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    By - Aishwarya Pore

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    Nelson Lobo
    This document discusses pivd (prolapsed intervertebral disc) and its physiotherapy management. It covers the 4 stages of pivd, common causes like repetitive stress and obesity, clinical features like back pain and numbness, assessment tests, and treatment approaches including McKenzie exercises, modalities like ultrasound and TENS, traction, core strengthening, and addressing muscle imbalances like in lower and upper cross syndromes.

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    © All Rights Reserved
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    By - Aishwarya Pore

    Uploaded by

    Nelson Lobo
    78 views38 pages
    This document discusses pivd (prolapsed intervertebral disc) and its physiotherapy management. It covers the 4 stages of pivd, common causes like repetitive stress and obesity, clinical features like back pain and numbness, assessment tests, and treatment approaches including McKenzie exercises, modalities like ultrasound and TENS, traction, core strengthening, and addressing muscle imbalances like in lower and upper cross syndromes.

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    Prolapse intervertebral disc ppt

    Original Title

    PIVD

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    This document discusses pivd (prolapsed intervertebral disc) and its physiotherapy management. It covers the 4 stages of pivd, common causes like repetitive stress and obesity, clinical features like back pain and numbness, assessment tests, and treatment approaches including McKenzie exercises, modalities like ultrasound and TENS, traction, core strengthening, and addressing muscle imbalances like in lower and upper cross syndromes.

    Copyright:

    © All Rights Reserved
    Download as ODP, PDF, TXT or read online from Scribd
    Download as odp, pdf, or txt
    78 views38 pages

    By - Aishwarya Pore

    Uploaded by

    Nelson Lobo
    This document discusses pivd (prolapsed intervertebral disc) and its physiotherapy management. It covers the 4 stages of pivd, common causes like repetitive stress and obesity, clinical features like back pain and numbness, assessment tests, and treatment approaches including McKenzie exercises, modalities like ultrasound and TENS, traction, core strengthening, and addressing muscle imbalances like in lower and upper cross syndromes.

    Copyright:

    © All Rights Reserved
    Download as ODP, PDF, TXT or read online from Scribd
    Download as odp, pdf, or txt
    of 38

    PIVD

    By - Aishwarya Pore
    Introduction
    • Stages of pivd-
    It has 4 stages-
    1. Bulging – the disc is stretched and doesn’t return to its normal shape
    when pressure is relieved. It retains a slight bulge at one side of the
    disc.
    2. Protrusion – the bulge becomes more prominent and nucleus pulposus
    spills upto inner edge of outer fibres.
    3. Extrusion – herniation of disc, the nucleus pulposus is completely
    spilled out.
    4. Sequestration – the nucleus pulposus spreads into the surrounding area.
    5.
    Etiology
    • Repetitive mechanical stress.
    • Sedentary lifestyle
    • Trauma to spine
    • Obesity
    • Poor posture etc
    •
    Clinical features
    • Severe low back pain
    • Radiating pain
    • Neurological claudication
    • Pain worsens with coughing, laughing, sneezing
    • Muscle spasm
    • Tingling or numbness in extremities
    • Altered posture
    • Reduce strength in extremities
    •
    Assessment
    • History – any strenuous activity in past few days which aggrevated
    back ache.
    • Posture – curvature of spine, pelvic tilt scoliosis
    • Movement – ranges of lumbar and cervical spine
    modified Schober’s test for lumbar ranges
    • Tenderness and spasm – palpate paraspinal muscles.
    •
    Cross syndromes-
    Opposite and diagnol muscles go into tightness and other pair goes
    into weakness
    • Upper cross syndrome
    Weak muscles- cervical flexors
    rhomboids and lower trapezius
    Tight muscles – upper trapezius and levator scapulae
    pectoralis
    • Lower cross syndrome
    weak ms. - abdominals
    gluteus maximus
    tight ms. – thoracolumbar extensors
    hip flexors
    • Special test
    for cervical spine
    1. Foramina compression test / spurling test
    2. Distraction test
    3. ULTT

    1.
    • https://youtu.be/rir6x6Iiqc4
    For lumbar spine
    1. Slr
    2. Lasegues’s test
    3. Bowstring test
    •
    Slump test and modification
    • Slr/ lasgues testand modifications
    • Prone knee bending test
    •
    Investigations
    • MRI
    Physiotherapy management
    • Determine the functional position – position of comfort or reduced
    symptoms Mekenzie exercises to centralize pain
    1. Extension bias- reduced symptoms in extension of spine
    1. Flexion bias – reduced symptoms on flexion
    Spinal extension is contraindicated if –
    • When no position or movement decreases or centralizes the pain
    • When urinary incontinence
    • When patient holds the body immobile due to extreme pain
    •
    • Modalities to reduce pain –
    Tens – sweep mode
    Waveform – trapezoid Duration- 10min

    Ultrasound - phonophoresis for pain relief and accelerates healing


    Intensity – acute 0.5 W/cm2 Chronic 0.8 W/cm2
    Duration – 5-8 min
    Moist heat – for spasm
    IFT – 4 pole vector for radiating pain
    Frequency Base 100- sweep 50hz

    Traction – relieves pressure over the disc


    • Traction
    Manual traction
    Core strengthening
    Isometric exercises
    Upper cross syndrome
    Strengthening the cervical flexors and scapula retractors
    Stretching cervical extensors, scapula elevators and pectorals
    Lower cross syndrome
    Strengthening the abdominals and glutes
    Stretching back extensors and hip flexors
    •
    Thank you

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