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Treating Back Pain,[link widoczny dla zalogowanych]
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Treating back pain with non-surgical and minimally invasive techniques
If you have back pain, you are not alone. Nearly everyone at some point has back pain that interferes with work,[link widoczny dla zalogowanych], routine daily activities or recreation. And although many think invasive surgery may be the only relief for severe back pain,[link widoczny dla zalogowanych], in many cases it can be treated with minimally invasive techniques. Following are some non-surgical treatment options.
Medications often are used to treat back pain. Effective pain relief may involve a combination of prescription drugs and over-the-counter remedies. Patients should always check with a doctor before taking drugs for pain relief. Over-the-counter analgesics,[link widoczny dla zalogowanych], including nonsteroidal anti-inflammatory drugs (aspirin, naproxen, and ibuprofen), are taken orally to reduce stiffness, swelling, and inflammation and to ease mild to moderate back pain. Muscle relaxers also may help alleviate muscle tension, easing the pain.
Exercise may be the most effective way to speed recovery from back pain and help strengthen back and abdominal muscles. Maintaining and building muscle strength is particularly important for persons with skeletal irregularities. Doctors and physical therapists can provide a list of gentle exercises that help keep muscles moving and speed the recovery process. A routine of back-healthy activities may include stretching exercises, swimming,[link widoczny dla zalogowanych], walking,[link widoczny dla zalogowanych], and movement therapy to improve coordination and develop proper posture and muscle balance. Yoga is another way to gently stretch muscles and ease pain. Any mild discomfort felt at the start of these exercises should disappear as muscles become stronger. But if pain is more than mild and lasts more than 15 minutes during exercise, patients should stop exercising and contact a doctor.
Spinal manipulation is literally a "hands-on" approach in which professionally licensed specialists use leverage and a series of exercises to adjust spinal structures and restore back mobility.
Facet Joint Injection is an injection of long lasting steroid in the facet joints. The facet joints are those where the vertebrae connect to one another, keeping the spine aligned. The steroid injected reduces the inflammation and/or swelling of tissue in the joint space. This may in turn reduce pain, and other symptoms caused by inflammation / irritation of the joint and surrounding structures.
IntraDiscal Electrothermal Therapy (IDET) uses thermal energy to treat pain resulting from a cracked or bulging spinal disc. A special needle is inserted via a catheter into the disc and heated to a high temperature for up to 20 minutes. The heat thickens and seals the disc wall and reduces inner disc bulge and irritation of the spinal nerve.
Transcutaneous electrical nerve stimulation (TENS) is administered by a battery-powered device that sends mild electric pulses along nerve fibers to block pain signals to the brain. Small electrodes placed on the skin at or near the site of pain generate nerve impulses that block incoming pain signals from the peripheral nerves. TENS also may help stimulate the brain production of endorphins (chemicals that have pain-relieving properties),[link widoczny dla zalogowanych].
Minimally invasive surgery
Even if you require surgery to relieve back pain, minimally invasive surgical procedures are being preformed more often. Minimally invasive surgery uses a thin,[link widoczny dla zalogowanych], telescope-like instrument known as an endoscope,[link widoczny dla zalogowanych], which is inserted through small incisions. The endoscope is connected to a tiny video camera that projects an inside view of the patient body onto television screens in the operating room. Small surgical instruments may be passed through one or more additional half-inch incisions. Following the procedure,[link widoczny dla zalogowanych], the small incisions are closed with sutures and covered with surgical tape. Discetomies, spinal fusions and laminectomies all are being performed now with minimally invasive techniques.
Discectomy is one of the more common ways to remove pressure on a nerve root from a bulging disc or bone spur. During the procedure the surgeon takes out a small piece of the lamina (the arched, bony roof of the spinal canal) to remove the obstruction below. Spinal fusion is used to strengthen the spine and prevent painful movements. The spinal disc(s) between two or more vertebrae is removed and the adjacent vertebrae are "fused" by bone grafts and/or metal devices secured by screws. Spinal fusion may result in some loss of flexibility in the spine and requires a long recovery period to allow the bone grafts to grow and fuse the vertebrae together. Spinal laminectomy (also known as spinal decompression) involves the removal of the lamina (usually both sides) to increase the size of the spinal canal and relieve pressure on the spinal cord and nerve roots. Because the incisions are much smaller with minimally invasive techniques, there is less trauma to the back and surrounding muscles, leading to shorter hospital stays, less scarring and quicker recovery times. There are still risks associated with minimally invasive spinal surgeries, and candidates should discuss the pros and cons with their physician before making a decision.
Quick tips to a healthier back
Following any period of prolonged inactivity,[link widoczny dla zalogowanych], begin a program of regular low-impact exercises. Speed walking,[link widoczny dla zalogowanych], swimming, or stationary bike riding 30 minutes a day can increase muscle strength and flexibility. Yoga also can help stretch and strengthen muscles and improve posture. Ask your physician or orthopaedist for a list of low-impact exercises appropriate for your age and designed to strengthen lower back and abdominal muscles.
Always stretch before exercise or other strenuous physical activity. Don slouch when standing or sitting. When standing, keep your weight balanced on your feet. Your back supports weight most easily when curvature is reduced. At home or work, make sure your work surface is at a comfortable height for you. Sit in a chair with good lumbar support and proper position and height for the task. Keep your shoulders back. Switch sitting positions often and periodically walk around the office or gently stretch muscles to relieve tension. A pillow or rolled-up towel placed behind the small of your back can provide some lumbar support. If you must sit for a long period of time,[link widoczny dla zalogowanych], rest your feet on a low stool or a stack of books. Wear comfortable, low-heeled shoes. Sleep on your side to reduce any curve in your spine. Always sleep on a firm surface. Don try to lift objects too heavy for you. Lift with your knees, pull in your stomach muscles, and keep your head down and in line with your straight back. Keep the object close to your body. Do not twist when lifting. Maintain proper nutrition and diet to reduce and prevent excessive weight,[link widoczny dla zalogowanych], especially weight around the waistline that taxes lower back muscles. A diet with sufficient daily intake of calcium, phosphorus and vitamin D helps to promote new bone growth. If you smoke, quit. Smoking reduces blood flow to the lower spine and causes the spinal discs to degenerate. - National Institutes of Health
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