POSTURAL PAIN SYNDROME Definition Postural pain syndrome is

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 �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 �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 �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 factors �Musculoskeletal problems �Work-related back problems �Lower back pain �Repetitive strain injury �Carpal tunnel syndrome

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 �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 �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 �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.

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

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’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’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.

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

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 Mc. Kenzie. �The approach has had favourable clinical acceptance among therapists and patients and offers a conservative alternative to treating back and neck pain.

Evidence based article �Mc. Kenzie 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 article �He proposed three nonspecific mechanical syndromes; �Postural pain syndrome �Dysfunction syndrome �Derangement syndrome

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

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 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

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

References � Caruso, T. J. and Pleva, D. J. 2006. Getting your back to work: pain relief— where to start? International Journal of Mechanical Diagnosis and Therapy. 1(1): 18 -28. http: //www. mdtjapan. org/therapist/2006 IJMDT_1%20(1). pdf#page=19 � Retrieved on 4 June 2012. � http: //ebookbrowse. com/postural-pain-syndrome-jan 08 -pdf-d 79305710 � http: //www. bbc. co. uk/health/physical_health/conditions/in_depth/back_pai n/causesback_types. shtml#top � http: //www. physicaltherapy. zoomshare. com/5. html � http: //www. physioadvisor. com. au/8390250/postural-syndrome-posture-painpoor-posture-. htm

References �http: //www. google. co. za/imgres? q=postural+pain+sy ndrome&um=1&hl=en&sa=N&biw=691&bih=352&tbm =isch&tbnid=Tfs 1 j. Z 5 Tg. N 9 n. M: &imgrefurl=http: //www. back-inaction. co. uk/Pages/Back. Pain. htm&docid=T 3 pa 1 ZZ_UI TSVM&imgurl=http: //www. back-inaction. co. uk/Images/Pages/Back_Pain/image 003. jpg& w=315&h=400&ei=e. Rj. GT 9 az. DYy. Yh. Qe 17 Xa. BQ&zoom=1 �http: //www. the-good-doctor. net/posture-and-formsof-middle-back-pain/

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