The third time the doctor says to the patient: "Go home, and take a hot bath. Then open all the windows in the house and stand in the draft. " "But, excuse me," the patient is perplexed, "I, I'll get pneumonia." "I know," says the doctor, "but I can cure this." If you suffer from back pain, you will easily feel yourself in the place of the hero of this anecdote. The doctor appoints you first one medicine, then another, the third ... Perhaps, he will advise to undergo a course of injections, alternate hot and cold compresses ... Then he will appoint a massage and physiotherapy. So months pass with varying success. But a pill or a warming "dog" belt that does not help is one thing. And if you did the operation, you spent months recovering, and the pain continues? Let's find out how to treat pain in the back and muscles.
Warning: diagnosis
The operation on the spine may be useless for one simple reason - it was not needed, since the doctor incorrectly determined the cause and source of the pain. As a result, the person and after the operation does not feel relief and is forced after a while to do a second. 8% of people repeat the operation 2 years after the first and 20% after 10 years. Therefore, it is so important to make an accurate diagnosis. And the patient needs to know the following: as soon as he has pain in his back, it is necessary to appear to the therapist and / or neurologist, and if the pain does not pass within two months - it is such a period that is indicative of the effectiveness of treatment - and even more so if the pain intensifies, you should immediately call a neurosurgeon. It is also necessary to make an MRI (magnetic resonance imaging). X-ray is effective under two conditions: when it is necessary to confirm the presence or absence of fractures or deformations of bones, a violation of their integrity. And the second important condition is a highly qualified radiologist and a quality X-ray machine. The fact is that because of a bad, old X-ray apparatus, a doctor can make the wrong diagnosis, and the culprits may be poor-quality film or reagents. In addition, such expensive examinations as computer tomography (CT) and MRI, as a result, help save the patient's time and money. Moreover, MRI is preferable - it better "sees" soft tissue.
Operation: not so fast
Often it seems to us that the operation is heavy artillery, that is an extreme, but the most effective way to get rid of the problem. Sometimes - in a desperate desire to get rid of the pain - we hurry to jump over the stage of lengthy procedures and immediately move on to radical measures. Sometimes this, however, is necessary, for example, with the threat of paralysis, but such emergency cases are rare. Conclusion: if the doctor recommends an operation for you, always try to get one more, or better two opinions. Keep in mind that doctors are required to provide, at your request, all research and record results. In order to get a more objective and reliable picture and find out if the operation will help you, consult a different medical center with different specialists.
Algorithm of actions
• Start from scratch. Do not tell the second doctor about the recommendations of the first one. Let him look at you and the results of research with fresh eyes.
• Talk to a doctor of another specialty. Consult a good therapist and orthopedist. Perhaps you have not fully used alternative treatments.
• Do not trust the Internet. Stay away from online consultations of doctors. Without personal examination and examination of the results of the survey, this makes no sense.
• Get a third opinion. If the second doctor offers something completely different from what the first suggested, a third doctor can help you figure it out.
So what helps?
It happens that the pain in the back subsides with time, regardless of what we do. Usually we think that treatment or special procedures helped, although in reality it may not be so. However, there are several proven means for temporary pain relief:
First 48 hours
You straightened your back and ... oh, what a pain! It can be terrible, but if you are lucky, it will not last long. Below you will find several "home" ways to remove discomfort.
Use painkillers
Independently "prescribe" yourself compresses - warming or cooling - is not recommended, it can lead to deterioration. Take any anesthetic - cream or gel - and spread the sore spot with light movements.
Relax, but not for long
It is better to lie down if necessary, but it is important that the pose is correct. Lie on your back, head better to live on a thin pillow, and bend your knees to let your back relax. Or lie on your side with one pillow behind your neck and the other between your knees. Bed rest is needed only in the first 48 hours, after this period (or even earlier) the movement will relieve the painful tension in the muscles.
Anesthetics
To get rid of the pain for a while, external pain relievers can help. It is believed that they bring "moderate" relief.
Exercises
Your goal is to teach you how to work your back muscles. This will greatly facilitate your life, since such exercises relieve spasms and muscle tension. But do not overdo it and do nothing through pain. It is better to consult with a physician of physiotherapy, he will tell you effective and safe exercises.
Manual therapy
Studies have shown that manual therapy is no less effective than physiotherapy, pain medication or exercise, for patients with chronic or acute pain.
Epidural analgesia
Many women who give birth are familiar with the effect of epidural anesthesia. The injections, designed to relieve the pain in the back, usually consist of anesthetic and steroids to relieve inflammation. The injections of the epidural anesthetic do not treat problems with the spine, but they will give you a temporary respite. The relief is usually moderate and lasts no more than three months. Be careful with medicines! Analgesics can not be taken uncontrollably, in addition, they can be addictive.
Fight Disheartenedly
It is proved that a prolonged spleen can aggravate pain in the back. Which doctor should be treated first for back pain? It is better to start with a neurologist. Although our teachers also said that a competent therapist is better than any surgeon. If the doctor is sufficiently qualified, he will choose the right treatment tactic, even if he specializes in another area. It is possible to address and to the neurosurgeon - if there is a question on necessity of operation. And an orthopedist who can differentiate is associated with pathology with the locomotor apparatus or with a neurologic problem. The main thing is that a person gets to a qualified doctor, regardless of specialization. To get to a qualified specialist is a great success. And if the patient has a doubt, how can he direct the doctor in the right direction? It is necessary to say directly: "I want to consult a neurologist." I'll tell you a secret, any doctor with time there is some "star" and the desire to solve the problem yourself. Therefore it is better if the therapist does not cope with the problem, but does not refer to another specialist, turn to him alone. It can be a neurologist, an orthopedist or a neurosurgeon, saving drowning people is the work of the drowning themselves ...
In what cases is surgery necessary?
There are absolute and relative indications for surgical intervention. Absolute indications are the patient's desire: he wants to be operated on, which means that one needs to be operated on. But, if common sense denies the need for an operation, of course, it will not be done. This is already a matter of trusting the relationship between the doctor and the patient. The second - if there are clinical indications. This is a long and ineffective therapy of pain syndrome, which does not bring a result, or if the result is minimal. Need surgery for herniated disc, compression (compression) of the spine, when sensitive functions are lost. This is manifested by such symptoms on the background of back pain: a violation of the movement in the muscles, (and if the lumbar region is affected) by a violation in the legs: weakness appears, the leg does not obey, "splashes", there is no coordination when walking. And a very serious symptom is a violation of urination and defecation. These are formidable violations that must be taken into account. If they progress, you need to urgently contact a neurosurgeon. Only a neurosurgeon can decide whether to do the operation or not. And is it not better to consult a doctor when the pain just arose to grab the disease at the earliest stage? The more I work with patients, the more I am convinced that it is impossible to determine in advance what is better and what is not. In addition, you need to provide an opportunity to choose the type of treatment for the patient himself, and the doctor's task is to fully inform him: this is the disease you have. Here are three treatment options: conservative, operative and rehabilitative. In addition, everything depends on the situation: if it is not critical, then you need to directly say that the operation is not shown here. How to protect the spine from damage? Are there any reliable methods of prevention? Prevention is the gymnastics - at least in the 3-7 mode (3 days work, 7 - rest). This is the most optimal way. And there are several opinions on this matter. First: the muscles of the back need to be strengthened. Second: the muscles of the back need not be strengthened, you just need to teach them how to work properly. The first option can be compared to the fact that you are retraining the left-hander, trying to make him right-handed. The second option: you take anyone - left-handed or right-hander, no matter how physically developed he is, what his physique is - and teach the muscles of this person to work correctly and consistently. In order to teach the muscles to work, often enough repetitive movements. It can be fitness or swimming - in cardio-loading mode. As a result, when a person often performs the same movements, the muscles train and perform their functions correctly, thus protecting the spinal column. It is important for a person to be treated (and treated) as a whole, as a single system. For example, the manual therapist affects not only the muscles and vertebrae, but also the internal organs - not directly, but on their ligament apparatus. Pressure on hands on the ligamentous apparatus of the organs leads to the fact that the mobility of the organs changes, and the secretory function changes, pain disappears. So there is a complex effect.
A common opinion about manual therapy: this is a painful and painful process, accompanied by a crunch when the doctor turns his neck and shoulders. This is true? This is partly true. It is necessary to divide manual therapy (MT) into classical and MT soft techniques. Doctors who have a soft technique are, in my opinion, preferable. Because classical manual therapy is traumatic even if carried out correctly. Doctors themselves determine what type of treatment suits you. How to be, if you do not want to "crunch"? You can ask directly: "Doctor, let's not crunch." Most of all, any person is afraid of betrayal, deception. Therefore, the trust of the doctor and the patient provides the maximum effect from the treatment. The patient should be informed as honestly as possible about what you are going to do with it. This is necessary so that the person is not afraid, painful, unpleasant. Then he will become a real patient - the word "patient" is translated as patient ... And the person will tolerate - not pain, but time - in anticipation of recovery.