1 / 61

DR. BHARAT PATEL

DR. BHARAT PATEL. Jo i nt Rep l acement Surgeon. Introduction. Haldemann (1977) 26 causes Whyke (1976) 20 categories. BACK ACHE. DR.BHARAT PATEL M.S.(Ortho) SAMVED HOSPITAL. Introduction. Hazleman and Bulgar (1979) Disc prolapse over diagnosed. Introduction.

kimberly
Télécharger la présentation

DR. BHARAT PATEL

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. DR. BHARAT PATEL Jo i nt Rep l acement Surgeon

  2. Introduction • Haldemann (1977) 26 causes • Whyke (1976) 20 categories

  3. BACK ACHE DR.BHARAT PATEL M.S.(Ortho) SAMVED HOSPITAL

  4. Introduction • Hazleman and Bulgar (1979) Disc prolapse over diagnosed

  5. Introduction • Moorey and Robertson Benign lumbar pain syndromes

  6. Classification of low back pain • Spondylogenic back pain • Neurogenic back pain • Viserogenic back pain • Vascular back pain • Psychogenic back pain

  7. CAUSES OF BACK PAIN

  8. Causes of back pain • Poor Posture • Disturbed normal “natural S” shape of spine leads to back pain.

  9. Causes of back pain • Out of Shape • Your overall physical condition can affect your back.

  10. Causes of back pain • Tension and Stress

  11. Causes of back pain • Aging and Disease • Loss of muscle strength with aging. • “slip disc” • Osteoarthritis, a form of aging arthritis, can cause back pain.

  12. Causes of back pain • Impact Trauma

  13. Causes of back pain • Obesity

  14. Causes of back pain

  15. Adolescent acute back • 12 to 14 yrs in girls • 14 to 16 in boys • Disc space infection • Herniated lumbar disc • Spondylolysis or lysthesis

  16. Lumbar Instability • The tall young man • House wife • Post surgical patient • The keep-fit enthusiast • Young man in his 20’s with undetected lumbar osteochondrosis. • Mature woman between 40-50 with degenerative spondylolisthesis.

  17. The man fearful of his back • Over 40 and in past years suffered probably a minor episode of back pain. • Because of this temperament, combined at the time with a strongly worded caution from his doctor to take care, the patient has lost all confidence in the health and durability of the low back.

  18. Time dependent back ache • Particular movement aggravates the pain. • Particular time aggravates pain – rising in the morning.

  19. Over stressed labourers back • Strong solidly built man • Farmer • No sciatica • Insidious onset

  20. The Equinox Syndrome • Severe leg pain limb cold • Feel of numbness • Unless the neurological involvement is multiradicular, normal muscle power regained in 10 wks.

  21. Spinal stenosis • Congenital stenosis. • Acquired stenosis – facet joint arthrosis, ligamentum flavum thickening, disc trespass, posterior vertebral lipping, spondylolisthesis, venous congestion, isolated disc resorption, degenerative stenosis, disc prolapse.

  22. Chair bound back ache • 40 year old physically active in the past, but risen professionally to assume responsibility which entail much administrative work. • Obese. • Lumbar stiffness on rising in the morning.

  23. Low back pain in pregnant women • 50% of the pregnant women. • Sweden is the highest 70% (9 wks of sick leave). • Common with multiparus women. Mechanism : • Increased lumbar lordosis. • Hormone relaxing.

  24. How to prevent by exercise programme • Before pregnancy & during 1st trimester. • Can be continued in 2nd and 3rd trimester.

  25. Low back pain in children • Rare complaint. • Often illusive – Delayed diagnosis because of rarity. • Must be investigated. Causes : • Mechanical • Developmental • Inflammatory • Neoplastic • Tethered cord • Psychogenic

  26. Sports related low back ache

  27. Collapsed back with kissing spine • Women in late middle age • Lumbar ache on standing • Degenerated all joints

  28. DISORDERS OF IV DISC

  29. Backache Leads To…… • Pain • Disability to pursue activities of daily leaving • Absenteeism • Sexual dysfunction • Financial and psychological set back

  30. Diagnosis of back pain • Physical Examination & • Investigations

  31. Diagnosis of back pain • Physical Examination

  32. Diagnosis of back pain Investigation : • Blood Ix • Radiological Ix - Plain X-ray - Myelography - CT scan - MRI

  33. Management of back pain • Conservative Treatment • Operative Treatment • Preventive Treatment

  34. Conservative treatment • Medicines • Pain killers • Muscle relaxants • Vitamins

  35. Conservative treatment • Bed rest

  36. Conservative treatment • Physiotherapy • Activity modification

  37. Conservative treatment • Manipulation of back

  38. Conservative treatment • Orthosis- (belts)

  39. Conservative treatment • Weight reduction

  40. Conservative treatment • Injection therapy ( epidural steroids)

  41. Operative treatment

  42. Operative treatment WHY WHEN ? ? WHERE ?

More Related