How to really treat low chronic back pain (LBP)
Автор: MSK Neurology
Загружено: 2018-04-13
Просмотров: 10248
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Chronic low back pain is considered a idiopathic, psychogenic and all-over a mystery, but is this reasonable? Do we not see an obvious pattern of pathology in the region of pain, in long-standing sufferers?
With [extremely] common denominators of loss of lumbosacral lordosis, atrophied spinal extensors and posteriorly directed disc herniations, and evidence showing SIGNIFICANTLY higher risk of discal detriment in relation to increased flexion angles, there is in my opinion and experience little doubt that we want to increase the lumbopelvic lordotic angles in our LBP patients.
The patient must learn to change their lumbopelvic habits, i.e. alignment, so that continuous anterior discal shearing forces may cease, and circumferential loading may reestablish. Further, to engage the un-used muscles to provide optimal stability. The patient must learn to stop bracing their abs, glutes and hamstrings in posture, as well as stop creating valsalva when not necessary.
For evidence and more reasoning, see here:
https://treningogrehab.no/really-asse...
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