My name is Dr. Himanshu Gupta. I am orthopedic spine specialist based out of Gurgaon. Today, I will be talking about lower back and neck pain, this is the most common ailment which brings patients to the orthopedic OPD. Why has there been a sudden rise in these ailments? The major risk factor for this has been the prolonged sitting posture and the wrong posture of working, which has led most of the young population to end up in the doctor’s OPD or with physiotherapy machines.
What happens is when we are sitting for long hours specifically for more than an hour on the sustained wrong angle of the spine that leads to build-up of pressure in the spine which in turn leads to a lot of spasms in the back muscles. What then happens is, if this happens on a day in and day out the basis on a regular schedule, we get to have chronic back pain or chronic neck pains, which with sudden jerks, sudden activities will eventually be a slip disc so what effectively is the slip disc? this is basically in this spine of the body in between the bones, this part is the disc which has a jelly structure which supports and give spine some sort of flexibility. As we age this fluid starts decreasing in density it becomes harder which leads to lack of flexibility. Now if with this sort of spine when we are sitting for long hours and we get some jerks or we get wrong posture where we are lifting something and the back gets jerk, the fluid inside disc can leak out causing pressure on these nerves which are going into the legs, once that happens that is what is called sciatica.
So what should we do for prevention? What I would recommend is on a regular basis we should be doing some extension exercises, isometric exercises to keep our back and our neck strong. Secondly, while at work we should adopt postures which do not cause a lot of pressure on the lower and upper part of the spine, we keep changing our posture at every 45 minutes to 50 minutes wherein we get up, walk around, stretch round and again come back and sit wherein we are avoiding any sustained pressure and most importantly trying to do some sort of regular exercise in our daily routine in terms of cardio or cycling or walking which gives a good blood supply to the whole of the spine.
What to do if we have had this problem? If you have had a slip disc or problem of sciatica or nerve pain in the arm. What we can do is most of these cases will get better with medications, rest, physical therapy, conservative management. Only in about 8-10% of cases would you require a doctor's intervention in terms of treating it. Now, what would be doctors intervention be? After having examined you, done MRI examination of your spine, having seen where the disc is and how much the pressure that is exerting, we can still go ahead and try and do interventional treatment which is non-surgical, non-cut or non-stitch work wherein with the help of needles, lasers or with the help of endoscopes we are able to remove that part of the compression of the disc on the nerves and advantage is we are back to work within 48 hours, all the activities can be started off. We can join our offices within 3 to 4 days and the start with exercise within a week.
It has massive repercussions in terms of lesser off days, lesser cost and definitely lesser pain because the amount of intervention is very less. Would it be possible for each and every of these disc patients to undergo interventions? No, some of the disc would be associated with severe nerve injuries or compromises wherein we should do immediate decompression of the spinal canal that's where the open surgical treatment with the help of microscopes is indicated, so at the end I would like to remind everybody that we are working for our own selves it's better to be selfish for own body, try and make lower back, upper neck and these areas stronger by adopting good postures and activities and exercises and good diet.