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Author: spinesurgeonmumbai

25Dec

Back pain has multiple causes

1. Simple causes of back pain – Lumbar spine
spondylogenic / Metabolic / Mechanical/ Muscular / Postural / visceral / Reffered.

Often related to life style , posture , lack of exercise , Vit deficiency , increasing weight and stress. Do not have associated nerve compression
RED FLAG signs absent usually
Investigations often not needed unless pain persists >3 weeks

Pain is typically localised , fatigue related , better with rest , and exercises help a lot , need life style modification. Pain management with simple measures – exercise , medicines and heat therapy , supervised physiotherapy help. Meet spine specialist for supervised care.

Usually improve without any active / aggressive intervention

Contact specialist if pain persists or progresses.

2. Disease related back pain

  • Tuberculosis / Infection / Trauma / Instability / Tumor / inflammation / Nerve compression related causes.
  • Symptoms often more with activity / affect mobility / increase with walking
  • Symptoms often present at rest / night pain
  • Radiation to leg with nerve paresthesiae present if nerve compression is present.
  • Pain , Numbness , Heaviness weakness in leg – buttock and back of thigh and calf
  • RED flag signs noted.
  • Fever , Rest pain , Night pain , persistent pain , weakness leg , bowel bladder symptoms

May need investigations to detail to rule out exact cause , unsupervised pain management – self medication / self guided physiotherapy – not recommended and may not help.

7Aug

Scoliosis
1. Bend +rotational twist in spine causing – Hump / deformity / Swelling On back with posture tilt

2. Etiology -Idiopathic scoliosis in Young Adolescent female ( 8-15 years) present with back Hump

3. Other causes
– Congenital scoliosis(bony malformation)
– Syndromic scoliosis
– Neuromuscular Scoliosis among kids
– degenrative scoliosis among adults.
Correct diagnosis & etiology shall be ascertained at earliest

4. Presence of Pain and motor or sensory weakness / difficulty walking in scoliosis patient warrants – detailed investigation to rule out Infection / tumor / TB or some secondary pathology.

5. Proper X ray and MRI are primary investigations in scoliosis patients

6. Investigations in Scoliosis involve
– X ray Full spine PA view standing (not AP view)
– X Ray Full spine standing Lateral View
– X ray full spine PA views Bending films left and right
– MRI screening whole spine with dedicated study of affected spine ( only if pain or sensorimotor involvement )

7. Bracing, Casting and Physio have limited role or NO ROLE in correction of Scoliosis(only for mild deformity in young kids ). In severe deformity in gown up kids is a wastage of time.

8. Early diagnosis is important to manage the child surgically in safest manner. Late diagnosis can lead to severe deformity requiring bigger surgery.

9. Scoliosis Surgery is extremely Safe and predictable efficient straightening of spine is possible safely and is reocmmended if defomrity is progressive ( > 50 degree) or has pain, neuro deficit. Fear of surgery can sometimes can delay the need for worse.

10. Scoliosis surgery is extremely safe with modern innovations – navigation, Neuromonitoring and modern implant and imaging techniques.

Early diagnosis and early management is the key!!

18Jul

1. Pain around Neck / base of Head-Occiput/ trapezius to shoulders

2. common causes
“Posture / Muscle fatigue -constant dull aching pain/constant gaze in flexed position – advise – posture correction and supervised Physiotherapy”
“Degenerative ( wear n tear ) changes -neck spasm -common – omanaged by simple pain management and supervised physiotherapy”

3. NOT ALL NECK PAINS ARE ARE DUE TO SIMPLE CAUSES and need specialist opinion.
Neck pain ( seemingly subtle / simple neck pain ) can also be caused by problems requiring specific care

4. Causes of neck pain often requiring timely diagnosis and specialist opinion

  • Slip Disc with nerve compression
  • Cervical Myelopathy
  • Facet arthritis progressive symptoms
  • Cervical spine Tuberculosis
  • cervical Spine Tumors
  • cervical Spine metastasis
  • cervical Spine pyogenic infection
  • cervical Spine fracture or Whiplash
  • Metabolic Causes
  • cervical Spinal Deformity.

5. Early diagnosis is paramount and can have promising result timely intervention

6. Early Diagnosis can be established with detailed history taking to rule out any red flag signs – night Pain, Rest pain, Activity pains, 24 hours pain, Progressive symptoms, Neurological symptoms – paresthesiae, Numbness, Weakness of time movements of hands, Gait imbalance, Fever with pain

7. Any of these red flag signs shall raise suspicion and may need specialist opinion.

8. Cervical Spine Surgery has promising and predictable results and are routinely performed for Cervical slip disc, Cervical myelopathy, Cervical spine Tuberculosis, Cervical spine tumors, Cervical spine infections etc. All cervical spine surgeries are now performed under microscopic control with no risks.

9. Microendoscopic Spine Surgery, Minimal invasive spine surgery (Key hoke surgery technique) has promising results with added advantages in cervical spine surgery

Happy Spine – Spread smiles!!

Spine Tip of the Week - SCIATICA Slip Disc
8Jul
Sciatica

Definition

  • Pain radiating from back to buttock to back of thigh to calf is sciatica
  • Pain in sciatic neeve region / dermatome is sciatica
  • Leg pain from buttock to calf
Causes :-

Multiple causes can create sciatica

  • SPINAL CAUSES ( Common )
  • Slip Disc / herniated disc / disc bulge one of commonest commonest cause -pain and paresthesiae in dermatomal pattern
  • Nerve compression due to Degenerative facet arthritis /canal stenosis or some progressive disease like infection / TB / Tumor can present as sciatica. – In disease related sciatica the pain is not activity related and is usually present even at rest.
EXTRASPINAL CAUSES (Not uncommon)
  • Sacroillitis – one of the common causes usually missed in diagnosis
  • Hip pathologies – AVN, hip OA
  • Peripheral neuropathy
  • Visceral and vascular insufficiency
  • Reffered pain

Most of these may mimic like sciatica as pain is in same location but cause is extraspinal.

THUMB RULE For Management
  • Always examine and take detailed history to rule out exact cause and differentiate spinal vs extraspinal cause of sciatica
  • History taking and clinical examination is the best mode to establish near confirmed diagnosis
  • Conservative treatment with medication and physiotherapy under supervision – usually helps in degenrative pathology with no neurology deficit
  • Surgery may be required in small subset of patients progressive symptoms with neurology
  • MICROENDOSCOPIC SURGERY – MINIMAL INVASIVE SPINE SURGERY – is extremely safe simple and predictive with promising results and least bed rest/ hospital stay
Spine Tip of the Day - Backpain
2Jul

Back pain has multiple causes: 

Simple causes of back pain – Lumbar spine spondylogenic / Metabolic / Mechanical/ Muscular / Postural / visceral / Reffered.

  • Often related to life style, posture, lack of exercise, Vit. Deficiency, increasing weight and stress.
  • Do not have associated nerve compression
  • RED FLAG signs absent usually
  • Investigations often not needed unless pain persists >3 weeks

Pain is typically localised, fatigue related, better with rest, and exercises help a lot, need life style modification. Pain management with simple measures – exercise, medicines and heat therapy, supervised physiotherapy help.

Meet spine specialist for supervised care.

Usually improve without any active / aggressive intervention

Contact specialist if pain persists or progresses.

Disease related back pain

  • Tuberculosis / Infection / Trauma / Instability / Tumor / inflammation / Nerve compression related causes.
  • Symptoms often more with activity / affect mobility / increase with walking
  • Symptoms often present at rest / night pain
  • Radiation to leg with nerve paresthesiae present if nerve compression is present. – Pain , Numbness , Heaviness weakness in leg – buttock and back of thigh and calf
  • RED flag signs noted. – Fever, Rest pain, Night pain, persistent pain, weakness leg, bowel bladder symptoms

May need investigations to detail to rule out exact cause, unsupervised pain management – self medication / self guided physiotherapy – not recommended and may not help.

 

If you would like to Consult Spine Doctor for professional opinion for all spine problems Call for Appointment : 9619100123

19Jun

Neck pain is pain in the neck region resulting in loss of function causing disability is common. Pain in the neck is very common complaint and is only second to common cold in sickness absenteeism. It is believed that about 85 % of general population will have at least one episode of neck pain in their lifespan.

Neck and shoulder pain can be classified in many different ways. Some people experience only back pain or only shoulder pain, while others experience pain in both areas.

Causes of neck pain include:

  • Abnormalities in the bone or joints
  • Slip disc /Disc bulge /Herniated disc
  • Trauma
  • Poor posture
  • Degenerative diseases
  • Tumors
  • Muscle strain

To determine exact cause of your problem you should meet a nearest spine doctor or a spine specialist. Dr Vishal kundnani is one of the best spine specialist in mumbai and one of the best spine surgeon in India
The treatment of soft tissue neck pain and shoulder pain often depends on the source of pain. Pain also may be treated with a local application of moist heat or ice. Drugs like muscle relaxers and even antidepressants might be helpful. Local corticosteroid injections are often helpful. For both neck and shoulder pain movement, exercises may help. For cases in which nerve roots or the spinal cord are involved, surgical procedures may be necessary. To plan the best treatment option for yourself one shall meet a spinal doctor or a spine specialist in Mumbai. Dr. Vishal Kundnani is the best spine specialist in india.

Consult your Spine Doctor during Lockdown on video call / Telephonic call an get professional opinion for all spine problems

For Appointment Call : 9619100123

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