Treatment of back pain: Interview with Tokpessa Innocent Lakna, Physiotherapist and Director of CNAO-Lomé
- Posted on 09/02/2023 11:31
- Film
- By abelozih@sante-education.tg
Extract from the article: Les kinésithérapeutes sont très souvent sollicités pour traiter le mal de dos, extrêmement fréquent aujourd'hui. Ce professionnel de santé intervient sur prescription médicale uniquement. En fonction de la localisation du mal de dos et des éventuelle
« The
physiotherapist is the practitioner specialised in the rehabilitation of
musculoskeletal disorders. He can help cure a simple or serious back pain... »
Physiotherapists
are very often called upon to treat back pain, which is extremely common
nowadays. This health professional intervenes on medical prescription only.
Depending on the location of the back pain and any abnormalities found during
the assessment, they will use manual techniques such as massage or manipulation
to relieve the pain. In this interview, Innocent Tokpessa Lakna, Specialist in
Physiotherapy, Director of the National Centre for Orthopaedic Fitting
(CNAO-Lomé) talks about rehabilitation for the treatment of back pain.
Health-Education:
What is the role of the physiotherapist?
Innocent
Tokpessa Lakna: The role of the physiotherapist is in some
way to apply measures that allow the patient to improve his functional
autonomy. But there is not only the physiotherapist in this function, there is
also the physician-rehabilitator. These are two different but complementary
roles.
The
physiotherapist assists the rehabilitation physician. Both have one objective:
to improve the patient's autonomy in his activities of daily living without the
help of a third person.
When
does the physiotherapist intervene?
The
physiotherapist receives the patient after he/she has met the rehabilitation
doctor. The latter, after having received the patient in consultation, carries
out an examination following which a protocol of care is established. This protocol contains the main lines on
which the physiotherapist must work with the patient. And it is at this point
that the physiotherapist accesses the patient.
Can
a patient go directly to the physiotherapist without going through the
rehabilitation doctor?
No.
A patient cannot directly see a physiotherapist because the physiotherapist
works on a medical prescription, however in certain circumstances
physiotherapists can directly see the patient provided they necessarily do
their assessment. There is what is called the physiotherapy assessment which
allows the mapping of the patient's disorders and disabilities and to establish
a set of techniques to improve autonomy. Following this assessment, they can
refer the patient to the doctor or not in case there is no doctor in the area.
Who
should go to the physiotherapist?
All
those who are limited in activities of daily living, and those who have a
disability. These are: those who have difficulty walking, grasping objects,
difficulties in dressing or in using the toilet, in an area where there is no
doctor-rehabilitator.
What
is the role of physiotherapy in the treatment of back pain?
The
physiotherapist intervenes at several levels. The physiotherapist is the
practitioner who specialises in muscle rehabilitation. He can help treat simple
or severe back pain, by practising personalised relaxation exercises,
stretching and massage. Firstly, to calm the pain, a set of techniques is used
to reduce the patient's pain. Secondly, to improve the mobility of the spine,
as pain is accompanied by a limitation of the mobility of the spine. Finally, the physiotherapist formulates
lifestyle rules to avoid the recurrence of pain, i.e. how to proceed in order
to reduce the risk of pain occurring in the patient.
What
does rehabilitation consist of?
First
of all, there is a first step: calming the pain. To calm the pain, we have a
certain number of materials, devices that provide electricity or heat to combat
the pain but also to reduce the contractures. Once the pain has subsided, the
flexibility of the back must be improved by means of a massage to loosen the
muscles and a muscle stretch, before asking the patient to perform back
movements. Then the back and stomach muscles are strengthened in the case of
back pain, and the neck extensors and flexors in the case of neck pain.
Finally, we end with what is known as exercise training on an exercise bike or
treadmill, with the patient doing exercises of increasing duration.
These
are the four stages of physiotherapy for patients with spinal pain if there are
no contraindications.
Do
you have to go to a massage parlour to relieve back pain?
I
call "city massage" the massage that is done in the rooms. City
massage is for aesthetics and comfort. In case of back pain, the patient has to
go to the hospital, see a rehabilitation doctor after a check-up, and then be
sent to a physiotherapist for sessions. What people don't know is that there
are several types of massage: those to stimulate the muscles, relax the
muscles, improve blood circulation and finally those to improve lymphatic
circulation. In the city, I think people don't know the difference. Of course,
you can feel relief after city massage sessions, if you are lucky enough to get
sessions adapted to the back pain mechanism you are experiencing. But it is
preferable to go to the hospital, to see a rehabilitation doctor who will carry
out an examination and, depending on what he has found, will establish a
suitable protocol.
Interview
by Abel OZIH