When should are worry about my back pain/ consult a specialist?
Back pain is extremely is common. However, when associated radiating pain, numbness, tingling, weakness in arms/ legs or urine/ motion incontinence/ disturbances, it is recommended to consult a specialist. These are known as ‘Red Flag’ symptoms. These need to be taken seriously in children/ elderly, a person having fever, weight loss or anorexia, some known infection or tumour or a recent history of injury to spine.
Do I need to get an X-ray / CT scan done if I have a MRI?
MRI is an extremely sensitive investigation. It shows the soft tissues like disc and neural structures- spinal cord and nerve roots and their pathologies. However, MRI does not delineate the bony structures as clearly as CT/ X-rays. Similarly, MRI is done in lying down position which is the position of comfort for most patients. X-rays can be done while standing, bending forwards/ backwards which shows the biomechanical relations of vertebral structures better. Hence, it is recommended to get X-rays/ CT scan done in addition to MRI.
If the specialist has recommended an MRI, is it likely that he would recommend a Surgery?
Most spinal ailments (almost 90% of them) don’t require surgery. Most of the times, patients become completely fine over a period of 3-6 weeks. Usually, there is no emergency either. It is only when a person develops weakness in arms/ legs, has urine/ bladder incontinence or in fractures – is an urgent surgery recommended. Even if a surgery is recommended, it is solely a patient’s decision whether and when to have one. The doctor only advises what the best treatment to allay patient’s suffering is.
I repeatedly have back and neck pain. Is this worrisome?
Back and neck pain is extremely common. 80% of world population suffers from back pain once in lifetime. It is most common cause of absenteeism from work after common flu. Unless there is structural cause to your pain, these are benign and self-healing with rest, medications and physiotherapy. In most recurrent cases, the underlying condition is related to poor posture, sedentary lifestyleand poor nutrition. A nutritious diet rich in vitamins, regular exercise and rehabilitation with postural training and core strengthening exercises is recommended.
Is bed rest the best treatment to cure spinal ailments?
Bed rest is usually not recommended for more than 3 days as per recent literature unlike conventional treatment. Even in fracture (if stable) patient is not advised prolonged bed rest. Patients are recommended to listen to their body- Continue activities which do not cause pain and avoid those which aggravates it. Generally, bending forwards, lifting weights and sitting on floor are to be avoided.
Should I continue wearing belt to treat/ prevent spine problems?
Belts and braces are recommended to provide temporary external mechanical support. During back/ neck pain, doctor might recommend to wear to for a few weeks. Prolonged use of belts might cause atrophy of muscles supporting the spine.
What should I do during an episode of ‘Back / Neck Spasm’?
Back and neck spasms are usually disabling crippling a person to bed. They can happen to anyone anytime. During such episodes rest is advised. Modification of activities- avoiding which aggravates pain is recommended. Avoid bending forwards and lifting weights. Active physiotherapy exercises are not to be done, however, passive treatment like TENS/IFT can be done. Local application of gels/ cold or hot fomentation may be helpful. You should visit the doctor, so that medications can be prescribed. Kindly see When to Visit a Specialistabove.
If a patient undergoes spine surgery- will he be on prolonged bed rest?
Spine surgery is recommended to keep the patient independent and as active as possible. Usually, after spine surgery, patient is made to walk on the same/ next day (if there is no weakness of arms/ legs). The aim before discharge is that the patient can carry out his activities of daily living on his own. Most patients resume all previous activities are recovering from spine surgery.
Are spine surgeries safe?
Spine surgeries have recently evolved greatly. Advanced technology, modern instruments and implant system, high magnification with microscopes have made spine surgery extremely safe. A surgery is advised by the surgeon only if he feels the benefits of surgery are more than the risks. All activities – for example, travelling by flight, crossing a road etc. have risks. These risks have to be understood and taken to get better. These are well explained by your surgeon before the surgery.
Are spine surgeries successful?
Spine surgeries have very high success rates. To explain it, let’s put it this way- suppose you catch a flight from Mumbai to Delhi- usually you reach on time, sometimes you get late and rarely things turning bad. Same is with spine surgery- most of the times you achieve the desired results, sometimes it may take time and rarely things go bad.
Patients who undergo spine surgery develop paralysis? Is this true?
There are two types of such patients. First, those who had paralysis before the surgery. This usually happens due to compression of nerves. The aim of surgery s to relieve the compression and allow the nerve to heal. There is no medicine till date that expedites this healing. The recovery is dependent on numerous factors like severity, duration of compression and patient’s innate capacity to heal to name of few. Hence, when a person with deficit before surgery, guarded prognosis is explained. However, literature reports patients recovering extremely well even in these circumstances. Second group of patients develop weakness after the surgery. The chances of this happening is miniscule in most cases and is usually explained before the surgery.
I have severe back/ neck pain? Will I benefit from surgery?
Unlike common perception, spine surgeries are not recommended for back/ neck pain unless there is a mechanical cause like instability, tumour, fracture, infection, etc. attributable to it. Spine surgeries are done to relieve neurological compression which usually cause arm/ leg pain and weakness. Back/ neck pain is treated with conservative treatment most of the times.
What is Minimally Invasive Surgery? Can I undergo the procedure?
Any procedure that achieves the aims of conventional surgery causing less collateral damage is known as Minimally Invasive Surgery. You can undergo the procedure if your surgeon feels that you are the right candidate for the same.
I regularly take Calcium supplements, will I develop Osteoporosis?
Osteoporosis is decrease in bone mass which usually occurs due to increasing age and is inevitable. It is recommended to maintain normal calcium and vitamin levels in the body. However, there are medications to prevent and treat osteoporosis. Do consult the doctor for the same.
What are natural sources of calcium and vitamins?
Mild and milk products, green leafy vegetable and fruits are good sources of calcium and vitamins for vegetarians. Eggs and fish are recommended for non-vegetarians. Sunlight exposure between 11 am – 3pm for 15-20 min daily is advised. In spite of these, many people have deficiencies and need supplements to maintain normal levels.
What is ‘text neck’ syndrome?
Recently, due to prolonged use of mobile phones and tablets, there is increased incidence of neck pain. The idea is to avoid such long usage. Also, mobile should be brought at a convenient level rather than bending the neck to use it.
Can traction cure my back/ neck problem?
It was assumed that mechanical traction may act on soft tissues to treat the pathology. However, no conclusive evidence is present till date. It is mainly used as a method of rest and immobilization.
What kind of mattress is recommended?
A firm mattress made of foam and coir is advised. Popular beliefs like sleeping on hard bed or on the floor to treat spinal ailments holds no ground. Soft mattresses and pillows are not recommended either.
Are the implants used in spine surgery safe? Do they need to be removed later? Will they buzz while passing metal detectors?
Implants used in spine surgery are extremely safe. They are usually made of titanium and PEEK (Poly ether ether ketone). They are bio inert and bio compatible. They are extremely strong. They do not require a surgery for removal most of the times. They may buzz while passing through metal detectors. It is recommended to carry doctor’s certificate/ X-ray while travelling.
If I have spinal TB, are my family members at risk of contracting it through me?
Spinal TB does not have person to person transmission. However, if you have Pulmonary (Lung) TB you can spread the infection. Your doctor will guide you for the precautions to be taken.