BACK PAIN 

 

Back pain is pain felt in the back.Back pain is one of the most common reason for which  people go to the doctor. It is a leading cause of disability worldwide.

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Causes

• Muscle or ligament strain

• Bulging or ruptured discs

• Skeletal irregularities. 

• Spinal Injury and Vertebral compression fracture

• Metastatic Cancer

• Osteoporosis

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 Signs and symptoms of back pain –

• Muscle ache

• Stiffness in back

• Shooting or stabbing pain

• Pain that radiates downleg

• Pain that worsens with bending, lifting, standing or walking

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Danger Signs-

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Seek immediate care if  back pain:

• Is severe and doesn't improve with rest

• Spreads down one or both legs

• Causes weakness, numbness or tingling in one or both legs

• Causes new bowel or bladder problems

• Is accompanied by fever

• Follows a fall, blow to back or other injury

• Is accompanied by unexplained weight loss

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Treatment

Most of the patients with back pain can be managed medically with drugs, physiotherapy , proper posture and life style modification. Patients who do not improve or worsen with medical management are candidates for surgery. There are different types of surgeries depending upon the type of pathology. When a herniated disc is compressing the nerve roots, microdiscectomy or endoscopic disectomy (MISS) may be performed, in which the disc material compressing on the nerve is removed.  When the vertebrae are unstable, spinal fusion surgery may be performed.  If infection, such as a spinal epidural abscess, is the source of the back pain, surgery may be indicated when a trial of antibiotics is ineffective. For metastatic disease different options are available depending upon the the pathology as surgery, radiotherapy and chemotherapy.

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NECK PAIN

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Pain is the neck region with stiffness and difficulty in neck movement.

Causes-

• Muscle strains due to improperposture and long working hours.

• Nerve compression- Herniated disc or bone spurs in the vertebrae  neck can press on the nerves branching out from the spinal cord.

• Injuries as whiplash injury, bone fracture

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Symptoms

In most cases, there is pain in the neck, stiffness, and occasional headache. Neck pain may spread to the shoulders, arms and hands, and the base of the skull. There may be numbess and tingling sensation in the hands.

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Danger signs-

When pain is accompanied by any of the following -

• Weakness in fingers and limb

• Inability to move arms or hands

• Difficulty in walking, frequent falls

• Bladder or bowel dysfunction

• Weakness in legs

• Tightness in limbs with electric current like sensation

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Treatment-

Most cases of neck pain can be managed medically with drugs and neck exercises. Those patients who don’t improve on medical management or who have progressive weakness and are deteriorating are candidates for surgery. Depending upon the pathology there are different surgical procedures as ACDF , Laminectomy  with fixation, tumor excision.