Aastha RIBS

Core Strengthening exercises are very important type of exercises which is mainly ignore by everyone. It will help you to relieving and preventing lower back pain in future, in correcting posture and in increasing stamina for long sitting and standing.

Foot Drop Complication Rehabilitation after Surgery of Spine at Aastha RIBS 097082 51102

Rehabilitation of a Patient after Both Knee Replacement

CPM for BL TKR(Total Knee Replacement) Patient at Aastha RIBS

Herniated Disc Patient
Treatments
Treatment is restricting activity, ice/heat therapy, and physiotherapy to manage symptoms
Not every disc requires intervention. Surgery may be needed if numbness or weakness persists after six weeks, with poorly controlled pain. Difficulty standing or walking and loss of bladder or bowel control may also be present. Treatment may include medications such as muscle relaxants, neuropathic drugs, NSAIDs, physiotherapy, and possibly surgery when necessary.

Knee osteoarthritis is the most common type of arthritis diagnosed, and its prevalence will continue to increase as life expectancy and obesity rises.

Patient of Severe Low Back Pain recovered in 5 days

Lumbar spondylosis

Spondylosis may be applied non-specifically to any and all degenerative conditions affecting the disks, vertebral bodies, and/or associated joints of the lumbar Spine. It is described as a degeneration of the lumbar vertebrae. If this condition occurs in the zygapophysial joints, it can be considered facet syndrome. It Encompasses numerous associated pathologies including spinal stenosis, degenerative spondylolisthesis, osteoarthritis, ageing, trauma and just the daily use of the intervertebral discs, the vertebrae, and the associated joints. The lumbar region the most affected, because of the exposure to mechanical stress.
Lumbar spondylosis can be described as a degeneration of the lumbar vertebrae.
It is a form of low back pain and is an important clinical, social, economic and public health problem affecting the worldwide population.
It is a disorder with many possible etiologies and many definitions.
For the clinical diagnosis of lumbar spondylosis, a thorough investigation is necessary to ensure that other pathologies are excluded. In clinical practice we use: MRI, CT, SPECT and X-ray and a general examination of the spine.
The medical management can be approached by a surgical or non-surgical treatment, there is no consensus about the most effective therapy.
Physical Therapy Management
Educating the patient: may include reviews of lumbar anatomy, explanations of the concept of posture, ergonomics and giving appropriate back exercises.
Lumbar Back Support: Can be beneficial for patients suffering from chronic LBP. It occurs to limit spine motion, stabilize, correct deformity and reduce mechanical forces. There is no consensus if it may function as a placebo or really improve pain and functional ability. Sitting decreases lumbar lordosis and increase disc pressure, squeeze on the ischium and muscle activity in the lower back. These are all associated with low back pain.
Taping: Another non-surgical management could be taping. A lot of studies have shown that taping helps to relieve pain in the lower back. It is also important to note that taping alone is not enough, it should be used during the therapy to improve ROM etc.
Lumbar Support: Lumbar support with the help of braces is used for stabilization and reducing mechanical forces, they are also produced to limit spine motion and correct deformity of the spine. There is limited evidence-based research available about the efficacy of lumbar supports regarding patient improvement and functional ability to go back to work. An example of a brace for Lumbar support is The Lyon Antikyphosis Brace. This brace has the best results for patients with scoliosis but could also help patients suffering from lumbar spondylosis. Braces may have effects by massaging and heating the painful areas, there is also a probability that the lumbar supports work as a placebo.

Bio-psychosocial Approach: Multidisciplinary back therapy may be needed. A bio-psychosocial approach involved reinforcement, modified expectations, imagery/relaxation techniques, and learned control of physiological responses aim to reduce a patient’s perception of disability and pain symptoms.
Physical therapy for low back pain includes guided therapeutic exercises that strengthen the lower back muscles and condition the spinal tissues and joints. The short- and long-term goals of physical therapy for back pain typically include the following: Decrease painful symptoms in the lower back and/or leg

Lumbar spondylosis is a complicated diagnosis.

Degenerative changes can be seen on radiographs but are common in all ages, making diagnosis challenging.
85.5% of individuals aged 45–64 years show lumbar spine osteophytes.
Even without trauma, young individuals may show degenerative changes.
10% of women aged 20–29 display disk degeneration.
Despite being common in those over 40, lumbar spondylosis appears in 3% of 20–29 Year-olds.
High rates of asymptomatic degeneration in the young complicates causality in pain diagnosis

Has many possible etiologies and many definitions.
Incidence is 27-37% of the asymptomatic lower back pain population. eg In the United States, 3% of individuals aged 20-29 years and rising to more than 80% of individuals older than 40 years have lumbar spondylosis.
Approximately 84% of men and 74% of women have vertebral osteophytes, most frequently at T9-10 and L3 levels.
Approximately 30% of men and 28% of women aged 55-64 years have lumbar osteophytes.
Approximately 20% of men and 22% of women aged 45-64 years have lumbar osteophytes.
S*x ratio reports have been variable but are essentially equal.
Appears to be a nonspecific ageing phenomenon.
Most international studies suggest no relation to lifestyle, height, weight, body mass, physical activity, cigarette and alcohol consumption, or reproductive history.

Patients with lumbar spondylosis have pain in the axial spine.

The location of these degenerate changes is not surprising as nociceptive pain generators that were identified within facet joints, intervertebral disks, sacroiliac joints, nerve root dura and myofascial structures.
These changes may peak in different clinical presentations such as
Spinal stenosis
Disk herniation
Bulging of the ligamentum flavum
Spondylolisthesis
Lumbar Radiculopathy
All the above result in a constellation of pain symptoms encompassed in the term neurogenic claudication (NC).

It may include (to varying extents) lower back pain, leg pain, as well as numbness and motor weakness to lower extremities that worsen with upright stance and walking, and improve with sitting and supine positioning

1. General examination of the spine

Inspection of the entire spine
Look for any obvious swellings or surgical scars.
Assess for deformity: scoliosis, kyphosis, loss of lumbar lordosis or hyperlordosis of the lumbar spine. Look for shoulder asymmetry and pelvic tilt.
2. Palpation
Palpate for tenderness over bone and soft tissues.
Perform an abdominal examination to identify any masses and consider a re**al examination to exclude other pathologies in this region
3. Movement
Flexion, extension, lateral flexion and rotation. Examination of the spine must also include examination of the shoulders and examination of the hips to exclude these joints as a cause of the symptoms.
4. Neurovascular examination
Sensation, tone, power and reflexes should be assessed. All peripheral pulses should also be checked, as vascular claudication in the upper and lower limbs can mimic symptoms of radiculopathy or canal stenosis.
Medical Management
There is little consensus about the definitive treatment approach due to a lack of information about the sources of chronic lower back pain,

Facet joint injection There is a surprisingly high percentage of the patients that have misconceptions regarding the diagnosis and the treatment of lumbar spondylosis and these misconceptions persist in patients with a history of spine surgery.
Patients over-emphasize the value of radiological studies and have mixed perceptions of the relative risk and effectiveness of surgical intervention and conservative management.
These misconceptions have the potential to alter patient expectations and decrease satisfaction potentially negatively impacting patient outcomes and subjective valuation of physician performance.
Non-surgical Management
Pharmacology in Pain Management
Therapeutic Corticosteroid Injection
Lumbar Facet Joint Injections
2. Surgical Management

Each type comes with its own risks and benefits.

Spinal fusion. This is the most common surgery for chronic nonspecific back pain with degenerative changes (joining of vertebrae together aimed at limiting the motion between vertebrae stretch on associated nerves).
Laminectomy. This is the most common surgery for lumbar spinal stenosis (removal of part of the bone, bone spurs, or ligaments, aimed at relieving pressure on spinal nerves, can make your spine less stable)
Foraminotomy. This surgery is used to relieve pain associated with a compressed nerve in the spine.
Diskectomy.
Disk replacement.
Interlaminar implant

A patient of Facial Paralysis recovered in two weeks
-therapy
training


exercises

"𝐈𝐧 𝐭𝐡𝐞 𝐣𝐨𝐮𝐫𝐧𝐞𝐲 𝐨𝐟 𝐧𝐚𝐭𝐢𝐨𝐧-𝐛𝐮𝐢𝐥𝐝𝐢𝐧𝐠, 𝐞𝐯𝐞𝐫𝐲 𝐜𝐢𝐭𝐢𝐳𝐞𝐧 𝐩𝐥𝐚𝐲𝐬 𝐚 𝐯𝐢𝐭𝐚𝐥 𝐫𝐨𝐥𝐞. 𝐇𝐚𝐩𝐩𝐲 𝐑𝐞𝐩𝐮𝐛𝐥𝐢𝐜 𝐃𝐚𝐲!"