Introduction- Low back pain (LBP) is the fifth most common reason for physician visits.

  • Affects nearly 60-80% of people throughout their lifetime.
  • Some studies have shown that up to 23% of the world’s adults suffer from chronic low back pain. This population has also shown a one-year recurrence rate of 24% to 80%.
  • Some estimates of lifetime prevalence are as high as 84% in the adult population.
  • A systematic review demonstrated an annual rate of adolescents suffering from back pain of 11.8% to 33%.
  • 11-12% of the population being disabled by low back pain.

Low back pain is usually categorized in 3 subtypes: acute, sub-acute and chronic low back pain. This subdivision is based on the duration of the back pain. Acute low back pain is an episode of low back pain for less than 6 weeks, sub-acute low back pain between 6 and 12 weeks and chronic low back pain for 12 weeks or more.

Non-specific back pain accounts for over 90% of patients presenting to primary care and these are the majority of the individuals with low back pain that present to physiotherapy. Physiotherapy assessment aims to identify impairments that may have contributed to the onset of the pain, or increase the likelihood of developing persistent pain. These include biological factors (eg. weakness, stiffness), psychological factors (eg. depression, fear of movement and catastrophisation) and social factors (eg. work environment).

The first aim of the physiotherapy examination for a patient presenting with back pain is to classify the patient according to the diagnostic triage recommended in international back pain guidelines. Serious (such as fracture, cancer, infection and ankylosing spondylitis) and specific causes of back pain with neurological deficits (such as radiculopathy, caudal equina syndrome) are rare but it is important to screen for these conditions.

Recent guidelines recommend advice and non-pharmacological management such as physiotherapy interventions that include exercise and manual therapy.

The exercise program includes a warm-up session of five exercises (awareness of the back, pelvic tilt, lumbar rotation, arm movements, whole-body movement in standing), well-known exercises targeting the muscles of the back extensors, abdominals, lateral buttocks, trunk rotators, posterior buttocks, leg muscles, oblique abdominals (e.g. the plank, diagonal arm and leg lift), as well as exercises for flexibility For each of the eight types of exercise. After each type of exercise, the patient should records the level of each exercise for each training session during the eight-week period.

Ms. Seby Sajwani, BPT IV Year, Departmental of Physiotherapy, School of Health and Allied Sciences, Career Point University, Kota

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