Title: Neck
1Neck Back Care
- Michelle Kwong
- B.HSci(Phty), MSPA, Cert. Clinical Pilates
- Principal Physiotherapist
- Practice Director
Http//www.painrelief.sg
2SPEAKER 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
3SPEAKER 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
4TOPICS 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.
5SPINE FACTS
- 5 sections
- Cervical (7 vertebrae)
- Thoracic (12 vertebrae)
- Lumbar (5 vertebrae)
- Sacral (5 fused vertebrae)
- Coccyx (4 fused vertebrae)
6Spine Structure
- Lumbar vertebrae
- Intervertebral disc
- Nerve roots
- Ligaments
- Muscles
7Vertebrae
- Skeleton framework
- Support for muscles tissues
- Protection of vital organs
- Storage of minerals immature blood cells
8Joints
Allows movement between bones
9Intervertebral Disc
The intervertebral disc is a jelly like
substance, which consists of annulus fibrosis and
the nucleus pulposus. Acts as a shock absorber.
10Spinal 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.
11Ligaments
Ligaments are fibrous bands or sheets of
connective tissue. They link two or more bones,
cartilages, or structures together.
12Muscles
Muscles attach to the spinal column, pelvis, and
extremities. They serve to support the spine
13Core Muscles
- Deep trunk muscles- acts as stabilisers
- Power House
14Causes of Neck Back Pain
15Causes of Neck Back Pain
PoorCarrying Posture
PoorSitting Posture
16Causes of Neck Back Pain
PoorSleeping Posture
PoorWorking Posture
17Causes 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
18Common Problems Neck Back Pain
19Common 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
20Compression Fracture
- Usually due to trauma
- (very hard pressure or fall)
- Higher risk for osteoporosis/ elderly
21Disc Herniation
Stages of Disc Herniation Stages of Disc Herniation Stages of Disc Herniation
1 Disc Degeneration Chemical changes associated with aging causes discs to weaken, but without a herniation.
2 Prolapse The form or position of the disc changes with some slight impingement into the spinal canal. Also called a bulge or protrusion.
3 Extrusion The gel-like nucleus pulposus breaks through the tire-like wall (annulus fibrosus) but remains within the disc.
4 Sequestration or Sequestered Disc The nucleus pulposus breaks through the annulus fibrosus and lies outside the disc in the spinal canal.
22Effects of position on disc
23Slipped Disc
24 Spondylosis
- Degeneration
- (Wear and tear)
- Age related
- Activity related
- Previous injury/trauma
25Lumbar Spondylosis
Normal 58 yrs old Degenerative Changes
83 yrs old
26Nerve Root Irritation
- Shooting pain down the leg
- Constant pain
- Numbness
- Weakness
27Signs and Symptoms
28SIGNS SYMPTOMS
- Localised pain in the neck/ back
- Diffused pain over a wide area
- Pain radiating to the lower limb
29SEVERE 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
30MANAGING PAIN
- Self Management
- Doctor
- Physiotherapy
- Surgery
31Acute 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
32Pain 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
33Pain 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.
34Physiotherapy
- Goals of Treatment
- relieve pain
- improve joint function
- maintain flexibility
- Strengthening weak muscles
- Achieve a healthy lifestyle
35Physiotherapy
- 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
36ADVANCED 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 gt86
- 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
37Physiotherapy
- Education on lifestyle modifications
- Avoid prolong activities
- Avoid strenuous activities
- Avoid heavy load
- Avoid squatting/kneeling prolonged
- Avoid stairs climbing
38Medications
- 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.
39Supplements
- 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.
40Supplements
- 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.
41Surgery
In some cases surgery is necessary, more often it is not necessary. Another 6-8 weeks of physiotherapy, at 3 to 5 times per week.
Lower rate of success, dependent
- Pain - Increased danger from anesthetic - Increased danger from possible infections - Possible post operation complications (eg pneumonia, DVT, delayed union/nonunion, spinal cord injury) - Noticeable scars
Prolonged recovery time, generally 6 to 8 weeks
42Prevention of Neck Back Pain
PREVENTION IS BETTER THAN CURE!
43Prevention of Neck Back Pain
- Adopt good body mechanics/posture
- Adopt correct lifting technique
- Exercises for a healthy back
- Healthy Lifestyle
- Stress Management
44Strengthening Exercises
45Healthy Lifestyle
Flexibility
Mobility
Aerobic Endurance
Strength
46Healthy Lifestyle
47PRACTICAL
- 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.
48Neck 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
49Neck Mobility Exercises
- Neck Rotation
- Turn head from side to side as far as possible
- Slow, repeat 8-10 times
50Neck 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
51Neck Strengthening Exercises
- Isometric Neck Side-Flexors
- Place hands on side of the head and push head
against hands resistance - Hold 10seconds, 8-10reps
52Back Stretching Exercises
- Bent Over Stretch
- Hold the back of a chair with your arms
shoulder-width apart. - Walk backwards as you bend forward from the hips
and straighten out your arms. - Keep your feet together, your back straight and
your head between your arms in line with your
spine. - Hold for 10 30secs
53Back Stretching Exercises
- BACK EXTENSION SHOULDER BLADE PINCH
- Stand with feet apart lean backward to the
point of tension with arms reaching back. - Tighten shoulder blades and lower back muscles.
- Feel a mild stretch on your abdominals.
- Hold for 10-30secs
54Back Stretching Exercises
- Lower Back Stretch
- Stand with feet hip-width apart.
- Come into a squat position by bending your knees
and pushing your buttocks backwards. Place your
hands on your thighs. - Pull belly button toward your spine as you tilt
or curl your pelvis under. - Return to starting position.
55Stomach Hollowing
- Strengthens Transverse Abdominus
- Breath out and relax your stomach muscles
- Pull lower part of stomach inwards and upwards
- Hold 10 seconds and perform 8-10reps
- Crook lying, sitting, standing
56High Plank
- Strengthens the chest, shoulders, triceps,
buttocks, hamstrings trunk. - Start on your hands and knees. Arms should be
directly under your shoulders. - Extend one leg back at a time until your body
weight is supported on your arms and toes. - Hold for 5-10seconds, perform 8-10 reps
57Back Strengthening Exercises
- Bridging Exercises
- Lie on the floor with your knees bent, feet flat.
- Tighten the muscles of your lower abdomen and
buttocks. - Slowly raise low back and buttocks from the floor
- Hold for 5-10 seconds, do 8-10reps
58Back Strengthening Exercises
- Low Back Extensors
- Lie face down on a mat with your arms beside you
and your legs together. - Lift your head and shoulders off the mat by
squeezing the muscles in your lower back. Keep
your feet on the floor. - Slowly lower to the mat.
- Hold for 5-10 seconds, do 8-10reps
59Summary
- Prevention is better than cure.
- When self management does not work,
SEEK HELP EARLY if you are suffering from any
neck/back pain or any radiating pain down
arms/legs. - LIVE A PAIN FREE LIFE!
60QUESTIONS ANSWERS
- If you have any queries, please feel free to
email Michelle at michelle_at_painrelief.sg - Or call 67355368.
61THANK YOU
Presented By Michelle Kwong
B.HSci(Phty), MSPA, Cert. Clinical Pilates
Principal Physiotherapist Practice
Director
World Malayali Club http//groups.yahoo.com/group/worldmalayaliclub/
62Disclaimer
- The Pain Relief Practice Educational Material is
for information only. This information is not
intended to diagnose, treat, or cure any
medical/health condition. It is not a substitute
for formal, real world medical or physiotherapy
care, and should not be considered as such. The
Pain Relief Practice is not in a position to
independently evaluate any of the advice or
claims on behalf of any particular therapy. Any
information or suggestions we provide should be
discussed with your doctors or physiotherapist in
real person when treating your condition. Our
discussion of possible pain treatments are just
options which may be significantly limited by the
incomplete full physical examination of a
doctor/physiotherapist.