M.R Physiotherapy and Rehabilitation Center

07/01/2026

07/01/2026

How to Perform the Roos Test:
🔹Position: The patient sits or stands with a neutral head position.
🔹Arm Placement: Shoulders are abducted (lifted out to the side) to 90 degrees, externally rotated, and elbows flexed to 90 degrees, with elbows slightly behind the body's midline.
🔹Action: The patient quickly opens and closes their hands (flexing and extending fingers) for up to three minutes.
🔹Observation: The examiner watches for:
Reproduction of familiar symptoms (fatigue, heaviness, pain, tingling, numbness).
👉Dropping the arms due to distress or weakness.
👉Changes in hand color (pallor or cyanosis).

▪️Positive Test:

☑️ Inability to maintain the position for 3 minutes.

☑️ Onset of ischemic pain, heaviness, weakness, numbness, or tingling in the arm/hand.

☑️ Discoloration of the hand.

07/01/2026

L4-L5 central
Therapeutic exercises
Electro therapy
Hydrotherapy
Dry needling
Acupuncture
Spinal decompression

ADL

》Regular home exercises
》Posture correction ( Ergonomics) and proper sleeping
》To maintain spinal alignment
》Avoid Smoking, alcohol and in*******se
》Swimming
》Maintain good posture to prevent a hunched spine.
》Use ergonomic furniture and avoid prolonged sitting and forward bending position.
》 Position change after 30 min ( must)
》 Sunrise ☀ 45 min everyday
》 Avoid weight bearing
》Avoid soft sofas and poor sitting posture
》Avoid twisting, lifting heavy objects
》Use lumber corset during journey
》Avoid prolong sitting & bending position
》Avoid high heels or unsupportive shoes
》Lifestyle Modifications
》Don’t smoke or use other to***co products
》Keep a healthy weight and reduce obesity
》Stay Hydrated: Drink plenty of water
》Calcium and Vitamin D

👉Talk to your doctor!

🔎 It is important to consult your doctor before starting any exercise. If any of the exercises below cause more or worse pain, please stop immediately.

▪️Exercises should be done 3 times per day.
●Holding 10 seconds
●Repetitions 10 times


M.R Physiotherapy and Rehabilitation Center

Md. Mokhlesur Rahman

07/01/2026

This document provides exercises that can be performed after back surgery. It recommends consulting your physiotherapist or doctor about any restrictions. The exercises should be done daily, up to 2-3 times per day. Some pain may be expected during and after exercise, but any pain lasting over 30 minutes means lowering the intensity. It then describes 7 specific exercises - including pelvis lifts, knee lifts, knee and hip bends in bed, arm swings, knee lifts, toe lifts, and sideways weight transfers - and provides instructions and repetition/set recommendations for each.

07/01/2026

Back Pain Prevention Exercises Guide

07/01/2026

ᩣシ

07/01/2026

C3-C6
for neck

1. Neck Tilts – Gently tilt your head side to side

2. Chin Tucks – Pull your chin inward to align spine

3. Shoulder shrugs – Slowly up down your shoulder

4. Shoulder Rolls – Roll shoulders forward & backward

5. Upper Trapezius Stretch – Stretch the side of your neck

6. Levator Scapulae Stretch – Relax the back of your neck

7. Isometric Neck Holds – Apply gentle resistance with hand

8. Neurodynamic Stretching

9. Neck Decompression

■ Do each exercise slowly & hold for 10–15 seconds. Repeat (chronic) 5–10 times.

your physiotherapist before starting.

■ Stay pain-free, stay active!

✍️Telemedicine

06/01/2026

L4-S1
Physiotherapy management of disc hernia

of treatment:
▪︎To relieve pain and minimise caregiver burden
▪︎To prevent deformity and stiffness
▪︎To improve muscle strength and flexibility
▪︎To maintain functional activities
▪︎To maintain ROM
▪︎To reduce muscle spasms or tightness
▪︎To improve postural correction or modification
▪︎To rehabilate the patient
▪︎To maintain normal alignment of spine

▪︎ Intervertebral joint stabilization and improved general fitness.
▪︎ Improving movement and function for daily activities

procedure:

1. Back Stretching exercises :
》Stretching exercises - Erector spinae, Hamstring muscles, Piriformis, Gluteus muscles and Hip flexor stretches and hip rotations can help improve hip mobility and reduce stiffness.

2. Strengthening Exercises:

●Back Strengthening:
》Exercises like superman stretch, plank, and back extensions can help strengthen back muscles and improve posture.

●Core Strengthening:
》Exercises like crunches, leg raises, and planks can help improve core strength and stability.

3. Aerobic Exercises:

●Swimming:
》Swimming is another low-impact activity that can improve cardiovascular health and range of motion.
☆ Swimming: three times a week for six weeks: 10 min warm-up + 5 min stretching

4. Breathing exercises - deep breathing

5. Mobilizing exercise
▪️Cat - Cow

▪️Knee to chest stretch

▪️Child's Pose

▪️Pelvic tilts

6. Electrotherapy-
》Deep heat- SWD
》TENS
》Moist heat compression

7. Ergonomic correction

8. Core stability exercises
》Bridging
》Plank

9. Manual therapy by physiotherapist
➡️Mobilization and manipulation
➡️Isometric back muscle exercise
➡️Myofacial release
➡️Buttocks contraction
➡️Neurodynamic stretching
➡️Hydrotherapy - pool therapy
➡️DTFM
➡️Posture re-education exercise
➡️Aquatic vertical traction (decompression)
➡️Dry needling
➡️ Acupressure

ADL

》Regular home exercises
》Posture correction ( Ergonomics)
》To maintain spinal alignment
》Avoid Smoking, alcohol and in*******se
》Swimming
》Maintain good posture to prevent a hunched spine.
》Use ergonomic furniture and avoid prolonged sitting and forward bending position.
》 Position change after 30 min ( must)
》 Sunrise ☀ 45 min everyday
》 Avoid weight bearing
》Avoid soft sofas and poor sitting posture
》Avoid twisting, lifting heavy objects
》Use lumber corset during journey
》Avoid prolong sitting & bending position
》Avoid high heels or unsupportive shoes
》Lifestyle Modifications
》Don’t smoke or use other to***co products
》Keep a healthy weight and reduce obesity
》Stay Hydrated: Drink plenty of water
》Calcium and Vitamin D

👉Talk to your doctor!

🔎 It is important to consult your doctor before starting any exercise. If any of the exercises below cause more or worse pain, please stop immediately.

▪️Exercises should be done 3 times per day.
●Holding 10 seconds
●Repetitions 10 times


M.R Physiotherapy and Rehabilitation Center

Md. Mokhlesur Rahman

06/01/2026

L4-L5 posterior disc bulging

06/01/2026

How to relieve herniated disc pain in lower back at home
👉Effective lower back pain exercises for herniated disc recovery

◼️Gentle Stretches & Strengthening (Perform Slowly)

▪️Knee-to-Chest: Lie on your back, knees bent, feet flat. Gently pull one knee towards your chest, feeling a stretch in your buttock/lower back. Hold briefly, repeat on both sides.

▪️Cat-Cow: On hands and knees, arch your back (Cat), then let your belly sag (Cow). Repeat 3-5 times, twice daily.
▪️Cobra Pose (Modified): Lie on your stomach, hands under shoulders. Gently lift your chest, keeping hips on the floor, arching your back slightly. Hold briefly.

▪️Bridging: Lie on back, knees bent, feet flat. Tighten abs/buttocks, lift hips to form a straight line from shoulders to knees. Hold for three breaths.

▪️Figure-Four Stretch: Cross one ankle over the opposite knee, gently pull the crossed knee towards your chest for a glute stretch.

▪️Swimming
▪️Ice & Heat: Use cold to reduce inflammation and numbness, then heat to relax muscles and improve blood flow.
▪️Towel Support: Lie on your back with a rolled towel under the small of your back to support the natural arch for several minutes.

👨‍⚕️Consult a Professional: See a doctor or physical therapist first to get personalized guidance and ensure exercises are safe for your specific disc issue.

06/01/2026

is a medical term used to describe degenerative changes in the spine, most commonly affecting the intervertebral discs, joints, and ligaments. This condition can involve any part of the spine — cervical (neck), thoracic (middle back), or lumbar (lower back) segments.

▪️Impact of Spondylosis

Disc degeneration

Formation of osteophytes (bone spurs)

Compression of nerve roots

Limited mobility

Inflammation and pain

▪️Spondylosis develops

Excessive stress on the spine, injuries, poor posture, or genetic factors.
Spend a lot of time sitting, under stress, or engaged in physical work involving repetitive movements or heavy lifting.

🔸Cervical spondylosis – Degeneration of the neck spine
Cervical spondylosis affects the cervical spine, which consists of seven vertebrae and supports the head, allowing its movement and stability.

▪️Symptoms of cervical spondylosis:

Neck pain that radiates toward the shoulders or arms

Stiffness and limited neck mobility

Tingling or weakness in the arms

Headaches, especially in the occipital (back of the head) area

Sometimes pain radiates into the arms, which can become weak and have difficulty moving.

🔸Thoracic spondylosis – Degeneration of the mid-back spine
Thoracic spondylosis occurs in the thoracic (mid-back) part of the spine, which consists of 12 vertebrae and is located between the neck and the lower back.

▪️Symptoms of thoracic spondylosis:

Pain in the mid-back area (between the shoulder blades)

Stiffness or limited mobility

Tingling or weakness in the arms or legs, although less common than in other types of spondylosis

Sometimes pain worsens during breathing or bending.

🔸Lumbar spondylosis – Degeneration of the lower spine
Lumbar spondylosis is a degenerative condition affecting the lumbar (lower) spine, which consists of five vertebrae located in the lower back.

▪️Symptoms of lumbar spondylosis:

Lower back pain that worsens when sitting or lifting heavy objects

Stiffness in the lower back

Pain radiating into the legs (sciatica), often referred to as sciatica

Tingling or weakness in the legs

Reduced mobility in the lower body

▪️Cervical vs Thoracic vs Lumbar
✔️Cervical spondylosis causes neck pain, tingling in the arms, and headaches.

✔️Thoracic spondylosis usually causes pain in the mid-back but less frequently causes tingling or weakness in the arms and legs.

✔️Lumbar spondylosis causes lower back pain that can radiate into the legs, accompanied by tingling and weakness in the legs.

▪️Causes of spondylosis

Aging

Injuries

Excessive physical exertion

Body posture and poor alignment

Genetics

Excess body weight

Chronic diseases

▪️Symptoms of spondylosis

Back pain

Stiffness in the spine

Tingling and weakness

Headaches

Radiating pain to the limbs

Feeling of balance loss

◾️Treatment Methods for Spondylosis – Physiotherapy and Exercise Therapy

👉Physiotherapy – an effective approach to treating spondylosis

Mobilization and manipulation: Techniques to improve joint mobility and reduce stiffness, helping to relieve pain and restore normal movement.

Ultrasound therapy: Uses sound waves to pe*****te tissues, reduce pain and inflammation, and stimulate tissue regeneration—effective for spondylosis-related pain.

Electrotherapy: Electrical currents are used to decrease pain, improve circulation, and accelerate healing processes, enhancing mobility and reducing spinal pain.

Laser therapy: High-energy lasers stimulate tissues and reduce pain by activating cells and speeding up regeneration, helping decrease inflammation and discomfort.

Magnetotherapy: Magnetic fields improve blood circulation and promote healing, reducing pain and improving mobility to ease spondylosis symptoms.

Shockwave therapy: High-intensity acoustic waves target affected areas to stimulate tissue regeneration and reduce pain.

Stretching and flexibility exercises: These help reduce spinal stiffness and improve mobility, addressing the rigidity caused by spondylosis.

Breathing and relaxation exercises: Controlled breathing and relaxation techniques help decrease muscle tension, improve oxygen supply to the body, and promote tissue regeneration.

▪️Exercises and Prevention of Spondylosis

Stretching and increasing flexibility

Exercises to strengthen spinal muscles

Proper posture and ergonomics

Preventing injuries and spinal stress

Activities for spinal health

06/01/2026

Treatment in Lumbar Spondylolisthesis:

■ Electrotherapy
》SWD (Short wave diathermy
》TENS (transcutaneous electrical nerve stimulation)

■ Hydrotherapy
》 Ice application
》 Swimming therapy

:

》Transversus Abdominus
》Pelvic tilt
》Draw in
》Child’s pose
》Double knee to chest
》Hamstring stretch
》Gluteal stretch
》Quadruped arm/leg raises

》Shaker movement

》Bridging exercise
》 Single leg stretch
》 Hip abductor stretch

■Surgical Interventions (if failure physical therapy)

》Spinal Fusion

》Laminectomy

》Foraminotomy

》Posterolateral Fusion

》Transforaminal Lumbar Interbody Fusion (TLIF)

》Anterior Lumbar Interbody Fusion (ALIF)

》Posterior Lumbar Interbody Fusion (PLIF)

》Decompression Surgery

》Pedicle Screw Fixation

》Artificial Disc Replacement

■ DO’S and DON’TS :

》Sit only for a short period, taking breaks in between.

》Place a supportive towel roll at the belt line of your back when sitting in a car.

》Sleep on a good firm surface.

》Keep your back straight when performing activities like vacuuming, sweeping, etc.

》Keep your back and abdominal muscles strong to help support and stabilize the lower back.

》Maintain a healthy weight

》Avoid prolonged sitting and forward bending posture

》Avoid smoking and alcohol and in*******se during pain

》Proper sleeping and drinking water

》Proper ergonomics factor and postural correction

》Use lumbosacral brace or corset

👉N.B: Do not perform any exercises without the guidance of your physical therapist.