Hi, many years back I slipped and had a great fall. Specially in winter, I experience a lot of pain in my lower back. Recently I had done mri and the report says, 1. Straightening of lumbar spine noted. 2.disc desiccation changes with diffuse disc bulge causing mild anterior thecal sac indentation and bilateral neural foramina narrowing noted at l4-l5 level. 3. Diffuse disc bulge causing mild anterior thecal sac indentation and bilateral neural foramen narrowing noted at l5-s1 level. I would like to know more about the treatment. Should I go for medication or surgery?

Dr. Julie Mercy J DavidPhysiotherapist24yrs exp

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Back pain can affect people of any age, for different reasonsas people get older, the chance of developing lower back pain increases, due to factors such as previous occupation and degenerative disk disease. Lower back pain may be linked to the bony lumbar spine, discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, lower back muscles, abdominal and pelvic internal organs, and the skin around the lumbar area. ?acute pain starts suddenly and lasts for up to 6 weeks. ?chronic or long-term pain develops over a longer period, lasts for over 3 months, and causes ongoing problems. Home advise: ?resting from strenuous activity can help, but moving around will ease stiffness, reduce pain, and prevent muscles from weakening. ?applying heat, ice, ultrasound, and electrical stimulation ? as well as some muscle-release techniques to the back muscles and soft tissues ? may help alleviate pain. ?as the pain improves, the physical therapist may introduce some flexibility and strength exercises for the back and abdominal muscles. Techniques for improving posture may also help. ?the patient will be encouraged to practice the techniques regularly, even after the pain has gone, to prevent back pain recurrence. Regular exercise helps build strength and control body weight. Guided, low-impact aerobic activities can boost heart health without straining or jerking the back. Before starting any exercise program, talk to a health care professional. There are two main types of exercise that people can do to reduce the risk of back pain: ?core-strengthening exercises work the abdominal and back muscles, helping to strengthen muscles that protect the back. ?flexibility training aims at improving core flexibility, including the spine, hips, and upper legs. We suggest you to wear lumbosacral corset (belt) which is available at our clinic. If you want you can buy from us, if you are far away from chennai we can send you by courier. The reason why we are conveying you to buy from us is we can demonstrate over the videocall (using whatsapp) and also we can monitor you throughout when to wear it and how long to wear it. And also if you find any difficulty wearing the brace you can also revert back to us for few more suggestions and we can propose you good solution how to go about it. Uses of lumbosacral corset (belt) a lumbosacral corset adds pressure to the intra-abdominal area. This adds stability to the spine. It is prescribed to people suffering from moderate to severe pain. Other benefits of using a lumbar spine belt are: 1.helps in a certain degree of immobilization of facet joints. 2.reduces pain to allow continuation of normal activities. 3.speeds up the healing process. 4.the pressure exerted by a lumbar spine belt helps in stretching the erector spine muscles. 5.this belt can also be used to support the lower back while exercising. Ohelps prevent rolling oprovides stability to lumbar and sacral regions of the back ocan be used when performing actions like lifting and handling heavy items ocan also be used when playing sports orestricts back movement to aid treatment of back problems do?s and don?ts sitting do: ? sit as little as possible and then only for short periods. ? place a supportive towel roll at the belt line of the back especially when sitting in a car. ? when getting up from sitting, keep the normal curves in your back. Move to the front of the seat and stand up by straightening your legs. Avoid bending forward at the waist. ? try to keep the normal curves in your back at all times. Don?t: ? do not sit on a low soft couch with a deep seat. It will force you to sit with your hips lower than your knees and will round your back. You will loose the normal curve in your back. ? do not place your legs straight out in front of you while sitting (e.g. Sitting in the bath tub). Standing do: ? if you must stand for a long period of time, keep one leg up on a foot stool. ? adapt work heights. Don?t: ? avoid half bent positions. Lifting avoid lifting if you can. Do: ? use the correct lifting technique. Keep your back straight when lifting. Never stoop or bend forward. Stand close to the load, have a firm footing and wide stance. Kneel on one knee, keeping the back straight. Have a secure grip on the load and lift by straightening your knees. Do a steady lift. Shift your feet to turn and do not twist your back. Don?t: ? do not jerk when you lift. ? do not bend over the object you are lifting. Lying do: ? sleep on a good firm surface. ? if your bed sags, use slats or plywood supports between the mattress and base to firm it. You also can place the mattress on the floor, a simple but temporary solution. ? you may be more comfortable at night when you use a pillow for support. Don?t: ? do not sleep on your stomach unless advised to do so by your doctor or physical therapist. Bending forward do: ? keep the natural curves of your back when doing these and other activities: making a bed, vacuuming, sweeping or mopping the floor, weeding the garden or raking leaves. Coughing and sneezing do: ? bend backwards to increase the curve of your back while you cough or sneeze. Driving a car do: ? drive the car as little as possible. It is better to be a passenger than to drive yourself. ? move the seat forward to the steering wheel. Your seat must be close enough to the wheel to keep the natural curves of your back. If your hips are lower than your knees in this position, raise yourself by sitting on a pillow. Exercises for low back pain safety guidelines ? an increase in your low back pain can be expected with these exercises. This is acceptable as long as your leg symptoms are not increasing. ? if while doing these exercises, your pain worsens or you have new pain or symptoms, stop the exercises and discuss your symptoms with your doctor or physical therapist. ? stop exercising and let your doctor or physical therapist know right away if you have any change in your bowel or bladder control or any increase in weakness in your leg or foot. Exercises ? ?press-ups: keep your back and buttocks relaxed and use your arms to press up. Concentrate on keeping your hips down and push up your upper body as high as possible. ?double knee to chest: grasp both your knees with your hands and pull toward your shoulders. Hold the stretch for 1 second. Let your knees return, but keep them bent at arms length. ? ?lumbar spine stretches: lie on your back. Bring your knees towards your chest. Rotate your knees towards the pain. ?side-lying position: lie on your side and face forward. Have both arms straight in front and bend your knees. Turn your head as you move your top arm across your body as far as you can. Keep your arm in place and turn your head back to the starting position. Look back again and turn your head farther if you can. Bring your head and arm back to the starting position. Relax and repeat 10 times on each side. ?hamstring stretch: lie on your back with your legs out straight. Raise your leg up and put your hands around the upper leg for support. Slowly straighten the raised knee until you feel a stretch in the back of the upper leg. Hold, then relax and repeat 10 times on each leg. ?standing arch: stand with your feet apart and hands on the small of your back with fingers pointing backwards. Bend backwards at the waist, supporting the trunk with your hands. Keep your knees straight. Hold for 5 seconds. Repeat 3 to 5 times. Side glides: stand at a right angle to the wall about 2 feet o eliminate your pain? improve your muscular endurance and strength? attain better posture, balance, body awareness and co-ordination? improve your balance and flexibility? learn to lift properly.?  

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