| Treatment options of back pain – part 2 |
![]() Always seek doctors’ advice!When back pain begins many physicians will first recommend home treatment, in the form of bed rest and the use of over-the-counter pain relief medication. In cases when home treatment doesn't work, then doctors will take more dramatic measures. Different medications for back painThe most common pain relievers used for back pain are non-steroidal anti-inflammatory drugs, commonly referred to as NSAID’s. NSAID’s are very efficient for the treatment of back pain resulting from an inflammatory condition or a degenerative condition. Note however that prolonged use of NSAID’s can have very serious side effects. Therefore it is always advisable to see your physician before taking them. Corticosteroids are also sometimes used for temporarily reducing inflammation. A one-time injection of a corticosteroid into the affected area is sometimes administered to short-cut sciatic pain until the body heals itself naturally. Corticosteroids however are not a cure, and offer no long-term benefits. In some cases, physicians will also prescribe muscle relaxants to prevent secondary muscle spasms, but it is believed that NSAID’s are just as effective. Moreover there is some discussion about relieving muscle spasms, because these tensed muscles could be protecting damaged structures from further damage. In sub-chronic or chronic cases of back pain the use of anti-depressants is indicated. Long-term back pain is often complicated by socio-psychological problems. Are you worried about surgery?In some cases surgery is unfortunately the only way to provide pain relief. The most common reasons for surgery are sciatica and spinal stenosis. Generally pain should be present for at least 6 weeks and be so debilitating that normal daily activities are not possible. There are several surgical options depending on the cause:Discectomy is the surgical removal of a damaged intervertebral disc thereby relieving pressure on the surrounding structures, i.e. nerve roots. A discectomy is usually indicated in case of disc hernia with paralysis and/or incontinence signs. Today most discectomies are performed using endoscopy (a tiny tube with surgical instruments and camera to enter the joint), for which only a local anesthetic is required. In many institutes endoscopic discectomy is now an outpatient surgical procedure. A laminectomy or laminotomy are usually indicated in serious cases of spinal stenosis or spondylolisthesis with the aim to decompress the nerve. The procedures involve shaving off part of the vertebral arch (laminotomy) or removing the entire vertebral arch (laminectomy). In both cases a general anesthesia is required and at least two or three days hospitalization; total recovery usually takes up to six weeks.
When there is vertebral movement or instability, which causes pressure on the nerve roots, e.g. in spondylolisthesis, the surgeon can opt for a spinal fusion. This procedure involves stabilizing the structures with bone grafts. Sometimes a small metal cage is implanted in the disc space to offer extra stability and to allow the bone grafts to fuse the vertebrae together. Herniated discs can also be treated with chemonucleolysis. The procedure involves injecting a substance into the gel-like center of the disc (nucleus pulposus), which is herniating and putting pressure on the nerve root. This causes a chemical reaction and shrinks the nucleus, thereby relieving pressure on the nerve root. The procedure is usually done under local anesthesia. After the procedure some pain and muscle stiffness may persist, and generally, a 4 to 6 week recovery time is to be expected. Sometimes nothing can help us to stop back pain except surgery. But there are ways to relieve the pain and make it more endurable, before and after the surgery. And KOSMODISK products will do just that if not even chase the pain away. |



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