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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.

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Presentation on theme: "POSTURAL PAIN SYNDROME. Definition Postural pain syndrome is pain that develops in the cervical, thoracic or the lumbar area due to poor posture maintained."— Presentation transcript:

1 POSTURAL PAIN SYNDROME

2 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.

3

4 Postural pain syndrome Includes: 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.

5 Pathophysiology There 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.

6 Causes and Risk factors Some of the most common causes: Slouching in chairs Driving in hunched positions Standing badly Lifting incorrectly Sleeping on sagging mattresses Being unfit Inactivity and the wrong sort of movement Head and neck strain

7 Causes and Risk factors Musculoskeletal problems Work-related back problems Lower back pain Repetitive strain injury Carpal tunnel syndrome

8 Causes and Risk factors Common risk factors: Being unfit Being overweight Jobs involving lifting, bending or moving heavy objects Being seated in one place for long periods of time Frequent use of a telephone without a headset High levels of stress, anxiety and tension

9 Diagnosis Difficult for doctors to find the exact cause Pain usually starts a day or two after the injury has occurred or only after several years.

10 Signs and symptoms Usually patients with postural pain syndrome have normal and pain-free movement. When poor posture is maintained for a long time, pain is experienced.

11 Treatment Physiotherapy may include: Soft tissue massage Electrotherapy e.g. ultrasound Postural tapping The use of posture support e.g. braces Mobilisation Dry needling Exercises to improve strength of weak muscles. Improve posture Stretch short and strong muscles.

12 Treatment Teach patient about kinetic handling. Correct biomechanics. Clinical Pilates

13 Do’s and Don’ts Do’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.

14 Do’s and Don’ts Don’ts: (sitting) Slump sit Lean forward and downward to reach your work. Sit with your neck forward for an extended period of time(move around every 20 minutes).

15 Do’s and Don’ts Do’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.

16 X-Rays

17 Evidence based article Getting your back back to work: pain relief- where to start?

18 Evidence based article Focus 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.

19 Evidence based article McKenzie characterized mechanical pain as; Pain that can be constant or intermittent Limited range of motion of the back or neck that improves as symptoms diminish Movements in certain “incorrect,” or exacerbating directions increases the pain while simultaneously decreasing range of motion in the opposite direction.

20 Evidence based article He proposed three nonspecific mechanical syndromes; Postural pain syndrome Dysfunction syndrome Derangement syndrome

21 Evidence based article Dental 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.

22 Evidence based article We 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.

23 Evidence based article Eg. of an exercise; Slouch-overcorrect From an extreme, slouched position to an exaggerated, lordotic posture.

24 Evidence based article Indications Periods in the day when no pain is experienced Pain is confined to areas above the knee Symptoms are worse when sitting and generally better with standing or walking Symptoms are worse when bending and with inactivity If symptoms are better when in supine Several episodes of back pain have been experienced over the past few years.

25 Evidence based article Contra 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 trauma Leg pain below the knee including numbness, tingling or weakness Malaise Pain that disturbs sleep

26 Feeding an individual a fish takes care of their hunger, while teaching them to fish allows them to survive for life.(unknown)

27 References Caruso, T.J. and Pleva, D.J Getting your back back to work: pain relief— where to start? International Journal of Mechanical Diagnosis and Therapy. 1(1): japan.org/therapist/2006IJMDT_1%20(1).pdf#page=19 Retrieved on 4 June /causesback_types.shtml#top poor-posture-.htm

28 References drome&um=1&hl=en&sa=N&biw=691&bih=352&tbm=i sch&tbnid=Tfs1jZ5TgN9n- M:&imgrefurl=http://www.back-in- action.co.uk/Pages/BackPain.htm&docid=T3pa1ZZ_UI TSVM&imgurl=http://www.back-in- action.co.uk/Images/Pages/Back_Pain/image003.jpg& w=315&h=400&ei=eRjGT9azDYyYhQe17- XaBQ&zoom=1 of-middle-back-pain/

29 References drome&start=82&um=1&hl=en&sa=N&biw=1117&bih=7 03&tbm=isch&tbnid=wVGjb5CM624Y3M:&imgrefurl= articles/forward-head- posture/&docid=xJOUvc0XqBE0KM&imgurl=http://er ikdalton.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= &page=5&tbnh=154&tbnw=118&n dsp=21&ved=1t:429,r:10,s:82,i:26


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