General aspects of management

Relative rest

For acutely painful back problems 2 days strict rest lying on a firm surface is optimal treatment. 8 Resting for longer than 3 days does not produce any significant healing.

Patient education

Appropriate educational material leads to a clear insight into the causes and aggravation of the back disorder plus coping strategies.


An early graduated exercise program as soon as the attack phase settles has been shown to promote healing and prevent relapses. 9 All forms of exercise (extension, flexion and isometric) appear to be equally effective with extension exercises being favoured for a discogenic problem and flexion exercises for most dysfunctional problems (see Figs 33.14a , b). Swimming is an excellent exercise for back disorders.

Fig. 33.14 Examples of exercises for low back pain: (a) rotation exercise; (b) flexion exercise

Dealing With Back Pain

Dealing With Back Pain

Deal With Your Pain, Lead A Wonderful Life An Live Like A 'Normal' Person. Before I really start telling you anything about me or finding out anything about you, I want you to know that I sympathize with you. Not only is it one of the most painful experiences to have backpain. Not only is it the number one excuse for employees not coming into work. But perhaps just as significantly, it is something that I suffered from for years.

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