2DefinitionPostural 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.
4Postural pain syndrome Includes:Postural overloadCauses unbalanced mechanical load.Postural overexertionIntensity and duration of work is higher than the capacity of the muscles.Vibration syndromeSituations where continual compression is exerted on the structures.Postural painBad posture in static positions.
5Pathophysiology 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.
6Causes and Risk factors Some of the most common causes:Slouching in chairsDriving in hunched positionsStanding badlyLifting incorrectlySleeping on sagging mattressesBeing unfitInactivity and the wrong sort of movementHead and neck strain
7Causes and Risk factors Musculoskeletal problemsWork-related back problemsLower back painRepetitive strain injuryCarpal tunnel syndrome
8Causes and Risk factors Common risk factors:Being unfitBeing overweightJobs involving lifting, bending or moving heavy objectsBeing seated in one place for long periods of timeFrequent use of a telephone without a headsetHigh levels of stress, anxiety and tension
9Diagnosis 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.
10Signs and symptomsUsually patients with postural pain syndrome have normal and pain-free movement.When poor posture is maintained for a long time, pain is experienced.
11Treatment Physiotherapy may include: Soft tissue massage Electrotherapy e.g. ultrasoundPostural tappingThe use of posture support e.g. bracesMobilisationDry needlingExercises to improve strength of weak muscles.Improve postureStretch short and strong muscles.
12Treatment Teach patient about kinetic handling. Correct biomechanics. Clinical Pilates
13Do’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.
14Do’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).
15Do’s and Don’ts Do’s: (standing) Don’ts: (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.
17Evidence based article Getting your back back to work: pain relief- where to start?
18Evidence 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.
19Evidence based article McKenzie characterized mechanical pain as;Pain that can be constant or intermittentLimited range of motion of the back or neck that improves as symptoms diminishMovements in certain “incorrect,” or exacerbating directions increases the pain while simultaneously decreasing range of motion in the opposite direction.
20Evidence based article He proposed three nonspecific mechanical syndromes;Postural pain syndromeDysfunction syndromeDerangement syndrome
21Evidence 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.
22Evidence 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.
23Evidence based article Eg. of an exercise;Slouch-overcorrectFrom an extreme, slouched position to an exaggerated, lordotic posture.
24Evidence based article IndicationsPeriods in the day when no pain is experiencedPain is confined to areas above the kneeSymptoms are worse when sitting and generally better with standing or walkingSymptoms are worse when bending and with inactivityIf symptoms are better when in supineSeveral episodes of back pain have been experienced over the past few years.
25Evidence based article Contra indicationsA first episode of back pain that persists for more than ten daysBowel and bladder symptoms associated with back painBack or neck pain caused by traumaLeg pain below the knee including numbness, tingling or weaknessMalaisePain that disturbs sleep
26Feeding an individual a fish takes care of their hunger, while teaching them to fish allows them to survive for life.(unknown)
27ReferencesCaruso, 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):Retrieved on 4 June 2012.