Many suffer from back pain, and studies estimate that about 23% of the global adults suffer from, and this means that about 900 million people on the planet suffer from back pain, so what are the most prominent reasons for this condition? What are the treatments available? And when is surgery resorting to dealing with it?
These and other questions were answered by Dr. Imad Abu Rayan, the consultant of the first orthopedic and joint surgery, and a graduate of William Monastir University in Germany, at Al -Jazeera Clinic.
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Why did the back pain become so common?
If we come to a simple statistic, which is the number of patients we receive daily, it is the recognized Muslim that one out of every 3 patients visit the orthopedic clinic or the family clinic.
The issue of sitting, for example, is one of the most negative issues that negatively affect the lower back how to stand and walk, and this is also what we find for many patients that he tells you that if you move, he begins to hide my pain, and this is from the ground and this is what we hear from the mouths of patients over and over again.
The issue of obesity, for example, is one of the diseases that you can find very common, and this is also one of the things that causes this pain in the lower back. The issue of imbalance between the strength of the abdominal muscles and the strength of the back muscles, and this negatively affects the spine.
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What is the relationship of a problem with the abdominal and back muscles and the feeling of spine pain?
With regard to our bone and muscle system, there is a consistency between the muscles in its roles, so anatomy is the spine is present in an area surrounded by abdominal muscles and back muscles, and the process of tightening the abdominal muscles helps to maintain the straightness of the spine, and accordingly when the weight occurs, the muscles present in the abdomen are weakened, which causes the vigil of the curvature of the spine or its infection and the spine becomes convex and this increases the pressure on Paragraphs.
One of the constant matters in physical therapy, and in physical therapy in sports medicine that the strength of the abdominal muscles is in the interest of protecting the spine from being exposed to overwhelming pressure, milan or deviation.
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How can the abdominal muscles be strengthened?
With my own perception, it is necessary to balance the food, the balanced diversity must be primarily, and to maintain physical activity, and thus can be preserved with strong belly muscles that can support the back. Also, physical activity should take into account the patient’s health condition, for example, the youth in the twenties is not like what patients do in the 1940s.
One of the cases I have that I follow has a herniated disc. We do not start by restoring flexibility of the spine and improving the level of movement in the spine. We try to start from this point. It is a central thing in the treatment of patients, either before surgery, after surgery, or during conservative treatment.
- One of the most prominent recipes used to treat back pain is the use of oils. We talk specifically about olive oil. Is it a suitable treatment for back pain?
I expect to use any oil and do massage movements will have the same effect.
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Is Chinese needles effective to treat lower back pain?
Chinese needles are effective and proven and are now among the subjects taught in universities, and also medical certificates from medical unions.
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What are the treatments used for back pain?
What is customary and what has proven successful in this topic is non -surgical treatments, i.e. conservative treatment, and it includes medications, and here we mean anti -inflammatory drugs in the first place, and we do not mean to go immediately to the pain relievers, the pain reliever is used in acute pain attacks, and this requires mostly the patient’s entry or the patient undergoes clinical control and that he is in the hospital. In the event that he is in the clinic for the patient usually, we resort to anti -inflammatory, and inflammation is a series of reactions that are in the muscles in the nerves in the skeleton that causes this inflammation, and causes edema (fluid gathering). Through anti -inflammatory, fluid gathering, and accordingly, pains the pain depends on the effect of the anti -inflammatory. This differs from stopping the nervous signal or an paintings from the place of pain to the center and the nervous system in the human body, this is what happens in the case of analgesics.
So this first step. After improving the position of pain and improving the position of inflammation, the patient is ready for a physiotherapy journey. We always recommend that we get rid of part of our pain before starting physical therapy. The reason for this is to keep the patient from any counter -reaction. For example, if there is severe muscle spasm. It is preferable to give it a muscle relaxation to the patient. The reason for this is if the patient begins physical therapy and is still suffering from severe tension and acute muscle spasms. The reaction will be inverse. The patient’s reaction accordingly will also be inverse. Meaning, he will try to avoid physical therapy and he needs it. The patient must be prepared for this trip. Therefore, we always try to create an awareness atmosphere for the patient in the clinic. In the sense of what is the first, second and third step. What is the reason for arranging these steps? What is expected from these steps?
The third step if the patient does not improve is cortisone injection. This is a third step. But it is not as common. The first and second step.
In the injection, there must be an anesthetic substance in order to ensure that the procedure is without severe pain, enough for the patient to suffer from the pain of his back. We do not want his pain to increase. The place must be anesthetized, the cortisone is injected, preferably cortisone. With heavy weight, it means that they are molecules so that you cannot reach from the injection place to the blood circulation in the patient’s body, and that they remain in the tissues, most of which are crystal crystals that are injected in this place and melt over time, so their effect is not immediately effective, but the effect in the first 72 hours is the effect of the drug. After that (after the third day) these crystal molecules begin to melt in place.
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As long as it dissolves, how much does it continue?
Depending on the existing studies, the least time we can wait for the needle is 6 months, and there are some cases that continue to improve for years, and some cases can take the injection once and now the sixth, seventh and eighth year passes it, praise be to God without any pain.
If we cannot get 6 months, it is the minimum. The patient will return 6 months ago. Thus, we have benefited from the other part of this needle. The needle is an examination and treatment at the same time, meaning if the improvement is less than 3 months- 6 months. For weeks or days, this proves to us that the condition requires more intervention and treatment, and in this case surgical treatment may be.
Therefore, in some cases that are unclear, we try to avoid the patient, as we submit it to the needle and it is aware that the needle must be performed with the aim of treatment first and also for the purpose of examination. It is a test, so if things calmed down and the patient improves, and we continue for a long period of time to improve here, we make sure that we were able to avoid the patient. But if the patient came after 3 days and his experience was that during the first 24 or 48 hours he was in a tremendous and wonderful improvement. But then, unfortunately things returned to what they are. This is evidence that it is necessary to resort to treatment and more treatment than the needle.
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So this is the answer to our question, when is surgery resorting to? Is after using previous approaches?
Of course, in this regard, there must be something, there are some cases that we receive will have aggravated. Meaning when the patient attends and has a nervous symptom, meaning muscle delay, God forbid, muscle weakness, paralysis, sensory delay (what is known as numbness), in this case the surgical procedure is a need and not an approach, meaning that I will not have an area to offer the patient an alternative to surgery because the condition does not tolerate the delay, and it is intended to weaken the muscle that the patient can, for example, if he is on the status, if he is exposed to the stairs, it is necessary for it. As usual, he cannot descend the stairs smoothly. As for the issue of paralysis, the patient cannot stand on his foot and cannot move it. Here there is a limited period of time to save what can be saved.
In the midst of this conversation, it must be ensured that the patient still has some vital functions that we may not directly link with back pain, for example, urine control and stool, and some patients are asked immediately, are you surprised by the exit of urine without any control? What is known as urine incontinence, in this case, it is necessary to perform the procedure at full speed. The muscles of the bladder and the anal muscles lose their strength and lose control of the output, so in these cases and to maintain the quality of life, the patient must be informed of the maximum need for surgical procedure.
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Is there a relationship between back pain and stomach infections?
Yes, this thing exists, there are some infections that may affect the stomach, the digestive system, the urinary system and may also affect the respiratory system that can cause pain in the joints, for example it is known that if the child is exposed to a cold, he can be exposed to pain in the hips, knowing that no infection has occurred to the hips, and even in the case of examining the hips we do not find any real inflammatory sign for them, but it is known that if the patient is exposed to a cold attack or a fever that usually accompanies pain. In the muscles, this is slightly different from the pain of musk, the pain of the cotton vertebrae or the cervical vertebrae in the patient, so most of it is muscle pain and the pain of joints more than anything else.
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Is there a relationship between back pain and cancer?
Sometimes back pain is the last sign of cancer, after the spread of cancer, for example, from its source to the bone. There are many types of cancer whose end is the cause of cancerous injuries in the bone, especially the spine.
Usually, patients are asked, is there any cancerous disease? Patients are also asked about the three famous questions to which any patient suspected of this malignant disease is exposed to the issue of severe weight loss without desire without any diet, physical fatigue, and continuous lethargy, these are syndrome matters and come with each other.