FOR APRIL 23, 2023

Applied Rheumatology Made Simple (A.R.M.S.)

(Part 4)

Today, we are going to discuss the MANAGEMENT OF
SOFT TISSUE RHEUMATISM.
According to studies, the following are some recommendations to
manage soft tissue rheumatism:

  • Rest during the acute phase
  • Apply splints, bands, soft pads etc.
  • Apply heat and/or cold applications
  • Submit to physical therapy
  • Take medications e.g. NSAIDs, analgesics (systemic and
    topical)
  • Do some prevention activities e.g. exercises, avoid repetitive
    motion, weight reduction

We now move on to low back pain generalities. What are LOW
BACK PAIN: GENERALITIES?
Low back pain is a very common disorder which is mostly related
to dysfunction of muscles, ligaments, tendons and fascia.
Symptoms and x-rays seldom correlate in most cases to back
pain and it may be associated with several musculo-skeletal and
other medical disorders
There is also what we call as the SIMPLE BACK ACHE. These
are usually suffered by patients aged 20 to 50 years old. The pain
is in the lumbosacral region, buttocks and thighs. The pain is
mechanical in nature and varies with physical activity.
What are some SPECIAL CONSIDERATIONS IN CHRONIC
LOW BACK PAIN. Remember these:

  • Examine the person more than the pain and its mechanisms
  • Stay alert for secondary gains and malingering
  • Do Treatment modalities attempt to modify the pain to tolerable
    levels e.g. exercises, TENS, biofeedback, acupuncture etc.
  • Think of Analgesics, anti-inflammatory drugs, anti-depressants
  • Be aware that Treatment can be difficult (and frustrating)
    Next week we will discuss the topic on Osteoarthritis.