As Dr Knut Schroeder explains, "No such thing exists as a standard cure for back pain". There are many different types of treatment available from a range of different specialists. The one thing most doctors advise is that bed rest is usually not appropriate because it can slow the recovery. So, it is (in most cases) important to get on top of the pain and to keep gently moving.
When to get medical advice for back pain:
- When the pain travels from your back and into the chest area
- If you have a history of cancer or a depressed immune system (due to steroids, chemotherapy or infection)
- Loss of sexual function
- Following major trauma such as an accident (or minor trauma in the case of weak bones e.g. osteoporosis)
- If over 50 and you get new back pain
- If under 20 and you get new back pain
- Pain that prevents you from sleeping
- Numbness or lack of sensation around the bottom or 'saddle area', anus or genitals
- Problems walking
- Sudden muscle weakness
- Trouble passing urine of opening your bowels
- Unexplained night sweats, fever, weight loss or tiredness.
When Back Pain gets worse
To get on top of the pain and to get active usually requires adequate pain relief. If symptoms don't improve or get worse it is worth considering seeing a chiropractor or osteopath, or speak to your GP about about other options including physiotherapy, as well as different types of medication.
Assessing Loss of Spine Movement
A major contributing factor to the cause of back pain is movement, or loss of movement. Pain in one area of the spine may cause muscles to lock and protect that area, sometimes leading to over-use in other areas. However, until recently it has been difficult for doctors and physiotherpists to objectively assess precise locations and therefore recommend accurate treatment regimes.
An objective assessment of back movement and muscle activity in individual patients is therefore an ideal starting point, and increasingly the lead sports physicians are using the latest forms of back bio-sensors such as Dorsavi to help assess both their athletes and normal patients.
Treating Sciatica
As Dr Nigel Kellow explains, Sciatica is pain caused as a result of pinching, pressure or damage to the sciatic nerve, The pain from sciatica is normally felt in a line starting as high as the low back, but more often in the buttock. It then travels either down the back of the thigh and calf and into the heel and sole of the foot, or it travels down the outside of the thigh and calf to the ankle and outside of the foot. The route it takes is important as that helps to determine which lumbar nerve roots have caused it. For full information see - The Ageing Spine
Anyone diagnosed with sciatica can be referred to a specialist consultant in spinal medicine or surgery. The consultant will take a full history to try to establish what may have caused the problem, and examine the patient to see how the problem has affected things like posture, flexibility, and nerve function. It is then important to get some imaging of the spine and nerves to visualise and characterise the problem. MRIs show extraordinary detail of bones, ligaments, nerves, and intervertebral discs.
If you develop sciatica or brachialgia you should be evaluated and cared for by a spinal specialist who will know when to recommend that you have surgery.
Weighing up the pros and cons of Surgical Treatments
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Bleeding,
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infection, and
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general medical problems,
- whether to proceed to surgery, and if so
- when,
- what sort of surgery to have, and
- by whom,
Safest Forms of Surgery for Sciatica
Endoscopic Microdisectomy has particular advantages for those patients suitable for this form of intervention as the operation is performed through an incision no bigger than a needle puncture. The endoscope is far more gentle and precise as a technique, there is much less tissue damage and scarring. This means that the incidence of subsequent pain (both in the muscle and wound) is greatly reduced. Most patients are able to go home the same day. Also, because of the precision and gentleness of the system it is virtually bloodless.
As Spine Specialist, Mr Irfan Malik says, "The procedure is performed through a needle puncture, usually without the need for general anaesthesia, using sedation and local anaesthetic alone. This means that the risks inherent with a general anaesthetic are avoided."
