Review of Structure and Function

Functional Components of the Spine

• anterior pillar: vertebral bodies and intervertebral discs; weight bearing and shock absorbing
• posterior pillar: vertebral arch = articular processes and facet joints; provides motion and bony levers as points of attachment for dynamic and stabilizing muscles

  

 

 

 

 

 

Stages of Recovery

This table adds subcategories to the "acute" and "chronic" stages of recovery. Patients present in the clinic with acute findings, such as high pain levels and restricted motion, without a known source of inflammation or trauma. It also includes some general functional limitations that patients present with during these stages.

By understanding typical functional limitations along this continuum, a PTA can help educate patients on what is expected in a typical course of treatment and rehabilitation. When patients understand why they need to progress or limit activity and the expected goal of these behaviors, they are more likely to adhere to a home exercise and activity program.

Additionally, the "chronic" stage can refer to a patient who is seeing a physical therapist for the first time, and has complained of spine and related pain and limited function over a longer period of time. These patients may be referred to as experiencing "persistent" pain. Patients who experience persistent pain may present as "acute without signs and symptoms of inflammation". When the physical therapist and treatment team have determined that the spine pain and related functional loss is relatively unresponsive to conservative and other interventions, the physical therapy plan of care typically focuses on management strategies. Management strategies include, but are not limited to: breathing, pacing and prioritizing, a range of exercises (from gentle motions to resistance training), mindfulness and meditation, topical analegesics, heat, and sleep education).