What is back pain?

1.      Degeneration

The rate of degneration is vary from people. Generally, the interverbral disc and joints will become unstable after aged 30, leading to back pain or sciatia caused by nerve compressions.

2.      Bone Projection / over-growth

Osteophytes (bone spur) form naturally on the back of the spine as a person ages and are a sign of degeneration in the spine. In most cases, the spur are not the source of back pains. However, if the bone projections compress the adjunct nerves and suppress the blood supply to the nerve, the patients would suffer pain in running or standing position.

3.      Others

If back pain caused by tumor/ cancer or bacterial infections, patients may experience persistent pain in back, leading to insomnia and other associated syndromes.  

Back Pain - prevention

Exercise is an effective way to strengthen your muscles. The strong muscles can help to maintain a correct position of spine. Low-impact activities can increase overall fitness without straining the low back.

Reference information: www.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.

骨質疏鬆成因，預防及治療

在成長中，骨骼不斷形成和流失，此過程稱之為骨骼的新陳代謝。骨質密度在兒童及青少年時期會不斷增加，到30-45歲時，骨質密度會達至最高峰。期後，骨質流失的速度會比其形成快，因而引致骨骼變得脆弱，骨骼容易破裂或骨折，此情況稱為骨質疏鬆症。

骨質疏鬆症 - 成因

除了婦女於更年期受荷爾蒙的轉變影響之外，其他因素亦會增加患上骨質疏鬆症的風險：

1.       過早停經

2.       經常跌倒

3.       長期使用皮質類固醇類等藥物

4.       體型瘦小

5.       家庭成員曾患有骨質疏鬆症

6.       吸煙或酗酒人士 .. 等等

如何診斷骨質疏鬆症？

在患病的初期，骨質疏鬆症患者可能沒有出現任何症狀，直到病況惡化才被發現。因此很多時候，骨折便成為首先出現的『症狀』。若醫生認為您有患骨質疏鬆症的危機，便會替您進行骨質密度檢查，較常用雙能量X光檢查（DEXA）。

骨質疏鬆症 – 預防及治療

1.       運動及均衡飲食。適量運動及攝取充足的鈣質和維他命D可增加骨質形成。建議諮詢您的骨科醫生及物理治療師去度身訂造適合您的運動和餐單。

2.       藥物治療。目前，有多種用於治療骨質疏鬆症的藥物，當中以雙磷酸鹽為治療的首選，雙磷酸鹽是一種能抑制骨質分解及流失的藥物。

3.       骨科手術。骨科醫生診斷骨質疏鬆症的嚴重程度。如果合適的話，骨科醫生會建議進行手術處理骨折或骨骼脆弱的部分。

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。

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.