The Role of Physiotherapy Against Activity Disorders in Lower Back Pain Sufferers!

Physiotherapy is a rehabilitation measure aimed at avoiding or minimizing physical disabilities resulting from an injury or underlying illness.

A person with a specific illness condition or after an equalized injury will experience physical and functional limitations that will further affect his or her ability to perform either basic activities or his/her role in the social and work environment.Low back pain is a pain that is felt in the lower back area between the lower edge of the thigh to the fold of the lower buttock, can be local pain as well as radical pain / chasing to the limbs / legs or both.

The prevalence of lower back pain was 3.71% or 12.914 according to RISKESDAS (2021). This data is supported by the association of neurospecialists Indonesia PERDOSSI in 14 educational hospitals, known of 4,456 pain sufferers from the total visit, of which are 819 people suffering from low back pain (Goin et al., 2019) Women over the age of 50 are most susceptible to lower waist pain ranging from 60 to 90 per cent, and men from 50 to 80 per cent.

Causes of lower back pain, among them:

1. Injury/ Fall: for example fractures in the spine, sprain or muscle strain
2. Infection (for example: TBC infection in the vertebra)
3. Tumor / violent
4. Metabolism (e.g. osteoporosis)
5. Structural abnormalities (scoliosis, spina bifida, hyperkiphosis etc.)
6. Early factors (eg: spondylosis, canalis stenosis and HNP)
7. Psychogenic 8.Viscerogenic: derived from other organs such as kidney stones, ISK, PID, ovarian cysts etc.

Risk factors for LBP are age, poor health conditions, degenerative arthritis, smoking, obesity, excessive height, work-related things such as sitting and driving for long periods of time, sitting or standing for hours (static working body position), vibration, lifting, carrying loads, pulling weights, bending, rotating, and pregnancy.

Treatment of lower thigh pain is basically divided into 2 :
1.Conservative consists of a.Medikamentosa (drugs): analgetic, NSAIDs, gabapentin, muscle suction etc b.Non medikamentosa: physiotherapy, nutrition patterns, lifestyle modification

1. Surgery/ surgery
   
   This therapy is a therapy that performs certain movements designed to re-train the strength of the muscles of the back and abdomen, so that the elasticity is restored

1. Exercise therapy can also be done in water/hydrotherapy
2. Modality It is a supportive tool in physical therapy using physical energy (water, thermal heat/cold, electricity, sound waves, magnetic waves etc) to cope with the effects of a disease (pain, stiffness of muscles, tissue degradation, inflammation etc.) For example a cold compress can be given to reduce pain in the waist due to inflammations or minor injuries that occur within < 1 week. It's pretty easy to wrap the ice with a plastic or a thin towel, then stick it to the hurting waist for 10-15 minutes. This activity is done regularly for 3-5x a day. If the pain is gone for more than a week, replace the compress with warm water to relieve muscle tension and increase blood flow.
3. Education Providing important information to patients related to how to prevent lower knee pain include: 1.Reducing all activities that put pressure / load on the backbone that aggravate the pain 2.Regular exercise 3 times a week with a minimum duration of 30 minutes to strengthen muscles, so that you can stabilize and support the spine better 3.Maintain a good posture, either at work, or rest, to reduce pressure on the spinal cord 4.Lift heavy objects with the correct body position, with more focus on the legs and not on the backs.

If your lower back pain is not overcome, Friend Hermina, you can do further examination with Dr. Unggulan at Hermina Samarinda Hospital.

Created by: Dr. Ary Santy, Sp.KFR
Reviewed by: Dr. Syamsul Rizal

Reference:
Basic Health Research Data (RISKESDAS) (2021)
WHO. (2013). Low Back Pain: Priority Medicines For Europe And The World. WHO.
Shipton, E. (2018). Physical Therapy Approaches in the Treatment of Low Back Pain. Pain and Therapy. 7(2), pp. 127–137.