I have 5 herniated disks (l1-l5), and one the is complete?blown out? of its sheath. I can only walk short distances, and it hurts to stand up. They are saying that surgery may or may not be effective, and the medications they have me on here in Dharamsala are also ineffective. I have a job to do but cannot currently function. What painkillers would you recommend for my crippling? breakthrough? pain, as I try to improve my spinal condition through physical therapy?

Dr. Julie Mercy J DavidPhysiotherapist26yrs exp

94% (40218 ratings)

Ask Free Question

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. Helps prevent rolling provides stability to lumbar and sacral regions of the back can be used when performing actions like lifting and handling heavy items can also be used when playing sports restricts 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 1. Bridges ?lie on the ground and bend the knees, placing the feet flat on the floor hip-width apart. ?press the feet into the floor, keeping the arms by the sides. ?raise the buttocks off the ground until the body forms a straight line from the shoulders to the knees. ?squeeze the buttocks with the shoulders remaining on the floor. ?lower the buttocks to the ground and rest for a few seconds. ?repeat 15 times and then rest for 1 minute. ?do 3 sets of 15 repetitions. 2.lying lateral leg lifts ?lie on one side with the legs together. ?keep the lower leg slightly bent. ?draw the bellybutton into the spine to engage the core muscles. ?raise the top leg about 18 inches, keeping it straight and extended. ?hold the position for 2 seconds. ?repeat 10 times. ?turn onto the other side of the body and repeat, lifting the other leg. ?perform 3 sets on each side. 3.supermans ?lie face down on the ground and stretch both arms out in front of the body, keeping the legs stretched out and flat on the ground. ?raise both the hands and feet, aiming to create a gap of about 6 inches between them and the floor. ?try to pull in the bellybutton, lifting it off the floor to engage the core muscles. ?keep the head straight and look at the floor to avoid neck injury. ?stretch the hands and feet outward as far as possible. ?hold the position for 2 seconds. ?return to the starting position. ?repeat 10 times. 4.partial curls ?lie back on the floor and bend the knees, keeping the feet flat and hip-width apart. ?cross the hands over the chest. ?breathe in deeply. ?on the breath out, engage the abdominal muscles by pulling in the stomach. ?gently raise the head and shoulders 2 inches off the ground while keeping the neck in line with the spine. ?hold for 5 seconds then return to the starting position. ?repeat the exercise 10 times. ?perform 3 sets. 5.knee-to-chest stretches ?lie on the back on the floor. ?bend the knees, keeping both feet flat on the floor. ?use both hands to pull one knee in toward the chest. ?hold the knee against the chest for 5 seconds, keeping the abdominals tight and pressing the spine into the floor. ?return to the starting position. ?repeat with the opposite leg. ?repeat with each leg 2?3 times twice a day. 6.lower back rotational stretches ?lie back on the floor with bent knees and feet flat on the ground. ?keeping the shoulders firmly on the floor, gently roll both bent knees over to one side. ?hold the position for 5?10 seconds. ?return to the starting position. ?gently roll the bent knees over to the opposite side, hold, and then return to the starting position. ?repeat 2?3 times on each side twice a day. 7.seated lower back rotational stretches ?sit on a stool or chair without arms, keeping the feet flat on the floor. ?twist at the core to the right, keeping the hips square and the spine tall. ?position the hands behind the head or place the left hand on the right knee to support the stretch. ?hold the position for 10 seconds. ?repeat the exercise on the left-hand side. ?repeat on each side 3?5 times twice a day. Posture when standing: make sure you have a neutral pelvic position. Stand upright, head facing forward, back straight, and balance your weight evenly on both feet. Keep your legs straight and your head in line with your spine. Posture when sitting: a good seat for working should have good back support, arm rests and a swivel base. When sitting, try to keep your knees and hips level and keep your feet flat on the floor, or use a footstool. You should ideally be able to sit upright with support in the small of your back. If you are using a keyboard, make sure your elbows are at right-angles and that your forearms are horizontal. Shoes: flat shoes place less of a strain on the back. Driving: it is important to have proper support for your back. Make sure the wing mirrors are properly positioned so you do not need to twist. The pedals should be squarely in front of your feet. If you are on a long journey, have plenty of breaks. Get angle. Out of the car and walk around. Bed: you should have a mattress that keeps your spine straight, while at the same time supporting the weight of your shoulders and buttocks. Use a pillow, but not one that forces your neck into a steep.  

0 person found this helpful