Management of OLBP

Question 1

treatment plan outline

Answer 1

tissue sensitivity 
local function
remote function
general function
psychosocial

Question 2

tissue sensitivity

Answer 2

settle the pain
explanation and reassurance
medications
EPA (heat)
NM massage
taping
low grade mobs (not for mobility dysfunction)

Question 3

local function (mobility) - acute irritable LBP

Answer 3

correct maladaptive deformities
provide movements to centralise pain
reduce movements that peripheralise pain
can use tape/education to limit unwanted movements

Question 4

local function (mobility) - mobility

Answer 4

promote mobility into direction of dysfunction
exercises and stretches
jnt manip
soft tissue manip

Question 5

local function (mobility) - control

Answer 5

promote mobility into opposite direction to dysfunction
jnt manip
soft tissue manip
exercises and stretches

Question 6

local function (mobility) - loading

Answer 6

promote movement to both sides of midline (flexion & extension)
low grad jnt manip into provocative direction
soft tissue manip
jnt manip
exercises and stretches

Question 7

local function (mm performance) - acute irritable

Answer 7

find it: independent mvnt into nonprovocative direction
control it: maintain neutral under load into provocative direction
prophylactic care

Question 8

local function (mm performance) - mobility

Answer 8

find it: independent mvnt into provocative direction
control it: maintain neutral under load into non provocative direction
tend to be able to do harder control ex with them

Question 9

local function (mm performance) - control

Answer 9

find it: independent mvnt into provocative direction
train normal breathing pattern
control it: maintain neutral under load into provocative direction

Question 10

local function (mm performance) - loading

Answer 10

find it: independent mvnt into either side of midline
gentle mvnt into provocative direction
train normal breathing pattern
control it: maintain neutral under load into either side of midline

Question 11

remote function - acute irritable

Answer 11

improve mobility into provocative directions

improve independent mm performance into provocative direction

Question 12

remote function - control

Answer 12

improve mobility into provocative directions

improve independent mm performance into provocative directions

Question 13

remote function - mobility

Answer 13

improve mobility into non-provocative direction

improve mm performance into non- provocative direction

Question 14

remote function - loading

Answer 14

improve mobility into direction either side of midline
improve mm performance either side of midline
improve Tx mobility
improve use of leg drive

Question 15

general function - acute irritable

Answer 15

advise to :
discourage bed rest
encourage general activity within tolerance
to increase activity 
temporarily reduce mechanical load
posture/ergonomics

Question 16

general function - mobility/control/loading

Answer 16

advise to:
encourage general activity
lifestyle factors i.e. diet, smoking, medication, weight
reduction of maladaptive loads
sporting technique/ training load
posture/ergonomics

Question 17

psychosocial treatment

Answer 17

provide support, reassurance and understanding
explain previous Rx failures
build confidence and restore hope
reorientate expectations and perceptions
emphasise favourable outcome
encourage involvement with rehab
encourage involvement of pleasurable activity/work/community involvement
discuss value of relaxation and stress reduction
educate on pain experience
emphasise reversibility
engage other stakeholders i.e. work family