At some point in life most people experience acute pain in their lower back which is extremely painful. Pain in the spine causes a lot of discomfort and disruption in the life of an individual and hence, it is always better to get it checked on time. There are patients who even wonder when they should consult a neurosurgeon or a spine surgeon for their back pain. It is advisable that a physical examination is done by a primary care physician for low back pain before consulting a spine surgeon.

Why consult a Physical care Physician First?
The main reason to consult a primary care physician at first is that he would prescribe medications for severe lower back pain. The medications could include non-narcotic pain medications such as Ultram or non-steroidal anti-inflammatory drugs such as Motrin. The physician can even refer you to a chiropractor or for physical therapy to get relief from the back pain. Mechanical means are made use of by a chiropractor mainly to alleviate the back pain of the patient.

If the patient feels better with the physical therapy or the medications prescribed by the family doctor and is able to resume normal activities, then there is no need to see a spine surgeon. It is often recommended to take good care of the back and to exercise. A combination of ergonomics, regular stretching and improved everyday posture is beneficial as it reduces the chance of causing pain in the lower back. Exercise plays a very important role and it provides the possibility of reducing the pain.

Conservative Care for Treating Lower back Pain
It is best for patients to consult a conservative care specialist if after consulting a chiropractor they do not find any reduction in their pain and they do not want to undergo spine surgery. The conservative care specialists are well-trained in rehabilitation of musculoskeletal disorders and specialize in spine care. The role of the conservative care specialist is similar to a cardiologist who specializes in treating neurological disorders.

The specialist for spine care works along with the surgeon in a spine center to treat the lower back pain. The specialist is trained in diagnostic techniques and is capable of making use of a combination of diagnostic tests as well as injection techniques such as epidural steroid injections to diagnose the source of the lower back pain in a patient. They can even advise patients whether it is appropriate to consult a spine surgeon for surgery. Surgery is done to correct the anatomical conditions and it is performed only when non-surgical treatments are not successful in alleviating the pain of the patient.

When Is The Right Time To See A Spine Surgeon?

Your spine or backbone is composed of 26 bone discs, known as vertebrae. The vertebra shields your spinal cord and allows you to bend forwards and backwards, and stand. However, a number of problems, such as the following can change the structure or cause the vertebrae and its surrounding tissues to become damaged  

  Injuries
  Infections
  Tumours
  Changes in bone formation due to ageing   herniated disks, spinal stenosis
  Conditions like scoliosis and ankylosing spondylitis

Spinal disorders often lead to pain and discomfort when bony projections put pressure on the spinal nerves or cord. Over time, spinal disorders limit movement and reduce flexibility.
Treatment varies depending on the disease, ranging from medications and therapy to bracing and surgery.

Endoscopic Spine Surgery: what is it?

Contradictory to traditional open surgery, the new age endoscopic surgery is a minimally invasive procedure used to detect and treat a disorder. Unlike open surgery, minimally invasive endoscopic surgery does not require the patient to undergo general anaesthesia. The procedure is possible under local anaesthesia, considering the fact that it can be performed without cutting open the portion of the surgery site.

How does surgery work?

During the procedure, the surgeon first administers local anaesthesia to numb the site of the operation. You will be awake during the entire procedure but will not feel any pain. Then, he/she will make a small incision and insert a slender, tubular instrument   known as an endoscope   with a camera attached on one end through the soft tissues and skin, down to the spinal column. This allows the surgeon to get a clear view of the spinal tissues and understand where the problem exists. The endoscope holds the muscles open, allowing the surgeon to remove the damaged tissues or disk.

Endoscopic spine surgery preserves normal mobility, as the spine is not fused with rods and crews. When performed under an experienced surgeon, the procedure takes less than an hour.

Benefits of the Procedure

The advantages of going for an endoscopic surgery are the following  
  Local anaesthesia
  Surgery and discharge on the same day
  Microscopic incisions
  No removal of bone or muscles
  Zero or minimal blood loss
  Preserves spinal mobility
  Immediate recovery
  Reduced intake of pain medicines
  The high rate of success
  Improved quality of life

Minimally invasive endoscopic surgery has made it possible to rectify spinal problems and disorders without having to go under the knife. With less pain and quicker recovery, you can improve your spine health and get back to your usual activities in a day or two.

Consult a specialist and discuss the procedure in detail before opting for the same.


Endoscopic Spine Surgery Under Local Anaesthesia!

A spinal cord injury is a damage to the spinal cord. It s an extremely serious type of physical trauma that s likely to have a lasting and significant impact on most aspects of daily life.

The spinal cord is responsible for sending messages from the brain to all parts of the body. It also sends messages from the body to the brain. We are able to perceive pain and move our limbs because of messages sent through the spinal cord.

If the spinal cord sustains an injury, some or all of these impulses may not be able to  get through . The result is a complete or total loss of sensation and mobility below the injury. A spinal cord injury closer to the neck will typically cause paralysis throughout a larger part of the body than one in the lower back area.

Causes-

A spinal cord injury is often the result of an unpredictable accident or violent event. The following can all result in damage to the spinal cord:

a violent attack such as a stabbing or a gunshot
diving into water that s too shallow and hitting the bottom
trauma during a car accident (specifically, trauma to the face, head and neck region, back, or chest area)
falling from a significant height
head or spinal injuries during sporting events
electrical accidents
severe twisting of the middle portion of the torso
Symptoms-

Some symptoms of a spinal cord injury include:

problems walking
loss of control of the bladder or bowels
inability to move the arms or legs
feelings of spreading numbness or tingling in the extremities
unconsciousness
headache
pain, pressure, stiffness in the back or neck area
signs of shock
unnatural positioning of the head
If you suspect that someone has a back or neck injury:

Don t move the injured person   permanent paralysis and other serious complications may result
Call 911 or your local emergency medical assistance number
Keep the person still
Place heavy towels on both sides of the neck or hold the head and neck to prevent them from moving until emergency care arrives
Provide basic first aid, such as stopping any bleeding and making the person comfortable, without moving the head or neck
Prevention-

Because spinal cord injuries are often due to unpredictable events, the best you can do is reduce your risk.

 Some risk-reducing measures include:

always wearing a seatbelt while in a car
wearing proper protective gear while playing sports
never diving into water unless you ve examined it first to make sure it s deep enough and free of rocks

Spinal Cord Injury - Signs, Causes & Prevention

Spinal fractures are extremely painful and usually happen when an external force applied to the spine exceeds the vertebral column s ability to bear the load. Many times, the bone fragments pinch and damage the spinal cord, which leads to an injury or dislocation of the bony vertebra. Although spinal fractures can develop anywhere along the spine, the most common site is the lower back.

What causes spinal fractures?

Spinal fractures can occur due to both minor trauma/falls and major accidents. The following are the probable causes of such fractures-

  Injuries sustained while playing a sport
  A traumatic injury
  Spinal instability
  Injuries sustained after falling from a height
  A whiplash
  Injuries sustained in an accident
  An underlying condition such as Osteoporosis, which causes the spinal bones to weaken

Symptoms observed:

Spinal fractures are characterized by the following symptoms-

  Muscle spasm and swelling
  Numbness
  Acute pain that worsens when you walk or stand for a long time
  A tingling sensation
  Restricted mobility of the spinal column
  Spinal deformity/disability
  Sudden onset of pain in the lower back region

What are the various types of spinal fractures?

Spinal fractures primarily fall into four categories, namely the following-

  Compression - Compression fractures are quite common in people with osteoporosis or bone cancer. The bones become fragile and brittle. If sudden force is applied with extreme pressure, the vertebra may not be able to support the load and that may result in a fracture.

  Burst - Severe trauma, such as a car accident can cause burst fractures. The external pressure is so much that the vertebra gets crushed. As a result, the bony fragments spread out and cause spinal cord injury. Unlike a compression fracture, where only a part of the vertebra is damaged, a burst fracture leads to multiple fractures in the vertebra.

  Flexion-distraction - This type of fracture is likely to happen if you are involved in a car accident. Normally, the spine is made to flex forward. However, a sudden jerk that pushes your body forward can put a lot of pressure on the spine and cause the vertebrae to break.

  Fracture-dislocation - This debilitating condition results from a torn ligament and broken bone.

What is the treatment for spinal fractures?

Treatment options for spinal fractures include both non-surgical and surgical methods.

  Non-surgical treatment - Most cases of spinal fractures can be treated with immobilization in a corset or brace for up to 10-12 weeks. Bracing will help prevent deformity and reduce pain.

  Surgical treatment - The doctor may recommend surgery in severe cases. The two standard surgical procedures are-

Vertebroplasty - The surgeon will insert a tube, known as a catheter, into the compressed vertebra. Through the catheter, he/she will inject bone cement into the fracture site. This will harden and stabilize the vertebral column. Vertebroplasty has proved to be an effective procedure to reduce pain. The surgery restores mobility and prevents loss of bone due to bed rest.

Kyphoplasty - During this procedure, the surgeon inserts a catheter into the spinal column under the guidance of an X-ray. Next, he/she makes small incisions along the back and inserts an inflatable bone stamp. The tamp, once inflated, bring back the vertebral body to its original height. It also creates a cavity to be filled with bone cement, which seals the cracks. The bone cement stops the vertebra from collapsing again. After the whole procedure, the surgeon will remove the catheter and stitch the incisions.

Following surgery, you will need to wear a brace for about 6-12 weeks. Physical therapy is strongly recommended initially to help you get back to your daily activities in a week or two.

Spinal Fractures - All You Should Know!

Spinal trauma, also referred to as spinal cord injury, occurs when a section of your spinal cord or the nerves at the edge of your spinal canal is damaged. The spinal cord acts as a messenger between the brain and other parts of your body. If the spine sustains an injury, all or some of these impulses may not get through. This may result in complete loss of mobility and sensation below the site of injury. An injury closer to the neck can cause paralysis throughout a larger part of the body than in the lower back region.

How do such injuries occur?

Often, spinal trauma or injury results from a violent event or an unpredictable accident. The following may severely damage your spinal cord-

  A violent attack (a gunshot or a stabbing)
  A motor vehicle accident that may cause trauma to the neck, back or head
  Falling from a great height
  Spinal or head injuries during some sports activity
  Electrical accidents

What are the signs of a spinal cord injury?

The followings signs and symptoms can be observed after an injury to the spinal cord-

  Difficulty walking
  Restricted movement of the legs and arms
  Stiffness, pressure and intense pain in the neck/back
  Loss of sensation
  Muscle spasms
  Loss of bowel or bladder control
  A twisted neck or back
  Lack of coordination, weakness or paralysis in any of the body part

When should you see a doctor?

If you experience significant trauma to the neck or head, accompanied by the above symptoms, then visit a doctor immediately. Spinal trauma or injuries is a debilitating condition and can deteriorate further if you do not seek medical intervention. In fact, if such an injury is not detected on time, you may have to face more severe complications. For instance, paralysis or numbness may develop immediately or gradually as blood clots and swelling occur in the surrounding region of the spine.

The doctor can detect spinal injuries using any of the following methods-

  CT Scan
  MRI
  X-ray

What is the treatment for spinal trauma?

An orthopaedic will recommend the correct treatment for spinal trauma or spinal cord injuries, depending on the severity of the condition.

  Medications - Intravenous medications can help reduce the pain and symptoms of acute spinal cord injury
  Immobilization - Braces, corsets, or neck collar can help realign and stabilize the spine
  Surgery - Surgery may be performed to remove bone fragments, herniated disks, foreign objects, or fractured vertebrae that are compressing the spine. Surgery also prevents deformity and pain in the long run.

Recovery starts typically within a week after the treatment. If you undergo surgery, you will have to wait a little longer to get back to your day-to-day activities. It is advisable that you follow up with your doctor and carry on physiotherapy for the first six months at least.

Spinal Trauma - When Should You Consult A Doctor?

A hand fracture is a condition characterized by broken bones of the hand. The bones in the hand include the bones that are present in the fingers and the wrists. A fracture of the hand tends to occur when you bend or twist your hand in the wrong manner. It may also be caused by injuries related to sports and falls.

Symptoms
Symptoms of swelling and pain are the most common of them all. The range of motion for the affected hand will be reduced as well. The knuckle bone may appear to have been sunken in. Most obviously, it will be difficult in carrying out regular tasks which need the hands.

Therapies
The initial treatment for a hand fracture will be focused on reducing the pain. Pain relieving medications such as ibuprofen will be administered which provides relief from the pain. The next step will be to keep the affected hand immobilized so as not to hamper the recovery process. Once stability is restored, therapeutically relevant exercises are prescribed to help normalize the regular hand movements.

The following exercises are relevant in case of a hand fracture:

Wringing a towel: This is an exercise wherein you wring a towel to improve flexibility and strength in the hand. Simply grab a towel and twist it in both directions; imagine wringing water from the towel.
Rolls of the wrist: Wrist rolls aim to increase the ROM (range of motion) in your wrists and the hands. Hold the hand steady and rotate your wrists both clockwise and anticlockwise. You can also hold a light weight in your hand to make it more challenging.
Prayer stretch: A prayer stretch is another exercise that can help boost your wrist flexibility. You start by positioning the palms together like in a prayer, then hold up the elbows while pushing the hands against each other. You should feel a stretch in your wrists and hands.
Grasping: This is a technique wherein you grasp objects to improve your grip strength. Try gripping objects such as tennis ball or stress balls to get your gripping ability up to normal levels.


4 Effective Therapies Post Hand Fracture!

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