Fibro and Lower Back Flashcards
What is Fibromyalgia
Non-articular, painful, rheumatic condition of at least 3 months duration.
How is Fibromyalgia characterized?
Widespread muscular achiness, specifically the palpation of 11 of 18 tender points
Causes of Fibromyalgia
Immune abnormalities
genetics
Triggered/Aggravated by:
- Overexertion
- lack of exercise
- Stress
- anxiety/depression
- lack of or too much sleep
- trauma
- extreme temp
- infectious illness
Symptoms of Fibromyalgia
-Generalized pain
-Stiffness, worse in morning and evening
-Mod to severe fatigue
- Poor sleep
-Intolerance to cold
-Headaches
Massage therapy goals for client with Fibromyalgia
-Full body wellness and relaxation
-Fibro clients generally prefer firm pressure
-Relax key areas (head, neck, shoulders, hands, feet)
Fibromyalgia self care
-Warm/hot hydrotherapy
-Self massage
-Meditation
-light to moderate aerobic exercise
Common causes of lower back pain
-Spondylosis of the lower back
-Slipped/herniated disc
-Nerve root impingement
What is Spondylosis?
degenerative changes in facet joint and eventual ankylosing (Stiff and rigid) joints
Symptoms of lumbar DDD
pain is noted across lower back and hips and sometimes legs, worse with activity and there is a history of back injury
Symptoms of lumbar disc herniation
pain is deep and poorly localized, starts centrally at level of disc and over time moves laterally and gets worse, can spread down glutes, legs and feet
Symptoms of nerve root impingement
can lead to bladder and bowel dysfunction, numbness across low back, glutes and hips
symptoms of piriformis syndrome
pain and parastheisa in the posterior thigh and glute, usually local to one leg
Signs of DDD (assessment)
AFROM and PROM reduced lumbar flex and ext with possible pain
Signs of acute herniation (assessment)
AFROM and PROM limited in all ranges with possible spasms, AF flex may have deviation to one side
Special tests for lower back pain
Valsalvas
slump
kemps
quadrants
kernels
SLR
Reflex testing for Lower back pain
L3-L4 - patellar tendon
L4-L5 - Tib poterior tendon
L5-S1- semimembranous tendon
S1-S2 - achilles tension
Goals of treatment for lower back pain
-Decrease SNS firing
-Reduce compression
-Reduce pain and spasms
-Maintain tissue health
Lower back massage contraindications
- if not comfortable position can be found, refer to Dr
-do not mobilize hyper-mobile joints
Muscles affected by DDD
QL, hip flexors, IT band, Quads, TFL, hamstrings, calves
Techniques for Lower back treatments (lumbar spine DDD, herniation, spondylosis, slipped disc, impingement)
-heat to tight areas
-myofascial release
-GTO
-Petrissage
-joint play for hypomobile joint
-Passive stretching
