Aquatic Therapy in the Management of Chronic Low Back Pain
Introduction
Chronic Low Back Pain
Aquatic Therapy
Assessment and Diagnosis
1. Subjective History – it is important to gain a subjective history from the patient regarding their back pain such as onset, duration, location, character, aggravating and relieving factors and severity- more about subjective history can be found here
2. Physical Assessment
a. Observation – posture, abnormal deformity, and curvature
b. Palpation – along spinous process and transverse process, musculature, sacroiliac joint
c. Gait – through stance and swing phase
d. Range of Motion – Passive and Active of lumbar, thoracic spine, and hip
e. Muscle strength – Lumbar spine and Hip
f. Neurological testing – Reflexes, Motor and sensory testing, straight leg raise, femoral nerve test
g. Testing SIJ and Hip – thigh thrust test, pelvic compression, FABER’s
h. Motor control testing – Waiter’s Bow, Pelvic tilts
i. Imagining is not routinely offered in non-specialist setting for people with low back pain – NICE
3. Patient-reported outcome measures
a. Physical function – Oswestry Disability Index or Roland Morris Disability Questionnaire
b. Pain intensity – Numerical Rating Scale or Visual Analogue Scale
c. Health-related quality of life – Short Form Health Survey 12 or EuroQol-5D-3L
d. Work – Work Ability or Work productivity questionnaire
e. Psychological functioning – Hospital Anxiety and Disability Scale
f. Pain interference – Pain Interference subscale of the Brief Pain Inventory
Psychosocial Effects of Chronic Low Back Pain
The effectiveness of Aquatic Therapy for Chronic Low Back Pain
Aquatic Therapy vs Land-based Therapy
Psychosocial Effects of Aquatic Therapy on Chronic Low Back Pain
Prescription of Aquatic Therapy for Chronic Low Back Pain
Conclusion