Back pain - Physical therapy & Surgery

A physical therapist can apply a variety of treatments, such as heat, ice, ultrasound, electrical stimulation and muscle-release techniques, to your back muscles and soft tissues to reduce pain. As pain improves, the therapist can teach you specific exercises to increase your flexibility, strengthen your back and abdominal muscles, and improve your posture. Regular use of these techniques will help prevent pain from returning.
Injections
If other measures don't relieve your pain and if your pain radiates down your leg, your doctor may inject cortisone — an anti-inflammatory medication — into the space around your spinal cord (epidural space).
Surgery
Types of back surgery include:

• Spine navigation surgery. It is a new techniques that can enhance the precision in the surgical regions, reduce the surgical time, reduce radiation exposures to patients and surgeon. Increase safety and accuracy through more precise screw placement and enables minimally invasive approaches.
• Partial removal of disk. If disk material is pressing or squeezing a nerve, your orthopaedics doctor may be able to remove just the portion of the disk that's causing the problem.
• Partial removal of a vertebra. If your spine has developed bony growths that are pinching your spinal cord or nerves, orthopaedics surgeons can remove a small section of the offending vertebra, to open up the passage.
• Fusion. This surgery involves joining two vertebrae to eliminate painful movement. A drawback to the procedure is that it increases the chances of arthritis developing in adjoining vertebrae.

Reference information: knowyourback.org, ispine.com.hk, www.stryker.com

It is not intended as medical advice to any specific person. If you have any need for personal advice or have any questions regarding your health, please consult your personal physician.

Back pain Prevention

The prevention of back pain is, itself, somewhat controversial. It has long been thought that exercise and an all-around healthy lifestyle would prevent back pain. This is not necessarily true. In fact, several studies have found that the wrong type of exercise such as high-impact activities may increase the chance of suffering back pain. Nonetheless, exercise is important for overall health and should not be avoided. Low-impact activities such as swimming, walking, and bicycling can increase overall fitness without straining the low back.

·         Specific exercises: Talk to your doctor about how to perform these exercises.

Abdominal crunches, when performed properly, strengthen abdominal muscles and may decrease the tendency to suffer back pain.

·         Although not useful to treat back pain, stretching exercises are helpful in alleviating tight back muscles.

·         The pelvic tilt also helps alleviate tight back muscles.

·         Lumbar support belts: Workers who frequently perform heavy lifting are often required to wear these belts. There is no proof that these belts prevent back injury. One study even indicated that these belts increased the likelihood of injury.

• Standing: While standing, keep your head up and stomach pulled in. If you are required to stand for long periods of time, you should have a small stool on which to rest one foot at a time. Do not wear high heels.
• Sitting: Chairs of appropriate height for the task at hand with good lumbar support are preferable. To avoid putting stress on the back, chairs should swivel. Automobile seats should also have adequate low-back support. If not, a small pillow or rolled towel behind the lumbar area will provide adequate support.
• Sleeping: Individual needs vary. If the mattress is too soft, many people will experience backaches. The same is true for sleeping on a hard mattress. Trial and error may be required. A piece of plywood between the box spring and mattress will stiffen a soft bed. A thick mattress pad will help soften a mattress that is too hard.
• Lifting: Don't lift objects that are too heavy for you. If you attempt to lift something, keep your back straight up and down, head up, and lift with your knees. Keep the object close to you, don't stoop over to lift. Tighten your stomach muscles to keep your back in balance.

Reference information: knowyourback.org, ispine.com.hk

It is not intended as medical advice to any specific person. If you have any need for personal advice or have any questions regarding your health, please consult your personal physician.

Back pain

Acute or short-term low back pain generally lasts from a few days to a few weeks. Most acute back pain is the result of trauma to the lower back or a disorder such as arthritis. Pain from trauma may be caused by a sports injury, work around the house or in the garden, or a sudden jolt such as a car accident or other stress on spinal bones and tissues. Symptoms may range from muscle ache to shooting or stabbing pain, limited flexibility and range of motion, or an inability to stand straight. Chronic back pain is pain that persists for more than 3 months. It is often progressive and the cause can be difficult to determine.

Reference information: www.ispine.com.hk

It is not intended as medical advice to any specific person. If you have any need for personal advice or have any questions regarding your health, please consult your personal physician.

Cervical Fractures

The seven bones in the neck are the cervical vertebrae. They support the head and connect it to the shoulders and body.
Cervical fractures usually result from high-energy trauma, such as automobile crashes or falls. Athletes are also at risk. A cervical fracture can occur if:

• A football player "spears" an opponent with his head.
• An ice hockey player is struck from behind and rams into the boards.
• A gymnast misses the high bar during a release move and falls.
• A diver strikes the bottom of a shallow pool.

Any injury to the vertebrae can have serious consequences because the spinal cord, the central nervous system's connection between the brain and the body, runs through the center of the vertebrae. Damage to the spinal cord can result in paralysis or death. Injury to the spinal cord at the level of the cervical spine can lead to temporary or permanent paralysis of the entire body from the neck down.

In a trauma situation, the neck should be immobilized until x-rays are taken and reviewed by a physician. Emergency medical personnel will assume that an unconscious individual has a neck injury and respond accordingly. The victim may experience shock and either temporary or permanent paralysis.

Conscious patients with an acute neck injury will usually have severe neck pain. They may also have pain spreading from the neck to the shoulders or arms, resulting from the vertebra compressing a nerve. There may be some bruising and swelling at the back of the neck. The physician will perform a complete neurological examination to assess nerve function and may request additional radiographic studies, such as MRI or computed tomography (CT), to determine the extent of the injuries.

Treatment

Treatment will depend on which of the seven cervical vertebrae are damaged and the kind of fracture sustained. A minor compression fracture can be treated with a cervical brace worn for 6 to 8 weeks until the bone heals. A more complex or extensive fracture may require traction, surgery, and internal fixation, 2 to 3 months in a rigid cast, or a combination of these treatments.
Improvements in athletic equipment and rule changes have reduced the number of sports-related cervical fractures over the past 20 years. You can help protect yourself and your family if you:

• Always wear a seat belt when you are driving or a passenger in a car.
• Never dive in a shallow pool area, and be sure that young people are properly supervised when swimming and diving.
• Wear the proper protective equipment for your sport and follow all safety regulations, such as having a spotter and appropriate cushioning mats.

Reference: www.aaos.org

The above information serves as disease educational purpose, you should consult your orthopedic doctors for diagnosis and treatment.

腰背痛 (back pain)

成因

1.    退化

腰背退化的速度因人而異，一般在三十歲後椎間盤和小關節開始步入不穩定的狀態，錐間盤或小關節會較容易移位，從而壓住神經線而導致腰背痛或坐骨神經痛。

2.    骨增生

隨著年紀增長，小關節和韌帶會因應身體需要而增生，導致骨刺。大部分骨刺不會引起痛楚，亦無需特別治療。但骨增生一旦壓住神經線，就會影響神經的血液循環，病人站立或走動時下肢會感到痛楚。

3.    其他因素

若腰背痛由癌症、細菌感染（包括肺癆）所引起，腰背痛會持續增加，影響睡眠，病人亦會有其它癌症或感染的病徵。

預防

身體結構就好像起重機，腰部就像鋼架，而肌肉（特別是背肌）就像繩索般平衡身體。故此，強健肌肉可確保腰椎保持良好姿勢，可以減少移位及其引起的腰背痛。因此，透過運動來強化腰背肌肉能夠有效預防腰背痛。

治療方法

1.    物理治療

分為主動和被動治療方法。主動治療是透過持續的指定動作，有效地強化病人的肌肉；被動治療是借助電流儀器，針對病人的症狀，舒緩痛楚。

誤解: 一般人認為有痛楚就要減少活動，甚至臥床休息，這樣只會使原本的肌肉變得更弱，長遠對痛症沒有幫助。應按照物理治療師的指示，練習指定動作以加強肌肉。

2.      藥物治療

經醫生確診後，醫生會因個別情況考慮處方口服藥物，如有需要，會以肌肉或皮下注射、神經注射，控制痛楚。

3.      手術

如有需要，醫生亦會建議病人進行手術，尤其是病人出現以下情況：

·         藥物/物理治療已不能控制腰背痛

·         因壓住底神經線而導致失禁

·         神經痛持續惡化，影響腳部正常活動

·         已進行4-6星期的物理治療而腰背痛未見改善

參考資料: http://www.ispine.com.hk

以上所提供的資訊僅作為教育及參考用途，如果你有任何醫療問題，應向自己的醫生查詢，而不應單倚賴以上提供的資料。