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physicaltherapy: 05 Feb : 06:54 pm

Is there anyone who has gone through CWT6 or type 1 evaluation with FCCPT?
If so, kindly let me know from where can the following deficiencies be fulfilled?
1. History
2. Systems Review
3. Findings that warrant referral
4. Supervision of support staff
5. Documentation

nani: 28 Sep : 04:31 am

plz pleasec tell me where to do phd in india

Nikhilphysio: 02 Jun : 03:55 am

I am working as physiotherapist in Shalby hospital ahmedabad for 4 years. I have passed out from Rajiv gandhi university of health and sciences Bangalore. I want to apply for Newzealand physiotherapy board registration so anyone there from India who got registered as physiotherapist in new zealand please help me.

Arun: 10 May : 12:36 am

Hi Priyank, welcome. Feel free to go through these forum threads returned by search [link]

Priyank: 09 May : 10:28 pm

Hi..need advice. What are the options in Australia after MPT?


Low Back Injuries

on Sunday 02 October 2005
by http://physioguy.com author list
in article > Public Awareness

Back pain is a common complaint among the average person. So common, in fact, that most people will experience a significant back injury at least once in their lifetime. Many factors are related in the onset of back pain, such as posture, occupation, activity, age and anatomical variation. In addition to these factors, the low back is simply subject to greater mechanical loads than any other part of the body. Any of these factors can result in injury, which may occur in one sudden event (direct or indirect trauma) or have a more insidious (gradual) onset.

spinal regions

Back pain is a common complaint among the average person. So common, in fact, that most people will experience a significant back injury at least once in their lifetime. Many factors are related in the onset of back pain, such as posture, occupation, activity, age and anatomical variation. In addition to these factors, the low back is simply subject to greater mechanical loads than any other part of the body. Any of these factors can result in injury, which may occur in one sudden event (direct or indirect trauma) or have a more insidious (gradual) onset.

Once injured, recovery time will vary immensely depending on the actual structures injured, as well as the chance of re-injury if a proper course of rehabilitation isn't followed. The difficulty often lies in getting an accurate diagnosis, for the back is one of the most misdiagnosed orthopedic injuries. For those who have experienced a significant back injury in the past, frustration at getting differing opinions or a lack of a full diagnosis can be difficult to deal with. The difficulty in diagnosis is due to the similar presentation of various injuries. Aside from similar symptoms, many injures will result in compensatory muscle spasm, which becomes the obvious focus which can mask the underlying cause of the injury. All this can make it difficult for a physician, or any health care professional for that matter, to provide a full diagnosis.

The best way to get an accurate diagnosis is through taking a full history (detailed account of the injury, symptoms and all related factors) followed by a complete objective assessment (tests looking at movement, strength, stability, function, circulatory system and nervous system). If care and attention is not given during the initial assessment, the accuracy of diagnosis will be limited. In some cases, certain forms of diagnostic imaging will be employed to get a better picture of the injury (such as X-ray, CT-scan or MRI)

simplified

To appreciate the complexity of the back injuries, an understanding of the basic structure and function of the back is needed.

ANATOMY

The back is made up of segmental bones called vertebrae. These bones vary in size and shape dependant on their function, which varies according to the region of the spine that they are from. The diagram here depicts simplified lumbar (low back) vertebrae, along with some of the related anatomical structures. The bulky part of the vertebra is called the body. The vertebral bodies are separated by shock-absorbing intervertebral discs. These discs are made up of strong, outer fibrous layers called the annulus fibrosus which surround a gel-like centre called the nucleus pulposus.

simplified

Two bony struts project out the rear aspect of the body, and then attach together to form an arch (when looking down from the top). This arch attached to the vertebral body forms a vertical canal when linked with all the other vertebrae. This canal houses the spinal cord. Spinal nerves, which are made up of roots from the spinal cord, exit the canal on both sides from openings called intervertebral foramen. These openings are simply the separation between stacked vertebrae. The spinal nerves go on to supply the motor and sensory functions of various structures, such as muscles, skin and other connective tissues. The cervical spinal nerves are primarily responsible for the function of the upper extremities while lumbar spinal nerves are primarily responsible for the lower extremities.

simplified

Bony projections on each side of the arch project upwards and downwards to form joints with the vertebrae above and below. These are called facet joints and allow for most of the movement of the back. Each facet joint, like most joints in the body, are housed in a joint capsule. This capsule contains the joint fluid and the cartilage covered surfaces of the joint. In the lumbar spine, small fibro-cartilaginous structures called meniscoids may also exist within the capsule.

Muscles and ligaments of the back have attachments to various parts of the vertebrae, namely the transverse and spinous processes. The transverse processes extend from the sides of the vertebrae, while the spinous process extends from the rear aspect of the arch. The sacro-iliac joint is between the sacrum (made up of fused vertebrae) and the iliac bones of either side of the pelvis. This joint has minimal movement, and is responsible for the transmission of forces from the lower extremities to the spine and vice versa. Truthfully this is part of the pelvis, but it is often included when discussing "back" injuries.

simplified
COMMON LOW BACK INJURIES
The following is a brief description of some of the more common back injuries. In time, more detailed information on each injury may be provided, including treatment and rehabilitation.

Ligament sprain - refers to injury of one or more of the ligaments of the back. Ligamentous injuries may be classified as gr.I (mild sprain), gr.II (some fiber tearing) or gr.III (complete tear). Due to the number of ligaments and other structures that share function, precise diagnosis can be difficult (ie: Can be diagnosed as a sprain without naming of the exact ligaments). This is usually the result of being forced beyond the stable range of movement.

Muscle Strain - refers to muscle injury. This can range from a mild "pull" to partial or complete tearing of muscle fibers. The term "pull" usually refers to injury where small fibers are damaged on a microscopic level, while the whole muscle is largely intact. Strains occur when a muscle is worked excessively, or when forces acting in opposition to the muscle are too great. This can be due to sudden trauma or repetitive strain.

Disc Injury - Often referred to as a "slipped disc". Truthfully, the disc is not "slipped" out of place. Instead, it may become slightly bulged or prolapsed. This occurs when the outer layer weakens and allows the gel-like centre to press outwards and sometimes even escape the disc altogether. This alone can cause pain and dysfunction, but can be further complicated when the bulge presses against a spinal nerve or, more seriously, the spinal cord.

Facet joint - Injury to the facet joint structures, including pinching of the capsule, the meniscoid structures, or underlying bone damage. This can be caused by a sudden trauma involving quick and/or excessive joint movement. May also be gradual onset, caused by degeneration of the joint surfaces and underlying bone (arthritic changes).

Sacro-iliac joint dysfunction - This may include spraining one or more of the sacro-iliac joint ligaments, or hyper-mobility (excessive movement) of the joint itself. It may be caused by biomechanical faults, sudden trauma, hormonal changes (such as in pregnancy), and with certain inflammatory conditions.

Fracture - Cracks or complete breaks in the bony structures of the back. Often occurs as the result of significant trauma, but may occur as an overuse injury as well.

Spondylolysis - A stress fracture of the pars of the vertebrae. The pars is simply the bony struts (referred to above) that extend from the rear aspect of the vertebral body on both sides, and attach the bony arch to the vertebral body. This overuse injury is common in sports, especially with adolescents. This usually occurs at the bottom of the lumbar spine.


Reprint Courtesy: http://physioguy.com