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Treatment is often dependent on the duration and severity of the pain and dysfunction. In the acute phase (first 1–2 weeks) for a mild sprain of the sacroiliac, it is typical for the patient to be prescribed rest, ice/heat, spinal manipulation, [35] and physical therapy; anti-inflammatory medicine can also be helpful. [1] [4]
The McKenzie protocol also now includes flexion protocols and stresses the importance of differentiating whether flexion or extension improves patient's symptoms. As a result, McKenzie principles are used by many physical therapists in the treatment of low back pain, whereas Williams Exercises are no longer taught as a physical therapy protocol.
Cold therapy reduces inflammation, edema, pain, and muscle spasms associated with acute back injury. [19] Heat therapy is used to reduce pain and alleviate sore and stiff muscles. [19] Heat therapy is proposed to work by facilitating delivery of nutrients and oxygen to the site of injury to accommodate healing. [19]
In acute injury resulting in lumbosacral radiculopathy, conservative treatment such as acetaminophen and NSAIDs should be the first line of therapy. [1] Therapeutic exercises are frequently used in combination with many of the previously mentioned modalities and with great results. A variety of exercise regimens are available in patient treatment.
Nerve gliding cannot proceed with injuries or inflammations as the nerve is trapped by the tissue surrounding the nerve near the joint. Thus, nerve gliding exercise is widely used in rehabilitation programs and during the post-surgical period. Radial, median, sciatic, and ulnar nerves require nerve gliding exercise during the rehabilitation period.
Although structured exercises provide small, short-term benefit for leg pain, in the long term no difference is seen between exercise or simply staying active. [49] The evidence for physical therapy in sciatica is unclear though such programs appear safe. [3] Physical therapy is commonly used. [3]
Spinal manipulation appears to provide similar effects to other recommended treatments for chronic low back pain. [57] There is no evidence it is more effective than other therapies or sham, or as an adjunct to other treatments, for acute low back pain [58] "Back school" is an intervention that consists of both education and physical exercises.
The McKenzie method is a technique primarily used in physical therapy.It was developed in the late 1950s by New Zealand physiotherapist Robin McKenzie. [1] [2] [3] In 1981 he launched the concept which he called "Mechanical Diagnosis and Therapy (MDT)" – a system encompassing assessment, diagnosis and treatment for the spine and extremities.
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