back-pains

Low back pain is the most common cause of pain in modern society. It is very common among the young and middle age population from 28 to 40 years of age.

Low back pain consider as pain in lower part of back only. This is considering as alarming sign for future problem. It is a pain felt in back only, not in buttocks or leg. Only Low back pain indicates that disc is started degenerating. If person suffering from low back pain is not consider it seriously then problem will ended up with sciatica and may go for future Spine Surgery.

CAUSES OF LOW BACK PAIN

  • Degenerative disc disease
  • Annular tear in disc
  • Slipped or herniated disc
  • Facet joint arthropathy
  • Muscular trigger points
  • Ankylosing spondylitis
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WHY DISC DEGENERATE :

Normally disc is round tough structure which made from Annulus (wall) and Nucleus (centre jelly like part).

When Nucleus comes under stress like lifting heavy weight or bending forward it starts degenerating. In that water content of jelly reducing gradually and under pressure it weaken the annulus (wall).

Sometimes when pressure is high nucleus will causing tear in annulus and patient start feeling pain in low back region.

SYMPTOMS (WHAT PATIENT FEELS) :

Degenerative disc pain feels like Belt like Pain in region of low back.
Pain usually aggravated with

  • Lifting heavy weight
  • Bending forward
  • Prolong standing
  • Prolong sitting without support
  • Sitting to standing
  • Morning time when wake up from bed

HOW TO DIAGNOSE THE CONDITION :

  • Clinical Examination :History of patient with detail examination by Pain Physician will give enough information about the source of pain.
  • X-ray and MRI-  Most probably MRI will be the best diagnostic tools for confirmation of degenerative disc related pain. MRI can show the reduce water content in Nucleus , Annular weakening , Annular tear, Herniated disc.

TREATMENT OPTIONS

1. Conservative management :
Initially patient of low back pain treated with short course of medicine and Lumber muscle strengthening exercise. If this measure fails and patient may not be benefited with 3 month of treatment then Interventional Pain Management Procedure will be the best options of treatment.

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Ozone Therapy :
Injection made from Ozone gas may be injected in the substance of disc in patient having early changes of degenerative disc. Ozone gas is Anti-inflammatory property which causes significant reduction in disc related pain.

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Disc Fx Procedure :
This procedure is the Best Treatment Option in patient suffering from moderate to severe degenerative disc disease.

This procedure done under Local Anaesthesia so does not having any risk to patient in form of major surgery and General anaesthesia related life threatening complication.

In Disc fx procedure we insert 3.3 mm cannula in the degenerative disc under x-ray guidance. We removed small fragments of degenerative disc. Give saline wash to reduce inflammation, doing Bipolar Radiofrequency Tissue ablation with shrinkage and come out after giving Anti-inflammatory injection.

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REHABILITATION

For any spine and disc related problem Rehabilitation is must for all patients.

All patients should continue LUMBER STRENGTHENING EXERCISE regularly.

As Lumber disc is always under continuous stress regular exercise always benefitted to patient for long term pain relief.

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M.B.B.S. , M.D.( B.J.M.C., Ahmedabad ) Fellow In Pain Management ( Aesculap Academy, Kolkata )