the role of physiotherapy in musculoskeletal disorder.pptx

My participation in the World Physical Therapy Day at the Libyan Academy for Postgraduate Studies and the World Physical Therapy Day Forum organized by the General Syndicate of Physical Therapy at the Libyan level.

1. The Role of Physiotherapy in Musculoskeletal Disorders By: PT. Inasse alarousi, BSc

2. What are Musculoskeletal Disorders? ’MSK relates to the function of the locomotor system, which includes muscles, bones, joints, and connective tissues. Musculoskeletal impairments include about 150 different diseases/conditions that affect the system and resulting in temporary or permanent restrictions in functioning and participation. (WHO, 2022).

3. - Pain relief or promote analgesia. - Enhance neuromuscular efficiency. - Prevention of further injury. - Restoration of function and improving ability to perform daily activities. Role of Physiotherapy: - Manual therapy (spinal manipulation) - Exercise therapy (various types) combination with reassurance, and education. - Modalities ( Ice, ultrasound / IFT / TENS) Physiotherapy Techniques:

4. -In 2020, 619 million people experienced low back pain, with a projected 843 million instances by 2050. -In 2020, the global age-standardized rate of YLDs was 832 per 100,000. The global burden of LBP: - (38.8% ) of YLDs were attributed to : Occupational variables. Smoking. High body mass index. (Ferreira et al., 2023) Risk factor of LBP:

5. Clinical Practice Guidelines for Low Back Pain Education: understanding LBP, avoid prolonged bed rest , its natural course, and self-management strategies. Exercise: Encouraging regular physical activity and specific exercises tailored to the individual’s condition. Manual Therapy: like spinal manipulation and mobilization. Cognitive/Behavioral Interventions: psychological factors that may influence pain and disability. drug: Long-term use of (NSAIDs)/ opioids is discouraged due to the risk of addiction and other side effects. Passive Modalities: Treatments like ultrasound, electrical stimulation, and traction have limited evidence supporting their effectiveness, and conflicting evidence on TENS for pain and function. Invasive Procedures: Routine use of injections (Steroidal epidural injections) or surgery is not recommended unless there are specific indications such as severe neurological deficits or structural abnormalities. (Fabio Zaina et al., 2023)

6. Physiotherapy verses surgery in the management of the LBP: - fusion surgery was no better than nonoperative treatment in terms of the pain and disability outcomes at either short- or long-term follow-up (Xu et al., 2021). -lumbar spinal stenosis there’s No clear benefits were observed with surgery versus non‐surgical treatment (Zaina et al., 2016). -chronic sciatica-related back pain, surgical intervention may be more effective than non-surgical treatment. as well as conservative is the initial approach unless surgery is warranted (Hammed et al., 2024). .

7. Case Study : LBP Patient Profile : 45-year-old female, teacher, experiencing chronic lower back pain for 5yr due to RTA. Assessment Findings : Pain in the back, radiating at RT back and front of thigh, Muscle tightness, poor core stability, and limited lumbar mobility. Intervention: - posterior chain exercises. - Neural mobilisation (sciatic, femoral). - Core stabilisation exercises. - Postural training and balance. - modalities (TENS) for pain management. Outcome: after 6 weeks, there’s significant relief with diminished pain levels, enhanced core strength, and better posture, leading to a reduction of pain.

8. Conclusion: - Physiotherapy is essential for managing MSK disorders. - Physiotherapy is first line of treatment in treatment of MSK disorder. - Focus on personalized treatment and patient education. - Importance of a multidisciplinary approach.

9. References: Fabio Zaina, Côté, P., Cancelliere, C., Felice, F., Donzelli, S., Rauch, A., Verville, L., Negrini, S. and Nordin, M. (2023a). A Systematic Review of Clinical Practice Guidelines for Persons With Non-specific Low Back Pain With and Without Radiculopathy: Identification of Best Evidence for Rehabilitation to Develop the WHO’s Package of Interventions for Rehabilitation. Archives of Physical Medicine and Rehabilitation, 104(11). doi:https://doi.org/10.1016/j.apmr.2023.02.022. Ferreira, M.L., Katie de Luca, Haile, L.M., Steinmetz, J.D., Culbreth, G.T., Cross, M., Kopec, J.A., Ferreira, P.H., Blyth, F.M., Buchbinder, R., Hartvigsen, J., Wu, A.-M., Saeid Safiri, Woolf, A., Collins, G.S., Ong, K.L., Stein Emil Vollset, Smith, A.E., Cruz, J.A. and Kai Glenn Fukutaki (2023a). Global, regional, and national burden of low back pain, 1990–2020, its attributable risk factors, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021. The Lancet Rheumatology, 5(6), pp.e316–e329. doi:https://doi.org/10.1016/s2665-9913(23)00098-x. Hammed, A., Al-Qiami, A., Alsalhi, H., Almansi, A., Massoud, M., Alzawahreh, A., Hamouda, A. and Tanislav, C. (2024a). Surgical vs. Conservative Management of Chronic Sciatica (>3 Months) Due to Lumbar Disc Herniation: Systematic Review and Meta-Analysis. Cureus. [online] doi:https://doi.org/10.7759/cureus.59617. World (2022a). Musculoskeletal health. [online] Who.int. Available at: https://www.who.int/news-room/fact-sheets/detail/musculoskeletal-conditions#:~:text=Musculoskeletal%20conditions%20are%20typically%20characterized%20by%20pain%20(often%20persistent)%20and [Accessed 24 Sep. 2024]. Xu, W., Ran, B., Luo, W., Li, Z. and Gu, R. (2021a). Is Lumbar Fusion Necessary for Chronic Low Back Pain Associated with Degenerative Disk Disease? A Meta-Analysis. World Neurosurgery, 146, pp.298–306. doi:https://doi.org/10.1016/j.wneu.2020.11.121. Zaina, F., Tomkins-Lane, C., Carragee, E. and Negrini, S. (2016a). Surgical versus non-surgical treatment for lumbar spinal stenosis. Cochrane Database of Systematic Reviews. doi:https://doi.org/10.1002/14651858.cd010264.pub2.

10. Thank You!