Table Of Content

E S S E NTI A L BACK CARE E S S E NTI A L BACK CARE CONTENTS LONDON, NEW YORK, MUNICH, MELBOURNE, DELHI ABOUT THIS BOOK 6 CHRONIC SCIATICA 46 Senior Editors Gareth Jones, Ed Wilson NONSPECIFIC NERVE-ROOT PAIN 47 Senior Art Editors Gillian Andrews, SPINAL STENOSIS 48 Keith Davis PIRIFORMIS SYNDROME 49 Project Editors Corinne Masciocchi, BUTTOCK AND COCCYX PAIN 50 Hannah Bowen, Cécile BACK & NECK ANATOMY COCCYDYNIA 51 Landau, Scarlett O’Hara SACROILIITIS 52 US Editor Jill Hamilton THE SPINE 10 GLUTEUS MEDIUS US Medical Consultant Eric N. Dubrow, MD THE SPINAL CANAL AND NERVES 14 DYSFUNCTION 53 Project Art Editors Phil Gamble, MUSCLES AND LIGAMENTS 16 WHOLE SPINE CONDITIONS 54 Yen Mai Tsang INFLAMMATORY DISEASE 55 Production Editor Joanna Byrne HYPERMOBILITY SYNDROME 56 Production Controller Sophie Argyris POSTURAL PAIN 57 Jacket Designer Mark Cavanagh SCOLIOSIS 58 Managing Editor Stephanie Farrow DIAGNOSIS & TREATMENT ACUTE VERTEBRAL COMPRESSION Managing Art Editor Lee Griffiths FRACTURE 59 Illustrators Philip Wilson, Debbie SYMPTOMS CHARTS 20 Maizels, Mark Walker, Debajyoti Dutta, Phil NECK 20 Gamble, Darren Awuah MIDBACK 22 LOW BACK AND LEG 24 First American Edition, 2011 ACUTE NECK AND CAUSES OF Published in the United States by DK Publishing NERVE-ROOT PAIN 26 BACK & NECK PAIN 375 Hudson Street CERVICAL DISK HERNIATION 27 New York, New York 10014 ACUTE TORTICOLLIS 28 MUSCULAR TENSION 62 11 12 13 10 9 8 7 6 5 4 3 2 1 WHIPLASH 29 ANKYLOSING SPONDYLITIS 63 001–179160–August/2011 CHRONIC NECK AND SPONDYLOLYSIS AND NERVE-ROOT PAIN 30 SPONDYLOLISTHESIS 64 Copyright © 2011 Dorling Kindersley Limited All rights reserved. FACET JOINT PAIN 31 VERTEBRAL COMPRESSION MYOFASCIAL PAIN SYNDROME 32 FRACTURE 65 Without limiting the rights under copyright reserved above, no part of this publication may be reproduced, DISK-RELATED PAIN 33 HYPERMOBILITY stored in or introduced into a retrieval system, or THORACIC PAIN 34 AND INSTABILITY 66 transmitted, in any form, or by any means (electronic, mechanical, photocopying, recording, or otherwise), MECHANICAL 35 DISCOGENIC PAIN 67 without the prior written permission of both the ACUTE LOW-BACK PAIN 36 FACET JOINT STRAIN 68 copyright owner and the above publisher of this book. ACUTE LUMBAR DYSFUNCTION 37 SACROILIAC STRAIN 69 Published in Great Britain by DISK HERNIATION AND SCIATICA 38 DISC HERNIATION 70 Dorling Kindersley Limited. SACROILIAC STRAIN 39 ACUTE TORTICOLLIS 71 A catalog record for this book is available CHRONIC LOW-BACK PAIN 40 WHIPLASH 72 from the Library of Congress. DISK-RELATED PAIN 41 SPINAL STENOSIS ISBN 978-0-7566-8264-4 FACET JOINT PAIN 42 AND DEGENERATION 73 DK books are available at special discounts when SPONDYLOLYSIS SCOLIOSIS 74 purchased in bulk for sales promotions, premiums, fund-raising, or educational use. For details, contact: AND SPONDYLOLISTHESIS 43 COCCYDYNIA 75 DK Publishing Special Markets, 375 Hudson Street, INSTABILITY SYNDROME PIRIFORMIS SYNDROME 76 New York, New York 10014 or [email protected]. AND SACROILIAC STRAIN 44 GLUTEUS MEDIUS Printed and bound in Singapore by NONSPECIFIC/ DYSFUNCTION 77 Tien Wah Press Ltd. Discover more at www.dk.com LUMBAR DYSFUNCTION 45 BMA MEDICAL EDITOR Dr. Michael Peters is Consulting Medical Editor to the British Medical Association and Director of the Doctors for Doctors Unit at the BMA, having previously worked as a GP. WORKING IN CONSULTANT EDITORS YOUR GARDEN 132 DRIVING YOUR CAR 134 Dr. John Tanner is a private practitioner WHERE TO FIND HELP DURING PREGNANCY 136 in musculoskeletal and sports medicine with a special interest in back injuries and CARING FOR YOUNG their treatment. He qualified in medicine CONSULTING YOUR CHILDREN 138 and psychology in London and trained PRIMARY CARE DOCTOR 80 as a general practitioner, then went on to CONSULTING A SPECIALIST 82 study medical and osteopathic methods TREATMENT WITH DRUGS 84 of manipulation, physical fitness training, TREATMENT WITH INJECTIONS 86 sports injuries, and pain management. He TREATMENT WITH SURGERY 88 STRATEGIES FOR now runs a multidisciplinary clinic in West CONSULTING A COPING WITH PAIN Sussex that specializes in musculoskeletal PHYSICAL THERAPIST 90 problems (www.ovingclinic.co.uk), is CONSULTING AN OSTEOPATH 94 COPING WITH PAIN 142 Education Chairman of the British Institute CONSULTING A PERCEPTION OF PAIN 144 of Musculoskeletal Medicine, and organizes the teaching program for doctors in this CHIROPRACTOR 96 PSYCHOLOGICAL FACTORS field. He lectures for the International Spine USING MASSAGE 98 IN BACK PAIN 146 Intervention Society in Europe and is Co CONSULTING AN PAIN RELIEF THROUGH Clinical Lead at Bupa Health and Wellbeing, ACUPUNCTURIST 100 RELAXATION 148 Barbican, London. RELAXATION TECHNIQUES 102 LYING DOWN AND SLEEPING 150 Eva Niezgoda-Hadjidemetri  Msc MCSP OTHER THERAPIES 104 WASHING AND DRESSING 154 HPC is a musculoskeletal physiotherapist MOVING AROUND 156 who gained a Masters degree in Physical Rehabilitation in Warsaw, Poland, after which she worked in Warsaw’s Rehabilitation Centre. Since moving to the UK in 1986 BACK & NECK she has attended numerous postgraduate MAINTENANCE REHABILITATION training courses in manual therapy, gaining EXERCISES an extensive knowledge of Maitland, Cyriax, HOW THE BACK WORKS 108 McKenzie, and neurodynamic methods. A WHO IS MOST AT RISK? 110 NECK AND BACK 160 specialist in the rehabilitation of neck and back conditions, with a special interest in IMPROVING YOUR POSTURE 112 BACK AND BUTTOCKS 178 sports injuries and hypermobility syndrome, EXERCISE AND SPORT 116 Eva currently works at the 999 Medical & THE BENEFITS OF STRETCHING 118 Diagnostic Centre, London. EATING FOR HEALTH 120 GLOSSARY 214 Disclaimer USEFUL ADDRESSES 216 The information in this book is designed to help INDEX 218 you make informed decisions about your health, diet, fitness, and exercise/rehabilitation program. ACKNOWLEDGMENTS 224 It is not intended as a substitute for professional STRATEGIES FOR advice from doctors and/or physical therapists. If you suspect that you have an injury or other PREVENTING PAIN medical problem, you should seek the approval of your doctor and physical therapist before you begin any form of exercise. Neither the publisher AT THE OFFICE 124 nor anyone else involved in the preparation of LIFTING AND this book is engaged in rendering professional CARRYING 128 advice or services to the individual reader. For further advice on safety, see page 224. DOING HOUSEWORK 130 6 ABOUT THIS BOOK ABOUT THIS BOOK Opening with an introduction to back and using a range of simple strategies and how to neck anatomy, this book profiles a range of cope with pain and adapt your behavior. The back and neck conditions, their causes, and closing section provides a range of rehabilitation the treatment options available. The following exercises which can also be used as part of a chapters offer advice on preventing problems fitness program. BACK AND NECK ANATOMY A Cartilage fi This section provides an insight into the anatomy of your back and neck, explaining the complex Bone structure of your spine and how it functions with the nerves, muscles, and ligaments surrounding it. 12 BACK AND NECK ANATOMY THE SPINE 13 TTfvvleehaHrrtett E siemcu bVarralfEalaiyneRc t eTpah rEaareortB tuat RhogliAefgh na Eteo evadpec, rh att,ehn tbedors wabe oaifsort dtmrom tmoh rae,e a cbonhardac lnkea ns essedm lcg—yaeltl.ilh n Whedo rshlipecei annrlu ,ay nwlo noiutirhrn ga lmppinrruooksivcnciedglse esyse o aasun,r erca hvnaeodtrtr taaaeclgbsheorea adteos at yotnho dteuh sres tpmr eriennumogsctuahlseien spni ncrinooggc np eytarsoaisru,c, ratt hlsalp enoi dntfr ewar.en hYlsaoivcxueh. rr sbea ck TevSelhePremt eIjoeNbnirnatAts sb: Ltabhl eaeJtnO wficreeIseN ton ins Ty atoSh ufear c uvepet prjtoeeirbn prta rioen c awersehs ieecsah co thfh temh leao dwveee rurt eppb roorafc tebwseosne ems aoatfhi no i tn e tlwiokh efio laer mmal soaol df auaclbctrilneu gmb aa (sl»l abb esehalrooicnwkg) ,a; abthlsloeo wrsbeinecrog. nydo uisr as pflienxei btole t dwiisskt tahnadt wbeonrdks, Smyenmovbiraal ne n areeTu hcraeal l lbceaadcn kpa rlo—ofc teheasacste hcs o.v neTrhttaeeinsbesr aaa rnheda as p rsrreaovnteegnce tdps riyono jetuhcrr tseiopeni npsaa, lwi rcsho wircdiht.h TEfaaHcceEht FojoAfi ntChtEe. TI vt eJisOr theINebrrTea Seth iant ytoheu rl ospwienra la crtoicluumlarn p mroeceetsss aets ao f Cartilage Afinbnrousluuss Npuulcploeusus s Synovial cavity an odd one out—the spinous process. Your spinous processes the first vertebra link up, or “articulate,” with the upper Bone a reT hthee s pkninoobubs lpy rboictse stsh asitt sr ubne tawlle tehne twhea ys idx opwainre ydo purro scpeisnsee.s aprrtoiccuelsasre sp arorec essmseoso othf tahned s felacto, nlidke. Tthhee fsaucrefatsc eosf ao fd tihamesoe nd— Disk containing fluid (three on either side). Two of the pairs—the upper articular hence the reason that the joints are called facet joints, as prNpiSsoe Toacr fRetcewrscoUostsle ysvC,s est TehratceneUtybido rRa naltle hE oh ea fa Or oveloen Fe ewixn aoTdecfHir tvt lhyiadE erau tllViaiocklw eEuc.ehlR AasatTrlr t athEpwcoBrtoueo RrgtcihhsAeto itscrEhsasee.c ySisc h—fi votae wtrcotntge ebbatreshal eoejor,w i n ts, wwtvoehe rtithlcelh eba rrhsaib aebvs, e,ew a ishnnmidgca h alkl hcnflraoaovtswe fs a mnsce euactctssih o(p cnlaoo rosgstftae eolr nrfpaieorc oeorct fsje ot)sh swieneh sfit es(rrs.sept ittnwhoeouy sl ua prmero bacatetras scehse).d Fjoaicnett ScBoyoSmnnnyoteenavmoiinavbilinr acagla n vfleiutyid Bone Bone indhainevnelidpdroA vulifielnag lustlaaah ,s ermtmetltore waebummtnoseoctein srctln eehkaotssesslf,, Lumbar vertebraeTvherotreabcriac UapTpLapFSpaorrprrrrrpCfattoooocawiiiponneccccccceessotuueeeee trvrjtsslsslua o aaessssslrrir n set NTNSchecpeapauorunionrTpnrraacaararolleallo c unscisssce v svesresretebrae LTarampnirsnovaecerSpsBvUapspreesroorpi torndciptccoeeyeuesub roslss arsf ar TcmalfsmfTTokpvurahnearhhofHicboc eaorroeeysetttirmuEui oniewiittfalocn ailbltubDjrodnaanadogtrrrt tn iia Ie i apanciwvtSnsne ,nhsue iu eKtdnigt weelsrtrahra h fS tf, lhnbyoew etajii woiqoni ercbnloehmieuut ehrgnntwer aisrhik tdt dac sehre,iesa hulen ptetebp tahghr jg n inuofrltjnu a aaheo oeotittlatcn eaihf efatcnleff t r .elioitotc.s t sclh oAals vooInsiioeitenpte sl lsct funpiy d rthe scaae wtmtr lfeharnliordfoymto e rendidi. crtlspi ima panue plfbecagrvo ncrsotoaogieoeidr t tmetva yttscit pahve p oeapas naeritlmsynnneradht snom dd td,eet le otooa c s oekbshvyv fa,caenv ey eeiltsatreleFTlmao rhlreiieetplt nahvp m hletedoep ufeeecse l lmeb iby fdae eum naar c torr rtncbeisrhw iea aadtadcyajurdtiadeoipata c—inrtirituntnt shui tns o iaonwikacen luylgpabb atv , ego islr r teoigos iu e oaflhups t erdvat ulrr r e oecuoyicdch u ct e intt vhsudesar eictnes aag ors ttfsih Ipabta fiTfieamTilastaonasheslvrhhsue t glcf esroes c eoAjaeeaelac stio ap mvncd.w, hrced i adhepsenTiylteasoaniythshnhmtei as vu.s p gjwgt keoasnabtoekHhseehee . nlmciusi l eictnelteni,Tyseo kah hsrldtea n udh te- wtaayo ndsa aoitaasiivbnbn ertsfseliv cdb ee.s ssft ynlohivaa eio amkrisr bsueiiubtnlo t g b kettwrraless oroh,uo buc obbaiids s sastrsdmnplriu iaiuetunbenfsesieb.i sknsog xbi gtgrT nestsot gcflDDwfim rrhtc rhd ogteoaoa btehihauimaaih srersnessmnacitkdmesbekce u rc,onstogheos h s aessemis ocrdnio tafno,atitiloeo. i snynru sreofrf oa nrTa nsiaui dbcsatfeldnstrtehifeol d c a netiiaspbaessccmrcnirtidhn su— tn ouerooivalgnr epiaala ietgrunptamnci nunowbpyientnneylgorndhsnmec le o plege—eegone—,yree dtersres buiex hr meftsl bttnnctaotaosqeoh o serueeeit bmfurrsureftiee cncn c l lsilacafamtoaalv eea oee thncynhsellce fauuusiletetu enuyk h r,onpsisrssa u n rce s odetcpos saefnl vlrs guuoa aeuirisafoettdisn sb f cthsrlsu ak st rp n eclse-fieehctahjsi stooasgqestbns aa t eoossmnepar, ebrnuntu eaorcc ni sudrcrriisa sjoe,skudneaau,dso li ul nipss.r ti,dc.g npisi tht ek.bsnori,h r a tvk oa,i aut csp eti,ll urs elt e s a. — FTlmaiDn ahleueecembde atr tbrwai tcjriioiaactlnthuieinen ldpat gsrr s u obflptrturrrreouoiecdcucta eitntvhskudesard eictnes aoag ors wttfsih ilasanet gf ssjae om c.i eTnotht v jesoee miscnyrtene naotertve.si a l your back and neck Lumbar vertebrae Bveordteyb orfa aTffiinhbbderroo obsuuuess tloc.e aTrw rhlt aeiitly a,ae genrensn ,a ouwblfu lhtisnhi cfigshib y drfoooisurskmu taso rwt ehm hemoantva bedisl e eak nnunddpos wt owwnf ii btsahtas yn tthodheuse r e o anbfn dotno dpuuyll.aug thse n—ooenra r r vtmuhepesist, u ndarounemrdsa— let hsirs,he soe ipnaftatcehienn o atarh sd aesio snrkcee iscaruavtelnetd ,no oowf rta i tesnhlvi peiann, j“bu sflurrioeptd mph eed adrisn tkdiea ipastrekr es”in s s ing obaf cthke a sntdru ncetucrke bs uinil dy ouupr cartilage, which coats the flat surfaces of each vertebra. the fibers of the annulus fibrosus itself. a full anatomical profile DIAGNOSIS AND TREATMENT CAUSES OF BACK AND NECK PAIN Opening with three symptoms diagnosis charts, this section profiles This section provides further information on the medical a range of neck and back conditions with information on prognoses causes of the back and neck conditions outlined in the and therapy options, along with sample medical and physical therapy previous chapter, with comprehensive profiles and fully treatment tables. annotated anatomical artworks. 30 DIAGNOSIS AND TREATMENT CHRONIC NECK AND NERVE-ROOT PAIN 31 CHRONIC NECK AND NERVE-ROOT PAIN TREATMENT—FACET JOINT PAIN CERVICAL SPINE IMMEDIATE SHORT TERM MEDIUM TERM LONG TERM Spleniusm cNSaupepsricinvtlieeBes ack view FaVceFerrttbo jeDoonSbRiintisnriadbekatle view Spproincoesuss MEDICALt(■▶▶▶▶▶adbyeitaoto(b»»rhhoncviyfna au eeIstltceupu tdiem fratgano rpam rpyp aa fikay synbwinro yfu.renrohpto aa9olnss 4ovh negouinac4ftu6ss e e a ceswurhuet–brlf5(mn t tteet»9ldaopaoe 0uh d wytij5lec elpnaou arra: maoo)e mtn viiprcit,dsidnnwun 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Treatment tables Anatomical illustrations provide examples of the treatments and therapies show at a glance how each of the various your doctor and physical therapist may suggest causes affect the bones, nerves, muscles, at different stages of your rehabilitation and ligaments of your back and neck 7 ABOUT THIS BOOK WHERE TO FIND HELP BACK AND NECK MAINTENANCE This section gives you an insight into the process of diagnosis, Explaining the role your back and neck play in most bodily and provides useful details of the wide range of medical and movements, this section discusses key risk factors and offers complementary treatment options now available to sufferers guidance on various strategies you can use to reduce your of back and neck pain. risk of developing problems in the first place. 80 WHERE TO FIND HELP CONSULTING YOUR PRIMARY CARE DOCTOR 81 120BACK AND NECK MAINTENANCE EATING FOR HEALTH121 wsIewYa■■■■■■■■DMsoPCTYoTstlAqeyomyoemoeofeohfloox rurmfwnl hEHWIDWIDW Huvsiya 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ecrd4676885hppiatui4Rdanteuneeegwesk854772e9riyp9s tl l yhotqn Eee ysy,7a169996lntiy.f6 r tep xooasa kutMliwo.aoTanae erc euiniocainhtrxt ub reasrmttcuo Eenif i,the iotdimv reyrsgsmooNdsa eaee rohfhutr,-i a i elyeywoguwToy ctt oon.e urruhSih ul utlrl o der Feature box panels Charts and infographics describe the types of treatment you may be given make key facts and figures by each of the various healthcare practitioners clear and easy to digest STRATEGIES FOR PREVENTING PAIN STRATEGIES FOR COPING WITH PAIN This section shows you the ideal postures and movements for This section arms you with helpful advice on coping with a range of common day-to-day activities at home and work, the often debilitating effects of back and neck conditions, in order to help reduce your chances of developing back or along with a range of strategies to help you manage your neck pain, or aggravating an existing condition. pain effectively on a more long-term basis. 124STRATEGIES FOR PREVENTING PAIN AT THE OFFICE125 150STRATEGIES FOR COPING WITH PAIN LYING DOWN AND SLEEPING151 SwlmlAIdsstaoefoutinLTsfoSAafyhauaagton aooaulotnhuisfy dpllfs Iygdaibkrro gk eppulutdetntmj wTTreAhrA eweohhiut ppp i m t iw nthhgcr cgtreha noeaes ToTpt aobfmihyaushheogost rre lroh lo ogsfrte o tip uadnbnIt e atwre,te etmp tlkr reut rtrtuehNhnreua i r tiarr esherha-trrsh e saseeratnn reeTe atmtoo yfleecls ytpsei bsowds—solgdrs .slncbG o locvu eeshh su spoa twblopa booa uytgeaauuM oahyepopytodxoynoeaots soafaso trr rtroiHo oi f.uIs a wpersebgrun feceyraiirT rduNuas ltrt uhasrrkkgadooods fieeh oyr d b .artksm ynrr m d islee omo Iok,lc llntol odluAme - fiay,e nmwsef sgiefEtidoet,f ucteo se threNwwhnnlyeeeauhaekae rurey tro slrhhotiao tblssl e.v piay csuyc nbsen.e ifEsns Is ,th eghr iaar ohn,tcfdsh s t OoRiahce mncoimchto aomyclioiye nklrrrhaeGmeeu iwoou avkrugla dlglcu c induopyOilein,thri h ds w s c s vFe bgo san tasiN hoaa oteiebn ro r.rreat ens date O Ftssihot ycni h ra phtitat fgooMkohoidlntretsalIu oees y,i un 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cteeto oseussinsuoe soi e uof iaaei tfaawtmat cca wlau low ln irtlophurltols rffinnoyuraofivos e.l euon sist fl earh,tfoslueo dsnltn y w.os l hewl”lrstanhsopinluis sn sk :n yne? g e . o a u s h gfiigea irrei nn l ks sl. d Annotated illustrations Q&A panels present key information on provide clear answers to the key issues that patients equipment and body positions tend to raise when they are undergoing treatment REHABILITATION EXERCISES 117788REHABILITATION EXERCISES BACK AND BUTTOCKS179 Iaatranhen rc cadetoothh mimyilaslou pbmsusrielrteeicr thnptaaiedthotiin oyontsson,ni ivc cs yp elageor lura outarihg dn aierengsar esmapyt poaor.uirufst ct e tt oxmhiofer a norcysui sg ehs tltylaytybsytrhBWtbsTpIeihhtahithot3ooopthegre avtakieiiiruuuulaahglsieesre6iiev sc noSytr dghrrrrAstlftTr. iaa.t l oi egis kepi sy batbrrnihRm Kgt,al a k ,uiixgo ont o ggotstehSegntg steporhoelsnd hh yshdedtCo ed,tEroi we sto,o attthpe lynyc ap e et ien bwy,dAfuonai e hsiwti eallantyss oiwlatrnr unhioedy 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Essential Back Care PDF

226 Pages·2011·29.722 MB·English
by  DK Publishing
#Medicine #Therapy
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E S S E NTI A L BACK CARE E S S E NTI A L BACK CARE CONTENTS LONDON, NEW YORK, MUNICH, MELBOURNE, DELHI ABOUT THIS BOOK 6 CHRONIC SCIATICA 46 Senior Editors Gareth Jones, Ed Wilson NONSPECIFIC NERVE-ROOT PAIN 47 Senior Art Editors Gillian Andrews, SPINAL STENOSIS 48 Keith Davis PIRIFORMIS SYNDROME 49 Project Editors Corinne Masciocchi, BUTTOCK AND COCCYX PAIN 50 Hannah Bowen, Cécile BACK & NECK ANATOMY COCCYDYNIA 51 Landau, Scarlett O’Hara SACROILIITIS 52 US Editor Jill Hamilton THE SPINE 10 GLUTEUS MEDIUS US Medical Consultant Eric N. Dubrow, MD THE SPINAL CANAL AND NERVES 14 DYSFUNCTION 53 Project Art Editors Phil Gamble, MUSCLES AND LIGAMENTS 16 WHOLE SPINE CONDITIONS 54 Yen Mai Tsang INFLAMMATORY DISEASE 55 Production Editor Joanna Byrne HYPERMOBILITY SYNDROME 56 Production Controller Sophie Argyris POSTURAL PAIN 57 Jacket Designer Mark Cavanagh SCOLIOSIS 58 Managing Editor Stephanie Farrow DIAGNOSIS & TREATMENT ACUTE VERTEBRAL COMPRESSION Managing Art Editor Lee Griffiths FRACTURE 59 Illustrators Philip Wilson, Debbie SYMPTOMS CHARTS 20 Maizels, Mark Walker, Debajyoti Dutta, Phil NECK 20 Gamble, Darren Awuah MIDBACK 22 LOW BACK AND LEG 24 First American Edition, 2011 ACUTE NECK AND CAUSES OF Published in the United States by DK Publishing NERVE-ROOT PAIN 26 BACK & NECK PAIN 375 Hudson Street CERVICAL DISK HERNIATION 27 New York, New York 10014 ACUTE TORTICOLLIS 28 MUSCULAR TENSION 62 11 12 13 10 9 8 7 6 5 4 3 2 1 WHIPLASH 29 ANKYLOSING SPONDYLITIS 63 001–179160–August/2011 CHRONIC NECK AND SPONDYLOLYSIS AND NERVE-ROOT PAIN 30 SPONDYLOLISTHESIS 64 Copyright © 2011 Dorling Kindersley Limited All rights reserved. FACET JOINT PAIN 31 VERTEBRAL COMPRESSION MYOFASCIAL PAIN SYNDROME 32 FRACTURE 65 Without limiting the rights under copyright reserved above, no part of this publication may be reproduced, DISK-RELATED PAIN 33 HYPERMOBILITY stored in or introduced into a retrieval system, or THORACIC PAIN 34 AND INSTABILITY 66 transmitted, in any form, or by any means (electronic, mechanical, photocopying, recording, or otherwise), MECHANICAL 35 DISCOGENIC PAIN 67 without the prior written permission of both the ACUTE LOW-BACK PAIN 36 FACET JOINT STRAIN 68 copyright owner and the above publisher of this book. ACUTE LUMBAR DYSFUNCTION 37 SACROILIAC STRAIN 69 Published in Great Britain by DISK HERNIATION AND SCIATICA 38 DISC HERNIATION 70 Dorling Kindersley Limited. SACROILIAC STRAIN 39 ACUTE TORTICOLLIS 71 A catalog record for this book is available CHRONIC LOW-BACK PAIN 40 WHIPLASH 72 from the Library of Congress. DISK-RELATED PAIN 41 SPINAL STENOSIS ISBN 978-0-7566-8264-4 FACET JOINT PAIN 42 AND DEGENERATION 73 DK books are available at special discounts when SPONDYLOLYSIS SCOLIOSIS 74 purchased in bulk for sales promotions, premiums, fund-raising, or educational use. For details, contact: AND SPONDYLOLISTHESIS 43 COCCYDYNIA 75 DK Publishing Special Markets, 375 Hudson Street, INSTABILITY SYNDROME PIRIFORMIS SYNDROME 76 New York, New York 10014 or [email protected]. AND SACROILIAC STRAIN 44 GLUTEUS MEDIUS Printed and bound in Singapore by NONSPECIFIC/ DYSFUNCTION 77 Tien Wah Press Ltd. Discover more at www.dk.com LUMBAR DYSFUNCTION 45 BMA MEDICAL EDITOR Dr. Michael Peters is Consulting Medical Editor to the British Medical Association and Director of the Doctors for Doctors Unit at the BMA, having previously worked as a GP. WORKING IN CONSULTANT EDITORS YOUR GARDEN 132 DRIVING YOUR CAR 134 Dr. John Tanner is a private practitioner WHERE TO FIND HELP DURING PREGNANCY 136 in musculoskeletal and sports medicine with a special interest in back injuries and CARING FOR YOUNG their treatment. He qualified in medicine CONSULTING YOUR CHILDREN 138 and psychology in London and trained PRIMARY CARE DOCTOR 80 as a general practitioner, then went on to CONSULTING A SPECIALIST 82 study medical and osteopathic methods TREATMENT WITH DRUGS 84 of manipulation, physical fitness training, TREATMENT WITH INJECTIONS 86 sports injuries, and pain management. He TREATMENT WITH SURGERY 88 STRATEGIES FOR now runs a multidisciplinary clinic in West CONSULTING A COPING WITH PAIN Sussex that specializes in musculoskeletal PHYSICAL THERAPIST 90 problems (www.ovingclinic.co.uk), is CONSULTING AN OSTEOPATH 94 COPING WITH PAIN 142 Education Chairman of the British Institute CONSULTING A PERCEPTION OF PAIN 144 of Musculoskeletal Medicine, and organizes the teaching program for doctors in this CHIROPRACTOR 96 PSYCHOLOGICAL FACTORS field. He lectures for the International Spine USING MASSAGE 98 IN BACK PAIN 146 Intervention Society in Europe and is Co CONSULTING AN PAIN RELIEF THROUGH Clinical Lead at Bupa Health and Wellbeing, ACUPUNCTURIST 100 RELAXATION 148 Barbican, London. RELAXATION TECHNIQUES 102 LYING DOWN AND SLEEPING 150 Eva Niezgoda-Hadjidemetri  Msc MCSP OTHER THERAPIES 104 WASHING AND DRESSING 154 HPC is a musculoskeletal physiotherapist MOVING AROUND 156 who gained a Masters degree in Physical Rehabilitation in Warsaw, Poland, after which she worked in Warsaw’s Rehabilitation Centre. Since moving to the UK in 1986 BACK & NECK she has attended numerous postgraduate MAINTENANCE REHABILITATION training courses in manual therapy, gaining EXERCISES an extensive knowledge of Maitland, Cyriax, HOW THE BACK WORKS 108 McKenzie, and neurodynamic methods. A WHO IS MOST AT RISK? 110 NECK AND BACK 160 specialist in the rehabilitation of neck and back conditions, with a special interest in IMPROVING YOUR POSTURE 112 BACK AND BUTTOCKS 178 sports injuries and hypermobility syndrome, EXERCISE AND SPORT 116 Eva currently works at the 999 Medical & THE BENEFITS OF STRETCHING 118 Diagnostic Centre, London. EATING FOR HEALTH 120 GLOSSARY 214 Disclaimer USEFUL ADDRESSES 216 The information in this book is designed to help INDEX 218 you make informed decisions about your health, diet, fitness, and exercise/rehabilitation program. ACKNOWLEDGMENTS 224 It is not intended as a substitute for professional STRATEGIES FOR advice from doctors and/or physical therapists. If you suspect that you have an injury or other PREVENTING PAIN medical problem, you should seek the approval of your doctor and physical therapist before you begin any form of exercise. Neither the publisher AT THE OFFICE 124 nor anyone else involved in the preparation of LIFTING AND this book is engaged in rendering professional CARRYING 128 advice or services to the individual reader. For further advice on safety, see page 224. DOING HOUSEWORK 130 6 ABOUT THIS BOOK ABOUT THIS BOOK Opening with an introduction to back and using a range of simple strategies and how to neck anatomy, this book profiles a range of cope with pain and adapt your behavior. The back and neck conditions, their causes, and closing section provides a range of rehabilitation the treatment options available. The following exercises which can also be used as part of a chapters offer advice on preventing problems fitness program. BACK AND NECK ANATOMY A Cartilage fi This section provides an insight into the anatomy of your back and neck, explaining the complex Bone structure of your spine and how it functions with the nerves, muscles, and ligaments surrounding it. 12 BACK AND NECK ANATOMY THE SPINE 13 TTfvvleehaHrrtett E siemcu bVarralfEalaiyneRc t eTpah rEaareortB tuat RhogliAefgh na Eteo evadpec, rh att,ehn tbedors wabe oaifsort dtmrom tmoh rae,e a cbonhardac lnkea ns essedm lcg—yaeltl.ilh n Whedo rshlipecei annrlu ,ay nwlo noiutirhrn ga lmppinrruooksivcnciedglse esyse o aasun,r erca hvnaeodtrtr taaaeclgbsheorea adteos at yotnho dteuh sres tpmr eriennumogsctuahlseien spni ncrinooggc np eytarsoaisru,c, ratt hlsalp enoi dntfr ewar.en hYlsaoivcxueh. rr sbea ck TevSelhePremt eIjoeNbnirnatAts sb: Ltabhl eaeJtnO wficreeIseN ton ins Ty atoSh ufear c uvepet prjtoeeirbn prta rioen c awersehs ieecsah co thfh temh leao dwveee rurt eppb roorafc tebwseosne ems aoatfhi no i tn e tlwiokh efio laer mmal soaol df auaclbctrilneu gmb aa (sl»l abb esehalrooicnwkg) ,a; abthlsloeo wrsbeinecrog. nydo uisr as pflienxei btole t dwiisskt tahnadt wbeonrdks, Smyenmovbiraal ne n areeTu hcraeal l lbceaadcn kpa rlo—ofc teheasacste hcs o.v neTrhttaeeinsbesr aaa rnheda as p rsrreaovnteegnce tdps riyono jetuhcrr tseiopeni npsaa, lwi rcsho wircdiht.h TEfaaHcceEht FojoAfi ntChtEe. TI vt eJisOr theINebrrTea Seth iant ytoheu rl ospwienra la crtoicluumlarn p mroeceetsss aets ao f Cartilage Afinbnrousluuss Npuulcploeusus s Synovial cavity an odd one out—the spinous process. Your spinous processes the first vertebra link up, or “articulate,” with the upper Bone a reT hthee s pkninoobubs lpy rboictse stsh asitt sr ubne tawlle tehne twhea ys idx opwainre ydo purro scpeisnsee.s aprrtoiccuelsasre sp arorec essmseoso othf tahned s felacto, nlidke. Tthhee fsaucrefatsc eosf ao fd tihamesoe nd— Disk containing fluid (three on either side). Two of the pairs—the upper articular hence the reason that the joints are called facet joints, as prNpiSsoe Toacr fRetcewrscoUostsle ysvC,s est TehratceneUtybido rRa naltle hE oh ea fa Or oveloen Fe ewixn aoTdecfHir tvt lhyiadE erau tllViaiocklw eEuc.ehlR AasatTrlr t athEpwcoBrtoueo RrgtcihhsAeto itscrEhsasee.c ySisc h—fi votae wtrcotntge ebbatreshal eoejor,w i n ts, wwtvoehe rtithlcelh eba rrhsaib aebvs, e,ew a ishnnmidgca h alkl hcnflraoaovtswe fs a mnsce euactctssih o(p cnlaoo rosgstftae eolr nrfpaieorc oeorct fsje ot)sh swieneh sfit es(rrs.sept ittnwhoeouy sl ua prmero bacatetras scehse).d Fjoaicnett ScBoyoSmnnnyoteenavmoiinavbilinr acagla n vfleiutyid Bone Bone indhainevnelidpdroA vulifielnag lustlaaah ,s ermtmetltore waebummtnoseoctein srctln eehkaotssesslf,, Lumbar vertebraeTvherotreabcriac UapTpLapFSpaorrprrrrrpCfattoooocawiiiponneccccccceessotuueeeee trvrjtsslsslua o aaessssslrrir n set NTNSchecpeapauorunionrTpnrraacaararolleallo c unscisssce v svesresretebrae LTarampnirsnovaecerSpsBvUapspreesroorpi torndciptccoeeyeuesub roslss arsf ar TcmalfsmfTTokpvurahnearhhofHicboc eaorroeeysetttirmuEui oniewiittfalocn ailbltubDjrodnaanadogtrrrt tn iia Ie i apanciwvtSnsne ,nhsue iu eKtdnigt weelsrtrahra h fS tf, lhnbyoew etajii woiqoni ercbnloehmieuut ehrgnntwer aisrhik tdt dac sehre,iesa hulen ptetebp tahghr jg n inuofrltjnu a aaheo oeotittlatcn eaihf efatcnleff t r .elioitotc.s t sclh oAals vooInsiioeitenpte sl lsct funpiy d rthe scaae wtmtr lfeharnliordfoymto e rendidi. crtlspi ima panue plfbecagrvo ncrsotoaogieoeidr t tmetva yttscit pahve p oeapas naeritlmsynnneradht snom dd td,eet le otooa c s oekbshvyv fa,caenv ey eeiltsatreleFTlmao rhlreiieetplt nahvp m hletedoep ufeeecse l lmeb iby fdae eum naar c torr rtncbeisrhw iea aadtadcyajurdtiadeoipata c—inrtirituntnt shui tns o iaonwikacen luylgpabb atv , ego islr r teoigos iu e oaflhups t erdvat ulrr r e oecuoyicdch u ct e intt vhsudesar eictnes aag ors ttfsih Ipabta fiTfieamTilastaonasheslvrhhsue t glcf esroes c eoAjaeeaelac stio ap mvncd.w, hrced i adhepsenTiylteasoaniythshnhmtei as vu.s p gjwgt keoasnabtoekHhseehee . nlmciusi l eictnelteni,Tyseo kah hsrldtea n udh te- wtaayo ndsa aoitaasiivbnbn ertsfseliv cdb ee.s ssft ynlohivaa eio amkrisr bsueiiubtnlo t g b kettwrraless oroh,uo buc obbaiids s sastrsdmnplriu iaiuetunbenfsesieb.i sknsog xbi gtgrT nestsot gcflDDwfim rrhtc rhd ogteoaoa btehihauimaaih srersnessmnacitkdmesbekce u rc,onstogheos h s aessemis ocrdnio tafno,atitiloeo. i snynru sreofrf oa nrTa nsiaui dbcsatfeldnstrtehifeol d c a netiiaspbaessccmrcnirtidhn su— tn ouerooivalgnr epiaala ietgrunptamnci nunowbpyientnneylgorndhsnmec le o plege—eegone—,yree dtersres buiex hr meftsl bttnnctaotaosqeoh o serueeeit bmfurrsureftiee cncn c l lsilacafamtoaalv eea oee thncynhsellce fauuusiletetu enuyk h r,onpsisrssa u n rce s odetcpos saefnl vlrs guuoa aeuirisafoettdisn sb f cthsrlsu ak st rp n eclse-fieehctahjsi stooasgqestbns aa t eoossmnepar, ebrnuntu eaorcc ni sudrcrriisa sjoe,skudneaau,dso li ul nipss.r ti,dc.g npisi tht ek.bsnori,h r a tvk oa,i aut csp eti,ll urs elt e s a. — FTlmaiDn ahleueecembde atr tbrwai tcjriioiaactlnthuieinen ldpat gsrr s u obflptrturrrreouoiecdcucta eitntvhskudesard eictnes aoag ors wttfsih ilasanet gf ssjae om c.i eTnotht v jesoee miscnyrtene naotertve.si a l your back and neck Lumbar vertebrae Bveordteyb orfa aTffiinhbbderroo obsuuuess tloc.e aTrw rhlt aeiitly a,ae genrensn ,a ouwblfu lhtisnhi cfigshib y drfoooisurskmu taso rwt ehm hemoantva bedisl e eak nnunddpos wt owwnf ii btsahtas yn tthodheuse r e o anbfn dotno dpuuyll.aug thse n—ooenra r r vtmuhepesist, u ndarounemrdsa— let hsirs,he soe ipnaftatcehienn o atarh sd aesio snrkcee iscaruavtelnetd ,no oowf rta i tesnhlvi peiann, j“bu sflurrioeptd mph eed adrisn tkdiea ipastrekr es”in s s ing obaf cthke a sntdru ncetucrke bs uinil dy ouupr cartilage, which coats the flat surfaces of each vertebra. the fibers of the annulus fibrosus itself. a full anatomical profile DIAGNOSIS AND TREATMENT CAUSES OF BACK AND NECK PAIN Opening with three symptoms diagnosis charts, this section profiles This section provides further information on the medical a range of neck and back conditions with information on prognoses causes of the back and neck conditions outlined in the and therapy options, along with sample medical and physical therapy previous chapter, with comprehensive profiles and fully treatment tables. annotated anatomical artworks. 30 DIAGNOSIS AND TREATMENT CHRONIC NECK AND NERVE-ROOT PAIN 31 CHRONIC NECK AND NERVE-ROOT PAIN TREATMENT—FACET JOINT PAIN CERVICAL SPINE IMMEDIATE SHORT TERM MEDIUM TERM LONG TERM Spleniusm cNSaupepsricinvtlieeBes ack view FaVceFerrttbo jeDoonSbRiintisnriadbekatle view Spproincoesuss MEDICALt(■▶▶▶▶▶adbyeitaoto(b»»rhhoncviyfna au eeIstltceupu tdiem fratgano rpam rpyp aa fikay synbwinro yfu.renrohpto aa9olnss 4ovh negouinac4ftu6ss e e a ceswurhuet–brlf5(mn t tteet»9ldaopaoe 0uh d wytij5lec elpnaou arra: maoo)e mtn viiprcit,dsidnnwun 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Treatment tables Anatomical illustrations provide examples of the treatments and therapies show at a glance how each of the various your doctor and physical therapist may suggest causes affect the bones, nerves, muscles, at different stages of your rehabilitation and ligaments of your back and neck 7 ABOUT THIS BOOK WHERE TO FIND HELP BACK AND NECK MAINTENANCE This section gives you an insight into the process of diagnosis, Explaining the role your back and neck play in most bodily and provides useful details of the wide range of medical and movements, this section discusses key risk factors and offers complementary treatment options now available to sufferers guidance on various strategies you can use to reduce your of back and neck pain. risk of developing problems in the first place. 80 WHERE TO FIND HELP CONSULTING YOUR PRIMARY CARE DOCTOR 81 120BACK AND NECK MAINTENANCE EATING FOR HEALTH121 wsIewYa■■■■■■■■DMsoPCTYoTstlAqeyomyoemoeofeohfloox rurmfwnl hEHWIDWIDW Huvsiya 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cteeto oseussinsuoe soi e uof iaaei tfaawtmat cca wlau low ln irtlophurltols rffinnoyuraofivos e.l euon sist fl earh,tfoslueo dsnltn y w.os l hewl”lrstanhsopinluis sn sk :n yne? g e . o a u s h gfiigea irrei nn l ks sl. d Annotated illustrations Q&A panels present key information on provide clear answers to the key issues that patients equipment and body positions tend to raise when they are undergoing treatment REHABILITATION EXERCISES 117788REHABILITATION EXERCISES BACK AND BUTTOCKS179 Iaatranhen rc cadetoothh mimyilaslou pbmsusrielrteeicr thnptaaiedthotiin oyontsson,ni ivc cs yp elageor lura outarihg dn aierengsar esmapyt poaor.uirufst ct e tt oxmhiofer a norcysui sg ehs tltylaytybsytrhBWtbsTpIeihhtahithot3ooopthegre avtakieiiiruuuulaahglsieesre6iiev sc noSytr dghrrrrAstlftTr. iaa.t l oi egis kepi sy batbrrnihRm Kgt,al a k ,uiixgo ont o ggotstehSegntg steporhoelsnd hh yshdedtCo ed,tEroi we sto,o attthpe lynyc ap e et ien bwy,dAfuonai e hsiwti eallantyss oiwlatrnr unhioedy 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