2019年2月20日星期三

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.


Back pain - treatment

1.      Physiotherapy. It can be classified as active and inactive treatment.

Active – effectively strengthen the patient’s muscle through persistent specific exercise.

Inactive – relieve pain in specific position through micro-current therapy


Misconception:

Many patients believe that reductions of physical activity can relieve their pain conditions, however, it is incorrect as physical acticity can help to strengthen your muscle and relieve the pain in long term. You are recommend to consult physiotherapy to personalize an exercise plan for you.


Medication

Depends on the severity of pain, orthopaedic doctor would prescribe oral medications for pain reliever. If needed or pain persist, orthopaedic doctor may recommend for intramuscular or percutaneous injections of nerve blocks to control your back pain.


Surgery

Orthopaedic doctor would recommend for orthopaedic surgery if needed, especially for patients suffering:



i.                    Medications and physiotherapy treatments cannot manipulate the back pain

ii.                  Incontinence caused by nerve compression

iii.                Progressive muscle weakness caused by nerve compression

iv.                No improvement of pain conditions after 4-6 weeks physiotherapy treatment.








references: 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 orthopedic doctors for diagnosis and treatment.

2019年1月23日星期三

人工關節用10年 再開刀風險大

人工膝關節置換手術一般用於治療退化性或類風濕關節炎,有骨科醫生指,亞洲人膝頭退化問題常見,隨着年紀增長,若軟骨組織磨蝕嚴重至影響日常生活,「有病人行路15分鐘就痛得好緊要」,「換骹」為治療的最終方案。


隨年齡增長軟骨易磨蝕

關節置換手術目的是把磨損的膝關節,以鈦金屬及纖維膠做的人工關節代替。骨科專科醫生張啟然指,膝關節退化程度主要受基因和年紀因素影響,「有啲人軟骨快啲磨蝕,有人慢啲,視乎軟骨嘅強度、耐唔耐磨」。隨着年齡增長,關節之間分泌逐漸減少,膝關節因長年累月磨擦而勞損,有機會導致膝頭關節痛、紅腫、僵硬或行動困難等症狀,嚴重可引致關節變形。

張啟然指,一般會建議患者先接受較保守治療,如在膝關節注射透明質酸,「好似汽車換偈油」,以減慢軟骨磨蝕,若情況未有改善,「換骹」為最終治療方案。他指一般只建議65歲以上患者換骹,因人工關節組件壽命有限,「就算個手術做得好好,一般都係用十幾年就會磨蝕返」,需再開刀更換人工關節,「個手術就會再複雜好多,風險亦大啲」。

張啟然補充,人工膝關節置換手術過程中,有機會引致神經損傷、骨頭爆裂、細菌感染等併發症,但他強調現時技術發展成熟,手術風險算低,「發生機會率係細過百分之一」。




 






參考資料:https://hk.news.appledaily.com/local/daily/article/20180429/20376100
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,
應向自己的骨科醫生查詢,而不應單倚賴以上提供的資料。