General Orthopedic Problem
About General Orthopedic Problem
More than 80% population suffer from common orthopedic problem like low backache, neck pain and joint painin whole life more than once. Commonest cause of backache and neck pain is the abnormal posture, muscle weakness. Degenerative changes due to aging is also one of common problem in middle age and geriatric population. Most of time, these entire problem can be prevented by the proper care which include proper nutrition, weight maintenance, physical exercise, correct posture, proper use of mattress and pillow and ergonomics. Due to stressful life in this modern era, we always ignore these facts so by repeated attack of these problem it became persistent and affect quality of life. Other causes are infection like tuberculosis, trauma etc. if backache or neck pain do not resolve by two week then investigation like blood profile, x-ray, MRI is required to rule out the causes. Joint pain also occur because of trauma, arthritis and bad posture. It also require detail evaluation.
Backache is very common entity after cough. In which low backache is the commonest problem. Backache can affect any age group people but it affects more to young adult and old age group. Backache can occur because of problem in vertebral bone, muscles, nerves, disc between two vertebrae and joint. Chances of having backache to a person’s lifetime is 80%. Commonest cause of backache is wrong posture. There are many other important causes, which include muscle pull, disc diseases, arthritis, infection like tuberculosis, cancer, deformity in vertebral bones and osteoporosis. In females, there are more chances of backache due to reproductive tract infection and pregnancy. Backache can also occur more frequently in cases of obesity, stressful daily routine, long duration of standing, sedentary lifestyle, old age, mental problems, and cigarette smokers. Usually it does not require any investigation. But if even after two weeks treatment, there is no relief then X-ray and MRI are done with medical advice. X-ray tells about problem in back bones and MRI detects finer problem of nerve, muscles, bone & joint. In the initial period of backache,proper posture in sitting and standing, pain killer medicines, hot fomentation, exercises and use of braces gives fast relief. But braces are advised only for few days. Exercises increase strength and flexibility in back muscle. Precautions to be taken in refraining from picking heavy weight in forward bending, sitting straight on the chair, using cotton mattress, avoid sleeping in prone position for long time. If there is loss of weight, persistent of fever, swelling in back, pain in legs, tingling, weakness, problem in urine, very old age and cancer in body along with back ache then we require specific investigations. Treatment is based on specific condition. In postmenopausal female, osteoporosis is very common. Osteoporosis needs specific treatment including ant osteoporotic drugs, calcium, vitamin d, belt, exercise, oil massage etc.
When we hear the name of cervical spondylosis, we are scared as looks that it is a very big disease. But this is not true. This is verycommon condition. It is a general term use for age related wear and tear affecting the spinal disc in neck. As the disks dehydrate & shrink, sign of osteoarthritis develop, including bony projection along the edge of bones (bone spurs). It became symptomatic with the injury, sprain, stress, long time work in wrong posture, bad sleep habit etc.
Because of our erect posture and we have to work continuously against gravitational pull using our neck too much in all four directions,which poses too much pressure on the neck muscles, bones and inter-vertebral discs. After twenty years of age, flexibility of these discs start reducing.Bone grows at the border of bone to balance this nearby bones & disc, start putting pressure on the nerves passing through neck. This leads to pain in neck, shoulders and hands and also sometimes vertigo. When pressure on nerves increases much more then there is weakness, tingling and numbness in limbs. In spite of all this facts, only few persons have neck and shoulder pain. Sudden trauma in neck, wrong use of neck,long working on computer, studying and watching TV in lying position, weakness in muscles & bones and mental stress leads to neck pain.
No investigation is required in initial phase but if no relief after two to three weeks of treatment then X-ray is needed. If patient also have tingling and numbness in limbs then MRI is advised. Prevention is always better. You can prevent having the pain in neck by doing exercise, precaution and correct posture.In mild pain light exercise, oil massage, hot water fomentation helps a lot. But in acute and sever pain, patient may need complete rest along with pain killer and supplements. Pain killer medicines must be used only for few days. In vertigo and radiating pain in upper limb, patient may need some specific medicine. In chronic pain & stiffness, there is need of long term exercise, precaution and supplementary medicine. Exercise is needed to increase flexibility & strength of neck, shoulder & upper back muscle. Don’t move your neck very fast in all directions.Use pillow below the head in side lying position but pillow should not be used during sleeping in straight supine position. Also don’t keep hand below the neck or head but keep in front of the chest. Cervical collars are used only in severe conditions when pain is unbearable. Massage with some pain reducing oils also help.Cervical traction may help in reducing the neck muscle stiffness but some time it increases vertigo and radiating pain in upper limb.
Dr. Jitendra Kumar Jain is a famous name in the field of childhood physical disability pediatric orthopedic problems in North India. He has been an MS Orthopedics, DNB Orthopedics, Pediatric orthopedic surgeon & also a cerebral palsy specialist for over 21 years.
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Dr. Jitendra Kumar Jain
Trishla Orthopedic Clinic & Rehab center, 182C / 350A, Tagore Town, Prayagraj (Allahabad) U.P-211002, India