BACK AND SPINE DISEASES

BACKACHE

Low back pain is one of the most common reasons for hospital admissions. It also causes loss of workforce. Many people experience back pain at some point in their lives. Studies have shown that 7 out of 10 people in the society face the problem of low back pain at some point in their lives. Fortunately, measures can be taken to relieve lower back pain. If the measures fail, recovery can be achieved after simple home treatments and appropriate exercises. Surgical treatment is rarely preferred for low back pain.

Low back pain manifests itself in several ways. There may be muscle pain, stabbing sharp pain, pain radiating down the leg, pain that worsens with bending forward, standing or walking, and pain that is relieved by leaning on a place.

Low back pain usually starts suddenly. Most low back pain gets better within 6 weeks. This type of pain is usually caused by a fall or heavy lifting. The cause of many low back pain can be determined by a physical examination by your doctor. If the diagnosis cannot be made, imaging methods (such as plain X-ray, MRI…) are helpful. Conditions that commonly cause low back pain include: Stretching of muscles and ligaments; Weakness in the lower back muscles and ligaments, or after lifting a load, low back pain may begin. Low back pain may occur if there is contact with nerves as a result of herniation or rupture of the discs between the vertebrae. However, herniation in the discs does not always cause low back pain, they can only be detected in MRI images taken for other reasons. Curvatures in the spine usually cause low back pain in older ages. In osteoporosis, compression fractures in the vertebrae can also cause low back pain.

Anyone, including children and teenagers, can suffer from low back pain. To address the risk factors for low back pain: The risk of developing low back pain increases with age. In general, the frequency starts to increase in the 30s. People are at risk for low back pain in cases such as being overweight, weak waist and abdominal muscles, some rheumatic diseases, lifting or carrying loads in the wrong position, depression or anxious mood, and smoking. Gallstones, kidney stones and kidney disorders, urinary tract infection, pain caused by intra-abdominal vascular damage can also manifest itself with low back pain.

PROTECTION FROM BACK PAIN

We can prevent low back pain by improving the physical condition of our body and by learning the mechanics of our body and acting accordingly. Regular walking or swimming increases the endurance of the lower back muscles. When we strengthen the abdominal and back muscles, our muscles will act as a natural corset. You can learn exercises that will strengthen the waist and abdominal muscles from your doctor or physiotherapist. Losing excess weight also protects the person against lower back pain.

There are 3 basic pieces of advice I give to my patients to avoid low back pain. First, stand straight (don't slouch, if you have to stand for a long time, put a step under one foot and change your foot on the step frequently, good posture reduces the load on the lower back muscles). Second, sit properly (the seat you will sit on should have lumbar support and armrests, if there is no lumbar support, place a small pillow in your lumbar cavity. Change your sitting posture every half an hour). Third, lift properly (if possible, do not lift heavy loads, if you are going to lift heavy loads, keep your back straight and only bend your knees to load the load on your legs. If possible, get help from someone else to carry the load). If we pay attention to these three things, the possibility of low back pain is considerably reduced.

What should we do when back pain starts? For mild low back pain that has just started, rest for the first two days by leaving your normal physical activity and apply cold to your waist these two days, from the third day you can apply hot application for your pain. Lie on your side and pull your knees towards you, placing a pillow between your legs. A warm bath and a gentle massage to your waist will relax your muscles and reduce your weight. If your pain does not go away within 3 days, you should definitely consult a specialist doctor. Your doctor will identify the underlying cause and start treatment accordingly.

CURVATURE of the SPINE (scoliosis)

Curvature of the spine (scoliosis) usually occurs during a growth spurt in children just before puberty. Although scoliosis is caused by conditions such as cerebral palsy and muscular dystrophy, the cause of most scoliosis is unknown. Approximately 3% of adults in the community have scoliosis. Most cases of scoliosis are mild, but some spinal curvatures can become more severe as children get older. Severe scoliosis can cause health problems. A particularly severe spinal curvature may reduce the amount of space in the chest, resulting in decreased breathing capacity and lung problems. In this article, we will talk about spinal curvatures that occur during adolescence.

Scoliosis is more common in girls than boys. Although having scoliosis in the family increases the risk, most scoliosis patients do not have a family history of spinal curvature. Curvature can progress rapidly during the growth spurt of children.

If your child does not have equality at both shoulder levels, especially if there is a unilateral hump in the waist, if the pelvis bones are not at the same level at the back, if the shoulder blades are not symmetrical, a curvature of the spine should be suspected. Low back pain does not usually occur in scoliosis, if there is low back pain, other disorders that cause pain in the spine should be investigated together with scoliosis.

When suspected of curvature of the spine, you should consult an orthopedic and traumatology specialist. After the orthopedic examination, an x-ray film is taken to include the entire spine to determine the degree of curvature. The degree of curvature is measured on the film by the doctor. If the child has pain with curvature and additional findings are detected in the doctor's examination, further evaluation with MRI or computed tomography may be required.

TREATMENT OF SPINE CURVE (SCOLIOSIS)

For a patient diagnosed with scoliosis, a follow-up and treatment program is created for the family by the specialist doctor. There are two factors that are important for the follow-up and treatment program. The first is the age of the child, and the second is the degree of curvature. Children diagnosed with scoliosis at a young age are more likely to increase the curvature when the amount of growth is high, so younger children are called for more frequent follow-up. Especially in children who have completed puberty and have completed their growth, follow-up can be done with an annual evaluation.

We can classify scoliosis as mild, moderate and severe according to the degree of curvature. The progression of mild curves is followed by x-ray films taken at 6-month intervals in pre-adolescent and adolescent patients. Exercises for the back and waist muscles are started in these patients. If the children who have completed their growth do not have complaints in the follow-up for mild curvatures, there is no need to follow up.

In moderate spinal curvatures, pre-adolescent and adolescent patients should be followed more closely according to the degree of curvature. These patients have a higher risk of curvature progression. For these patients, it may be necessary to use a curve correcting corset with a special exercise program. The body corset to be used is made specifically for the patient. These corsets should be used 23 hours a day. According to the advice of the specialist doctor following the patient, this period can be reduced to 14 hours. The aim of treatment in moderate curvatures is to prevent the progression of the curvature to the level of severe scoliosis by reducing the progression of the curvature until the child completes his/her growth. In some patients, there may be a decrease in the degree of curvature of the spine with exercise and corset treatment, but complete recovery of the curvature is not expected.

Severe scoliosis may also progress in adulthood. It can create an imbalance in the patient's body. For this reason, it causes back and low back pain in these patients at later ages. It also disturbs many patients cosmetically. In these patients, scoliosis surgery may be required. It is more appropriate to perform scoliosis surgery in centers specialized in this field.

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Oscar Ville Ofisleri
No:26/1 Tekirdağ Merkez

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