Physical therapy and surgery for severe back pain

As we already know, severe back pain, which occurs quite often in adults, less often in childhood, can be a symptom of serious diseases. But the pain syndrome itself does not provide enough information to determine its cause. Even a specialist cannot immediately say what the pain is caused by, not to mention people without medical education. Therefore, diagnosis and treatment of severe back pain should be entrusted to professionals.

The appearance of such an ambiguous and at the same time extremely important diagnostic sign requires special attention, so as not to miss a dangerous pathology. But at the same time, severe back pain affects the patient's condition and quality of life so much that it is simply impossible to ignore or tolerate it.

It is clear that due to the wide variety of causes of spinal pain, there is no single approach to their treatment. That is, the treatment plan is developed by the doctor individually in each specific case. So, to relieve pain caused by muscle fatigue, relaxation techniques and relaxing massage are sufficient, but the same muscle tension in myositis often requires drug treatment and a course of physical therapy.

Above we looked at what current diagnostic methods doctors use to make a diagnosis and determine the cause of the ailment, and now we will look at effective methods of treating severe back pain that doctors offer as part of complex therapy:

• Drug treatment, which consists of taking or parenterally administering drugs with anti-inflammatory and analgesic effects, as well as local application of the above-mentioned agents. In most cases, preference is given to non-narcotic analgesics and NSAIDs in the form of tablets, ointments, injections (Nimesulide, Ibuprofen, Diclofenac, Indomethacin, etc.). In case of unbearable pain caused by malignant neoplasms and severe spinal trauma, in the absence of the effect of simple painkillers, resort to the help of narcotic analgesics (Morphine, Codeine, Promedol, etc.).

In case of muscle spasms and severe muscle tension, muscle relaxants (Mydocalm, Sirdalud, Tizanidine, Baclofen, etc.) will help relieve pain.

• Conducting vertebral and paravertebral blocks using anesthetics or corticosteroids (relevant for fractures and pain caused by a herniated disc).
• Taking vitamins and vitamin-mineral complexes (for example, "Calcemin", "Neurovitan", "Neurobex", etc.), which contribute to:

• increasing immunity (and any chronic disease is a noticeable blow to it),
• maintaining the balance of vitamins and minerals and improving metabolic processes in the tissues of the back,
• strengthening bones and soft tissues (cartilage, muscles, ligaments),
• relief of neurological symptoms, including pain syndrome, caused by inadequate functioning of the nervous system.

Physiotherapeutic treatment, the purpose of which is to reduce tissue swelling and pain syndrome, as well as to improve metabolic processes in the tissues of the back and the functioning of the muscular-ligamentous apparatus:

• irradiation with ultraviolet rays,
• use of darsonval currents, dynamic currents, amplipulse therapy,
• medicinal electrophoresis with drugs that help relieve pain and inflammation or calcium, which strengthens the bone structures of the spine,
• phonophoresis with analgesics and hormonal anti-inflammatory drugs,
• magnetic and laser therapy,
• ultrasound and shock wave therapy,
• therapeutic baths and thermal treatments (mud therapy and paraffin therapy).

Additionally, after the acute pain syndrome has been relieved, the patient may be prescribed various types of massage procedures, including underwater shower massage, vacuum therapy and vibration techniques. Sanatorium and resort treatment also gives good results.

The choice of physiotherapy procedures depends on the diagnosed disease causing severe back pain, the patient's age, the presence of concomitant pathologies (especially heart and vascular diseases), and the individual tolerance of the procedures by a particular patient. The severity of pain also plays a significant role (mild pain is quickly relieved by electrophoresis with analgesics and NSAIDs, but if it is highly intense, anesthetics and corticosteroids are required).

• Therapeutic exercise or LFK helps to eliminate pain, strengthen the back muscles, and stabilize the spine. However, physical exercises for severe back pain are indicated after the acute symptoms have gone away, and are more likely to prevent relapse of the pain syndrome. The first classes are static relaxation techniques with minimal physical exertion. Gradually, the loads should increase along with the volume and number of movements performed. All exercises should be performed with great caution, at a slow pace, until pain appears. It is better if the classes are carried out under the supervision of a doctor or LFK trainer.

A good universal exercise for strengthening the muscles of the back and lower back is considered to be arching and bending the spine while standing on all fours.

Surgical treatment is used only in severe cases: discogenic radiculopathy, large herniated discs that severely compress the spinal cord roots, tumor processes accompanied by pain syndrome.

Current non-traditional methods of diagnosing and treating severe back pain include manual therapy sessions, manual massage, post-isometric muscle relaxation, reflexology and acupuncture, spinal traction and osteopathy (used for spinal pathologies). Certain yoga poses help with chronic pain.

As for the motor activity of patients, today doctors adhere to the point of view that it is not worth limiting it much, unless we are talking about serious spinal injuries. In case of exacerbation of osteochondrosis and some other diseases of the spine, accompanied by severe back pain, bed rest is recommended only for a few days, and as soon as the pain subsides a little, the person should begin to move to the best of his abilities, because physical inactivity only worsens the patient's condition. The main thing is not to make sudden movements, not to lift weights, avoid hypothermia, and also strictly follow all the doctor's recommendations and prescriptions.

If back pain associated with spinal pathologies does not go away, you can use special orthopedic corsets, wearing which helps relieve the sore neck or lower back. In the acute period, it is also recommended to sleep on a hard bed, which prevents the deflection of the spine and muscle tension during sleep.

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