Category Archives: Spine Treatment

Cervical-Lumbar

Cervical and Lumbar Spine Diseases

The spinal cord is protected by the bones of the spine as it travels from the brain to lower back, with a number of spinal nerve travelling across the spine to reach arms and legs.

To exit from the bony tunnel of the spine itself, the spinal nerves travel through holes in the bones which are separated by discs or shock absorbers. If these nerves are squashed or pinched, this can cause pain, numbness, weakness or loss of function in the limbs (sciatica).

There are many bones running up and down the spine, each separated by a jelly-like core and tough outer fibrous structure called a disc.

The nerves travel to the left and right of the spine through space called an intervertebral foramen. Either these nerves or the spine itself can be compressed by either further growth of bone, instability of the bone, or bulging or bursting of the disc ( disc prolapse ).

The symptoms to be particularly aware of are:

  • pain in neck/back
  • pain radiating to arms/legs
  • pain after walking / standing/sitting for too long
  • Weakness and numbness in arms or hand/legs or feet.
  • Balance problems.
  • Loss of function in the arms or legs.
  • Pins and needles sensation  in the limbs
  • Diminishing bladder control.

Investigations

After a thorough history and investigation, you may be required to have an x-ray, CT scan or MRI to look more closely at the bone and soft tissue structures around the neck.

Treatment

REST, MEDICATION AND PHYSIOTHERAPY, generally cure most patients in short term. But most pain can reoccur if your ergonomics (working and sitting posture) are not right. Long term solution to a problem is EXERCISE AND the RIGHT POSTURE.

Surgery

Sometimes surgery is required if the pain is severe and not responding to conservative therapy. Certain types of compression require surgery to prevent nerve damage from becoming permanent or irreversible. Surgical options include removing excess bone, removing bulging discs, fusion or stiffening of bones to remove instability or replacing dysfunctional discs. The disc can be removed with very minimal incision using endoscopes ( ENDOSCOPIC DISCECTOMY)  or sometimes open surgery is required to fix ( TLIF )the spine segment and to decompress the nerves.

WHAT CAUSES  SPINE PROBLEM

Since the IT boom, we are growing very fast economically and digitally. But somewhere compromising health especially our back and neck, Due to a prolonged sitting hour (10-12 hrs) on computer and top of that some of you are travelling to Noida /Gurgaon, again sitting for 2-3  hrs too n fro. This article is all about pains in the back, neck, shoulder, forearm and legs from which you may be suffering, the pain doesn’t correlate to your work.

“Mr X doesn’t wear a hard hat to work. He doesn’t lift heavy objects nor does he operate heavy machinery. Actually, Mr. X wears fairly comfortable clothing, and he doesn’t need to exert a lot of physical energy to accomplish his tasks. He sits at his desk from 8 a.m. to 5 p.m., Monday to Friday, and the only machinery he has to operate is a mouse and keyboard. Sitting in his office, Mr. X is generally safe and secure from injury………but still suffers from pain.”

Our bones and muscles make up our musculoskeletal system. As strong as this system might be, overuse of the muscles through repeated movements can put stress on your body, causing a Repetitive Strain Injury (RSI). Other names for RSI include Cumulative Trauma Disorder and Repetitive Motion Injury. Unfortunately, many office jobs require that we perform repetitive motions to fulfil our duties. For this reason, RSIs are the most common type of injury found in the office.

Symptoms of RSIs The first signs of an RSI may be subtle and mild, and the symptoms may appear long after performing the activity. For these reasons, people often ignore slight aches and pains, but eventually, these slight aches and pains can become serious problems down the road if ignored. Symptoms may include: • Dull aching • Loss of sensation (numbness), especially at night • Aches/pains which may be worse at night • Tingling and burning sensations • Swelling around the wrist/hand • Dry, shiny palm • ‘Pins and needles’ discomfort • Clumsiness (loss of ability to grasp items, impaired thumb and finger dexterity • Muscle weakness and fatigue • Muscle spasm • Joint restriction/loss of movement • A ‘crackling’ feeling when swollen tendons are pressed tightly • A cyst-like swelling or node, known as a ganglion, near a tendon or joint

Injury to the spine is very common in the office environment because constant sitting (desk job) either working on laptop or desktop, spine (lower back) is at risk. Because sitting causes 150%-200% stress on back while standing just 100%, sitting with a laptop is worse than desktop because of poor posture with a laptop. This constant sitting is just like a small drop of water in a big bucket, over a period of time bucket is filled, water splashes out, that is the time when people experiences severe pain. Getting treatment just takes out a few mugs of water but that little drop (constant sitting) still coming to a bucket. That means pain may reoccur. So what to do…”..STOP THE LITTLE DROP

HOW TO SAVE BACK & NECK FROM SITTING JOB STRESS
  • AVOID PROLONGED SITTING > 45 MINS –  do not sit more than 45 min at a stretch, get up after 45 mins take 2 min walk than sit again
  • AVOID FORWARD BENDING –   Bending forward causes double the stress over neck n back, our head wt is around 5 kg which increases to 30 kg if we bend our neck up to 60 degrees. so keep your head centre of shoulders. if u want to bend n lift something from lower down than bend from knee and hip as well so that stress on the spine is less.
  • AVOID HEAVY WT LIFTING – keep ur back as straight as possible while lifting wt or ask for help while lifting heavy wt.
  • FULL CHAIR SITTING – Try to sit in the office chair with hips at the back of a chair and back fully supported with backrest, by this your back is fully supported n slightly backwards tilted, keeping stress low on spine . do not sit half chair.
  • LAPTOP TO DESKTOP – with laptop one has to bend forward and work as in laptop screen and keyboard is so close to each other that you cant work without bending forward. So dissociate screen from the keyboard by using an external keyboard( preferably wireless ) and external mouse with laptop stand to keep the screen at your eye level.
  • HOLDING MOBILE AWAY FROM BODY –  So that neck does not bend too much for long, keep the neck as straight as possible.
  • NEVER WORK IN  BED OR WITH  BAD POSTURE – as it causes severe stresses on back and neck
  • DAILY EX-  Daily exercise of neck and back strengthens muscles so that they can take stresses of sitting
Low-Back-Pain

Low Back Pain

Low Back Pain is a very common condition (second only to the common cold), most of the individual at least once in a lifetime suffers from back pain. This is the price we are paying for standing erect.  It is not only a problem of old people – 50% of children will have experienced back pain by the time they reach 15.

Low back pain is a common problem and is caused by many different things. Often a definite source of the pain is never found.

Recovery Is The Rule but  recurrence too

Fortunately, low back pain is mild and short-lived in most cases. 80 to 90% of people with acute low back pain recover within a week but sometimes it can take longer. Serious injuries are uncommon and can be identified relatively easily.

Unfortunately, low back pain has a bad habit of recurring from time to time. Do not be surprised if you have more than one episode.

What To Look For

Some symptoms should be taken seriously if associated with back pain:

  • The young (<15 yrs) and the elderly (>60 yrs ).
  • Pain at night more than during the day or when resting pain is more than activity.
  •  weight loss > 10 % body wt .
  • fever
  • Sudden severe pain after trivial trauma (a simple fall).
  • Repeated infections.
  • Sharp pain that radiates down the leg to the ankle and foot.

Contact your orthopaedic in Delhi immediately if you experience these symptoms.

Treatment

The medical evidence in favor of early, progressive activity and avoidance of bed rest of more than 3-5 days for the management of Low Back Pain is substantial. Early activity and exercise are the keys to the successful management of acute low back pain.

REST, MEDICATION AND PHYSIO, generally cure most patients for the short term. But most pain can reoccur if your ergonomics (working and sitting posture) is not right. Long term solution to the problem is EXERCISE AND RIGHT POSTURE.

Individuals who remain active and physically fit have fewer recurrences (and their attacks are also shorter). There is ample evidence that bed rest for more than 3 or 5 days is not an effective therapy and often delays recovery.

Surgery

Back surgery is only required in very few occasions (less than 1%). There are different types of surgery but low back pain (generally) is NOT a surgical condition.

Medication

Orthopaedic doctor in Dwarka may prescribe medication (usually painkillers and anti-inflammatory tablets). They all have the same goal (to reduce the pain) but their effects are different. Make sure that you take your tablets as you have been advised.

Even if you need to rest in bed, you should be active (up and about) at least one hour every day doing physical activity (like walking up and down the corridor, or in the garden, street or local park).

Prevention

Low back pain is often the result of a combination of factors…

  • Poor physical condition.
  • Poor health.
  • Bad postural habits.
  • Stress and lifestyle.

In children hamstring, tightness and hours spent in front of the television are also risk factors for low back pain. A healthy lifestyle, regular exercise and identifying the causes of stress are the foundation to prevent or minimize low back pain.

Low back pain is frequent but generally not serious. Most people recover quickly.

  • AVOID PROLONGED SITTING > 45 MINS –  do not sit more than 45 min at a stretch, get up after 45 mins take 2-5 min walk then sit again
  • AVOID FORWARD BENDING –  Bending forward causes double the stress over the neck n back, our head wt is around 5 kg which increases to 30 kg if we bend our neck up to 60 degrees. so keep your head in the centre of your shoulders. If u want to bend n lift something from the lower down then bend from the knee and hip as well so that stress on the spine is less.
  • AVOID HEAVY WT LIFTING – keep your back as straight as possible while lifting wt or ask for help while lifting heavy wt.
  • FULL CHAIR SITTING – Try to sit in an office chair with hips at the back of the chair and back fully supported with a backrest, by this your back is fully supported n slightly backwards tilted, keeping stress low on the spine. do not sit half-chair.
  • LAPTOP TO DESKTOP – with a laptop one has to bend forward and work as the laptop screen and keyboard is so close to each other that you can’t work without bending forward. So dissociate the screen from a keyboard by using an external keyboard(preferably wireless) and an external mouse with a laptop stand to keep the screen at your eye level.
  • HOLDING MOBILE AWAY FROM BODY – So that neck does not bend too much for long, keep the neck as straight as possible.
  • NEVER WORK IN  BED OR WITH  BAD POSTURE – as it causes severe stress on back and neck.
  • DAILY EX- Daily exercise of the neck and back strengthens muscles so that they can take stress of sitting.
  • Take enough painkillers or anti-inflammatory tablets (as your orthopedic in Delhi has advised you). Do not wait “until the pain is bad”.