplasmic so as to restore nerve tissue homeostasis, as well as joint flexibility. (adel, 2011)
approximately 60% of people with LBP will recur again, this is due to the weakness of the back and abdominal muscles post back pain lower. Muscle weakness can trigger a back pain in the future. Exercise therapy is designed to retrain the strength of back and abdominal muscles by adjusting for the underlying causes of LBP. Improper movement can aggravate the complaints and condition of the patient.
-William’s flexion exercise
-Core exercises strengthening abdominal muscles and gluteus, stretching back muscles (knudsen, 2003)
Mc kenzie exercise
-Core stretching exercises muscle extensor backs (cole & reed, 2010)
combining rhytmic stabilization exercises and combinations of isotonic exercise (koffotolos & kellis, 2006)
-Core stability exercise
exercises aimed at improving the stabilization of the paralumbal muscles.