Physiotherapy and surgery for severe back pain

As we already know, severe back pain, which occurs quite often in an adult, less often in childhood, can be a symptom of serious diseases. But pain syndrome itself does not provide enough information to determine its cause. Even an expert can not immediately say what caused the pain, not to mention people without medical education. Therefore, the 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 in order not to miss a dangerous pathology. But at the same time, severe back pain is so reflected in the condition and quality of life of the patient that they simply can not be ignored or tolerated.

It is clear that due to the large variety of causes of spinal pain there is no single approach to their treatment. That is, the treatment scheme is developed by the doctor individually in each case. So, for relaxation of the pain syndrome caused by muscle fatigue, there is enough relaxation techniques and a relaxing massage, but the same muscle tension in myositis often requires medical treatment and 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 deal with effective methods of treating severe back pain, which are offered by doctors as part of complex therapy:

• Drug treatment, which is the admission or parenteral administration of drugs with anti-inflammatory and analgesic effect, as well as topical application of the above funds. In most cases, preference is given to non-narcotic analgesics and NSAIDs in the form of tablets, ointments, injections (Nimesulid, Ibuprofen, Diclofenac, Indomethacin, etc.). For unbearable pains caused by malignant neoplasms and severe spinal injury, in the absence of the effect of using simple painkillers, use narcotic analgesics (Morphine, Codeine Promedol, etc.).

With muscle spasms and strong muscle tension, pain syndrome can help relieve muscle relaxants ("Mydocalm", "Sirdalud", Tizanidine "." Baclofen ", etc.).

• Conducting vertebral and pararetbral blockades using anesthetics or corticosteroids (relevant for fractures and pains caused by spinal hernia).
• Reception of  vitamins  and vitamin-mineral complexes (for example, "Kalcemin". "Neurovitan", "Neurobeks", etc.), contributing to:

• increased immunity (and any chronic disease is a significant 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),
• removal of neurological symptoms, including pain, triggered by inadequate functioning of the nervous system.

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

• ultraviolet radiation,
• 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,
• exposure to ultrasound and shock wave therapy,
• therapeutic baths and thermal procedures (mud therapy and paraffin therapy).

Additionally, after the removal of the acute pain syndrome, the patient can be assigned various types of massage procedures, including underwater shower-massage, vacuum therapy and vibration techniques. Good results and spa treatment.

The choice of physiotherapy procedures depends on the diagnosed disease, which causes severe back pain, the age of the patient, the presence of comorbidities (especially heart and vascular diseases), the individual tolerance of the procedures by the particular patient. A significant role is also played by the severity of pain (mild pain quickly relieves electrophoresis with analgesics and NSAIDs, but at high intensity it requires the introduction of anesthetics and corticosteroids).

• Therapeutic exercise or exercise therapy to help eliminate pain, strengthen the back muscles, stabilize the spine. True, physical  exercises for severe  back pain are shown after the acute symptoms go away, and are more likely to prevent the recurrence of pain. The first classes are static relaxation techniques with minimal physical exertion. Gradually, the load should increase with the volume and number of movements performed. All exercises must be performed with great caution, at a slow pace, until the appearance of pain. It is better if the classes will be held under the supervision of a doctor or a physical therapy trainer.

A good universal exercise to strengthen the muscles of the back and lower back is flexion and deflection of the spine in a standing position on all fours.

Surgical treatment  is used only in severe cases: with discogenic radiculopathy, hernia of intervertebral discs of large size, severely squeezing the roots of the spinal cord, tumor processes accompanied by pain.

Sessions of manual therapy, manual massage, post-isometric muscle relaxation, reflex therapy and acupuncture, spinal traction and osteopathy (used in the pathologies of the spinal column) can be referred to the current non-traditional methods of diagnosing and treating severe back pain. For chronic pain, certain yoga poses help.

As for the patient's motor activity, today doctors adhere to the point of view that it is not worth severely limiting it, if we are not talking about serious spinal injuries. When 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 bit, a person should begin to move to the best of his abilities, because hypodynamia only worsens the patient's condition. The main thing is not to make sudden movements, not to lift weights, to avoid hypothermia, and to strictly follow all the recommendations and prescriptions of the doctor.

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

[1], [2], [3], [4]