LOW BACK PAIN

Dr.RiniLestariA .Sp.KFR
Department of Physical Medicine and Rehabilitation
School of Medicine, CenderawasihUniversity
JAYAPURAGeneral Hospital
PAPUA
DEFINISI
Suatugejalaklinisygditandairasanyeriataupe
rasaantidakenakdi
daerahtulangpunggungbagianbawahdan
sekitarnya.
Secaraanatomic,
daerahtulangbelakanglumbal1
sampaisacrum dan otot-ototsekitarnya.
LBP
merupakangejalaygdapatdisebabkanoleh
bermacam-macampenyakitdan dapatdi
pengaruhifactor psikososial.
• Epidemiologi
• •LBP : 50% -80% populasidewasa.
• •Angkakejadianpria&wanitasama
• •Dilaporkanwanita> usia60 thseringalamiLBP
• Etiologi
• •Traumatik: Fraktur/dislokasi, sprain lumbar
• •Degeneratif:Spondilosislumbar,Spondilolistesis,
osteoarthritis
• •Inflamasi: Spondiloarthrosis, artritisrheumatoid
• •Metabolik:Osteoporosis,osteosclerosis
• •Neoplastik: Tumor benigna/maligna
• •Kongenital:Skoliosis,Spondilolistesis
• •Infeksi:piogenikvertebraspondylitis (TBC)
• •Muskuloskeletal: Lumbar strain akut/ kronik,
LBP mekanis
• •dll
 diagnosa

Berdasarkan:
• Anamnesa:Faktorresiko, pekerjaan
• Pemeriksaan1.umum
:inspeksi:deformitas,spasmeparaspinal,scoliosi
s,atrofiotot,asimetris;palpasi:triggerpoint,nyer
itekan, spasmeotot, fleksivertebra normal 40°,
ekstensi15°; 2.khusus: Kekuatanotot, Lasegue,
SLR.
• Pemeriksaanpendukung:x.ray, CT Scan,MRI
EVOLUSI DARI QUADRIPEDAL KE BIPEDAL ANIMAL
LBP ?
LBP :
1. The most common musculoskeletal complaint and a
leading cause of work disability
2. 80% of the population will experience LBP during
their lifetime
3. 95% originally is mechanical  MECHANICAL LBP/
POSTURAL LBP : due to an anatomic or functional
abnormality without underlying inflammatory or
neoplastic disease ( mostly due to degenerative
change )
THE MAIN FUNCTIONS OF HUMAN SPINE :

1.UPRIGHT POSITION
2.PROTECTION
3.STABILIZATION
4.MOVEMENT

IT HAS TO BE VERY STRONG AND STABLE

FACTORS OF THE SPINAL STRENGTH AND
STABILITY :

1. THE SPINE AND THE PELVIS

2. THE SPINAL CURVATURES
3. THE LONG AND SHORT SPINAL LIGAMENTS
4. THE MUSCLES : Abdominal, Back extensors,
Hip flexors, Glutei, Hamstring
 WHICH IS
STRONGER ?
 THE SPINAL
CURVATURES MAKE
THE SPINE 16 x
STRONGER
THE CENTER OF GRAVITY
 THE LONG AND SHORT
LIGAMENTS OF THE SPINE
THE BACK MUSCLES
hyperlordosis
Muscle spasm
EXERCISE FOR LBP:
GOALS :
1.TO STRENGTHEN THE WEAK
MUSCLES : Abdominals, Glutei, Back
Extensors
2.TO STRETCH THE SHORTHENED
MUSCLES : Hamstring, Hip flexors,
Back extensors
TO REDUCE LUMBAR LORDOSIS
 TO STRETCH BACK
EXTENSOR MUSCLES
TO STRENGTHEN ABDOMINAL MUSCLES
TO STRENGTHEN GLUTEUS
MAXIMUS MUSCLE
TO STRENGTHEN
GLUTEI MUSCLES
TO STRETCH
HAMSTRING
TO STRETCH HIP FLEXORS
 TO STRENGTHEN
THE BACK MUSCLES
TO CORRECT POSTURE
TO CORRECT POSTURE
EMG BIOFEEDBACK
EXERCISE
EMG BIOFEEDBACK
EXERCISE
 EMG
BIOFEEDBACK
EXERCISE
EXERCISE TO PREVENT LOW BACK
EXERCISE FORPAIN
LOW BACK PAIN

Bayu Santoso
Department of Physical Medicine and Rehabilitation
School of Medicine, Airlangga University
Dr. Soetomo General Hospital
Surabaya
SLR TEST
THOMAS TEST
PATRICK FABERE
TEST
OBER TEST
GAENSLEN
TEST