Articles

We agree with the Treatment Based Classification of Low Back Pain. It is a good starting point for treating acute/sub-acute nociceptive pain or peripheral neurogenic pain symptoms and in some occasions it works for treating chronic pain as well, if there is an underlying tissue dysfunction. We need to be prepared to look into and manage central sensitisation, but this condition requires a totally different treatment approach.  Most conditions are complex. It is important we are able to diagnose the conditions. It would help if we could have an MRI scan for every single patient, but it is not the case. Pattern recognition is something can help to set up a diagnosis, find the source of the problem supported by the subjective and objective assessment.

Considering that the inflammation causes muscle inhibition and there are protective and adaptive changes that develop in the tissues throughout the healing phases allows us to choose the right treatment technique for the tissues involved. We need to know the pathology. We need to consider which tissue is damaged, healing time of the tissues and life style, work related movements, knowing what kind of work the patient has to do (are they at risk to develop a chronic pain), their mental state  is a good indicator for the clinician to form a prognosis. If these complex conditions could be treated with the 4 mentioned treatment methods there would not be the need to use acupuncture, Trigger point dry needling, muscle energy techniques, but this guidelines help the clinician to carry out a safe treatment on their patients. During the assessment/ treatment I combine the Maitland concept, McKenzie technique, Cyriax concept, Muscle energy technique and Pilates postural patterns to form a diagnosis instead of using the terminology - non-specific low back pain. I feel that this terminology does not help the therapist to find the source of the problem or it helps them to say something when they do not know what happens to the patient

Physio Medicine