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Neck & Back Care

Neck & Back Care. Michelle Kwong B.HSci(Phty), MSPA, Cert. Clinical Pilates Principal Physiotherapist Practice Director. SPEAKER PROFILE MichelleKwong.com. Qualifications Graduated with Bachelor of Health Science (Physiotherapy) in University of Sydney

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Neck & Back Care

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  1. Neck & Back Care Michelle Kwong B.HSci(Phty), MSPA, Cert. Clinical Pilates Principal Physiotherapist Practice Director

  2. SPEAKER PROFILEMichelleKwong.com • Qualifications • Graduated with Bachelor of Health Science (Physiotherapy) in University of Sydney • Australia Certified Clinical Pilates Instructor • Certified Aquatic Physiotherapist • Member of Singapore Physiotherapy Association • Experience • More than 7 years of clinical experience in: • Physiotherapist • Clinical Pilates Instructor • Ergonomics Consultant • Personal Trainer in Prehabilitation/Rehabilitation

  3. SPEAKER PROFILEMichelleKwong.com • Achievement • Awarded GOLD Service Excellent by SPRING Singapore 2003 • Principal Physiotherapist and Director of Physiotherapy Clinic THE PAIN RELIEF PRACTICE • Vision • Highly committed to help people with musculoskeletal pains to speedily recovery with latest clinically proven physiotherapy technologies & success in mastery of good health and fitness. http://www.painrelief.sg

  4. TOPICS COVERED • Structure of the Spine • Common Spinal Condition • Causes of Spinal Pain/ Conditions • Pain Management • Prevention of Neck/Back Pain • Exercises for Neck/Back muscles.

  5. SPINE FACTS 5 sections • Cervical (7 vertebrae) • Thoracic (12 vertebrae) • Lumbar (5 vertebrae) • Sacral (5 fused vertebrae) • Coccyx (4 fused vertebrae)

  6. Spine Structure • Lumbar vertebrae • Intervertebral disc • Nerve roots • Ligaments • Muscles

  7. Vertebrae • Skeleton framework • Support for muscles & tissues • Protection of vital organs • Storage of minerals & immature blood cells

  8. Joints Allows movement between bones

  9. Intervertebral Disc The intervertebral disc is a jelly like substance, which consists of annulus fibrosis and the nucleus pulposus. Acts as a shock absorber.

  10. Spinal cord& Nerves Roots • Nerve roots exit through holes in the bone of the spine (foramen) on the right side and left side. • Branch out at each level of the spine. • The nerve roots innervate different parts of body.

  11. Ligaments Ligaments are fibrous bands or sheets of connective tissue. They link two or more bones, cartilages, or structures together.

  12. Muscles Muscles attach to the spinal column, pelvis, and extremities. They serve to support the spine

  13. Core Muscles • Deep trunk muscles- acts as stabilisers • ‘Power House’

  14. Causes of Neck & Back Pain

  15. Causes of Neck & Back Pain PoorCarrying Posture PoorSitting Posture

  16. Causes of Neck & Back Pain PoorSleeping Posture PoorWorking Posture

  17. Causes of Neck & Back Pain • Overuse e.g. repetitive bending, static posture • Overstress e.g. heavy object, excessive turning • Degenerative changes i.e. Wear and tear • Trauma e.g. fall • Genetic predisposition • Physical inactivity • Mental Stress • Tumor

  18. Common Problems Neck & Back Pain

  19. Common Conditions of Neck & Back Pain • Joint sprain e.g. locked joint syndrome • Muscle and Ligament injuries • Degenerative changes e.g. spondylosis, osteoarthritis, spondylolisthesis • Prolapsed Intervertebrae disc (‘slipped’ disc) • Nerve roots irritation • Fractures

  20. Compression Fracture • Usually due to trauma (very hard pressure or fall) • Higher risk for osteoporosis/ elderly

  21. Disc Herniation

  22. Effects of position on disc

  23. ‘Slipped’ Disc

  24. Spondylosis • Degeneration (Wear and tear) • Age related • Activity related • Previous injury/trauma

  25. Lumbar Spondylosis Normal 58 yrs old Degenerative Changes 83 yrs old

  26. Nerve Root Irritation • Shooting pain down the leg • Constant pain • Numbness • Weakness

  27. Signs and Symptoms

  28. SIGNS & SYMPTOMS • Localised pain in the neck/ back • Diffused pain over a wide area • Pain radiating to the lower limb

  29. SEVERE SYMPTOMS • Numbness/ Pins & Needles in the upper/ lower limb • Weakness • Constant pain • Difficulty sleeping/ awaken by pain • Unsteady with walking • Inability to control bowel / bladder  To seek early medical doctor/ physiotherapist advice if presence of severe symptoms

  30. MANAGING PAIN Self Management Doctor Physiotherapy Surgery

  31. Acute Pain Self Management ACUTE PAIN (1st – 2nd day) • Apply ‘RICE’ • R: Rest for 24-48hours (NOT Complete Bedrest!) • I: Ice for 15-20mins,every 2-3hrs interval • C: Compression with bandage • E: Elevate • Avoid ‘HARM’ • H: Heat • A: Alcohol • R: Running • M: Massage

  32. Pain Management Advice • Avoid activity that may cause pain especially: - Strenuous activity - Prolonged activities, repetitive movement - Heavy loads • Neck/ Back Support for acute severe pain. (Not advisable for chronic pain.) • Heat • Gentle stretching when pain reduced

  33. Pain Management Advice • When self management does not work, SEEK HELP EARLY especially if you are suffering from any neck/back pain and radiating pain down arms/legs. • The longer your pain condition, the harder for doctor/physiotherapist to treat, the longer the time for recovery and more medical fees involved.

  34. Physiotherapy Goals of Treatment • relieve pain • improve joint function • maintain flexibility • Strengthening weak muscles • Achieve a healthy lifestyle

  35. Physiotherapy • Pain relief treatment • Heat (Ultrasound, Hotpack, Shortwave) • Electrical (Interferential, TENS, microcurrent) • Joint mobilisation/ manipulation • Massage • Traction • Postural Correction • Sports Taping/ Kinesio Taping • Core/ Back Therapeutics Exercises • Return back to sports/work

  36. ADVANCED TREATMENTS:  COLD LASER THERAPY - Stimulates immune system - Generate healthy cells & tissues - Promotes faster healing • Spinal Decompression Therapy (DTS) • - Advanced high tech Traction • - Proven to reduce most neck/back • symptoms >86% • EM SIGNAL THERAPY • - Activate & Regenerate cells • - Bone & Cartilage Repair • - Significant pain reduction  ELECTROACUPUNCTURE - Non-invasive - Effects of electrical & acupuncture therapy to reduce pain & promote recovery

  37. Physiotherapy • Education on lifestyle modifications • Avoid prolong activities • Avoid strenuous activities • Avoid heavy load • Avoid squatting/kneeling prolonged • Avoid stairs climbing

  38. Medications Medicines doctors use to treat osteoarthritis include: • Acetaminophen, which may help relieve pain. • Nonsteroidal anti-inflammatory drugs (NSAIDs), which reduce inflammation and relief fever. • Corticosteroid injections in the joint (intra-articular), which reduce inflammation. • Hyaluronan injections, which may relieve pain. • Opioids, which may relieve moderate to severe pain.

  39. Supplements • Chondroitin & Glucosamine sulfate • natural substances found in the joint fluid. • chondroitin is thought to promote an increase in the making of the building blocks of cartilage (collagen and proteoglycans) as well as having an anti-inflammatory effect. Glucosamine may also stimulate production of the building blocks of cartilage as well as being an anti-inflammation agent.

  40. Supplements • CH Alpha (Collagen hydrolysate) • Only product with a U.S. patent for cartilage regeneration • Clinically proven to stimulate specialized cells called chondrocytes. Chondrocytes control the rate of cartilage regeneration in joints and detect changes in the composition of the cartilage. They respond to these changes by growing more cartilage. • Studies have shown that CH-Alpha increases the concentration of collagen and proteoglycans through this stimulatory effect on chondrocytes.

  41. Prevention of Neck & Back Pain PREVENTION IS BETTER THAN CURE!

  42. Prevention of Neck & Back Pain • Adopt good body mechanics/posture • Adopt correct lifting technique • Exercises for a healthy back • Healthy Lifestyle • Stress Management

  43. Strengthening Exercises

  44. Healthy Lifestyle Flexibility Mobility Aerobic Endurance Strength

  45. Healthy Lifestyle

  46. PRACTICAL • Neck Mobility Exercises • Neck Strengthening Exercises • Back Mobility Exercises • Back Strengthening Exercises DISCLAIMER: Exercises shown should be done with caution especially for people suffering in pain or previous condition. In case of doubt, check with your doctor/physiotherapist with regards to your condition.

  47. Neck Mobility Exercises Neck Flexion/ Extension • Tilt head forward and backward as far as possible. • Slow, repeat 8-10 times • Neck Side Flexion • Tilt head toward shoulder keeping shoulder stationary • Slow, repeat 8- 10 times

  48. Neck Mobility Exercises • Neck Rotation • Turn head from side to side as far as possible • Slow, repeat 8-10 times

  49. Neck Strengthening Exercises • Deep Neck Flexors • Tuck in Chin • Hold 10 seconds, 8 -10reps • Isometric Neck Extensors • Giving resistance with clasped hands at back of head, push backwards with head. • Hold 10 seconds, 8- 10 reps

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