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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 over a long period of time. Excessive tension is placed on these areas. Pain is relieved with activity. Postural pain syndrome.

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definition
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.
postural pain syndrome1
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.
pathophysiology
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.
causes and risk factors
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
causes and risk factors1
Causes and Risk factors
  • Musculoskeletal problems
  • Work-related back problems
  • Lower back pain
  • Repetitive strain injury
  • Carpal tunnel syndrome
causes and risk factors2
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
diagnosis
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.
signs and symptoms
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.
treatment
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.
treatment1
Treatment
  • Teach patient about kinetic handling.
  • Correct biomechanics.
  • Clinical Pilates
do s and don ts
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.
do s and don ts1
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).
do s and don ts2
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.
evidence based article
Evidence based article

Getting your back back to work: pain relief- where to start?

evidence based article1
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.
evidence based article2
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.
evidence based article3
Evidence based article
  • He proposed three nonspecific mechanical syndromes;
    • Postural pain syndrome
    • Dysfunction syndrome
    • Derangement syndrome
evidence based article4
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.
evidence based article5
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.
evidence based article6
Evidence based article
  • Eg. of an exercise;
    • Slouch-overcorrect
      • From an extreme, slouched position to an exaggerated, lordotic posture.
evidence based article7
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.
evidence based article8
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
slide26

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

references
References
  • Caruso, T.J. and Pleva, D.J. 2006. Getting your back back to work: pain relief—where to start? International Journal of Mechanical Diagnosis and Therapy. 1(1): 18-28. http://www.mdt-japan.org/therapist/2006IJMDT_1%20(1).pdf#page=19
  • Retrieved on 4 June 2012.
  • http://ebookbrowse.com/postural-pain-syndrome-jan08-pdf-d79305710
  • http://www.bbc.co.uk/health/physical_health/conditions/in_depth/back_pain/causesback_types.shtml#top
  • http://www.physicaltherapy.zoomshare.com/5.html
  • http://www.physioadvisor.com.au/8390250/postural-syndrome-posture-pain-poor-posture-.htm
references1
References
  • http://www.google.co.za/imgres?q=postural+pain+syndrome&um=1&hl=en&sa=N&biw=691&bih=352&tbm=isch&tbnid=Tfs1jZ5TgN9n-M:&imgrefurl=http://www.back-in-action.co.uk/Pages/BackPain.htm&docid=T3pa1ZZ_UITSVM&imgurl=http://www.back-in-action.co.uk/Images/Pages/Back_Pain/image003.jpg&w=315&h=400&ei=eRjGT9azDYyYhQe17-XaBQ&zoom=1
  • http://www.the-good-doctor.net/posture-and-forms-of-middle-back-pain/
references2
References
  • http://www.google.co.za/imgres?q=postural+pain+syndrome&start=82&um=1&hl=en&sa=N&biw=1117&bih=703&tbm=isch&tbnid=wVGjb5CM624Y3M:&imgrefurl=http://erikdalton.com/media/published-articles/forward-head-posture/&docid=xJOUvc0XqBE0KM&imgurl=http://erikdalton.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=112601856111257986843&page=5&tbnh=154&tbnw=118&ndsp=21&ved=1t:429,r:10,s:82,i:26