Wednesday 11 March 2020

Chronic L5 / S1 Back Pain is not "NORMAL"

L5-S1-Disc

80% of the population have at least one round of debilitating low back pain at least once in a lifetime. Between 10 and 15 percent of the population has problems in the lower back that recur repeatedly throughout their adolescent and adult lives. Many people have back problems that originate from the lumbosacral joint, which is where the lower fifth lumbar disc meets the first sacral disc of the spine, L5 / S1, explains the orthopaedic in Delhi.

In plain language, this is the part of the lower back where the branches of the spine change to the pelvis and legs. In reality, this structure is not a single "joint." It includes a disc between the lumbar and sacral spine, and two facet joints (also known as zygophysical joints) that guide the movement of this part of the spine.

Many things can go wrong with this part of the spine. The disc may herniate. When this happens, the internal contents of the disc seep and touch the adjacent nerve. This condition is known as a lumbar herniated disc, explains the orthopaedic surgeon in Delhi.

Or the disc itself can degenerate. This condition is known as degenerative lumbar disc disease, or DDL. Another common possibility is that the facet joints fracture so that they cannot hold the lumbar disc in place. It glides over the sacrum in a condition known as L5-S1 isthmic spondylolisthesis. This part of the spine can also be damaged by stenosis, narrowing, or degenerative arthritis.

The spinal cord does not extend down into the lumbar spine. There is no danger of paralysis when this part of the spine is damaged. On the other hand, there is no end to the pain that can be generated by damage to this part of the spine. However, that doesn't mean that just because your lower back is killing you, you don't have a potentially serious condition. Sometimes you should not try to get pain care at home, and you need to see an orthopaedic in Dwarka right away:
  • Sudden bowel or bladder problems, either the inability to "go" or the inability to hold it, which appear suddenly, can be a sign of an urgent medical problem.
  • Severe back pain along with stomach pain from being unable to get up is also a potential sign of an emergency medical condition.
  • Weakness in the legs with problems in bowel or bladder control is also a signal to see a doctor right away.

However, chronic lower back pain can be treated in several ways at home:
  • Take pain relief as prescribed by the orthopaedic in Dwarka. If you need more pain relief, see the same doctor to request a change to your prescription. Avoid taking too much Tylenol (acetaminophen) to avoid liver damage.
  • Deep point massage (acupressure) is helpful in controlling pain but will not cure your back problems.
  • Movement-style acupuncture treatment (which receives acupuncture during exercise) is used in some Asian treatment centres.
  • Approximately two months of constant home exercise is required to restore strength and range of motion in the lower back. You cannot do the exercises again and hope to improve. Consistency is key. Your doctor can give you the specific exercises you need to do.
  • You may need a session with a physical therapist or coach.
  • Your orthopaedic in Delhi may prescribe a biofeedback machine to tell you when you are moving in a way that supports the recovery of your back.
  • Device-based therapy, using an exercise machine like the David Spine Concept system, is successful approximately 75 percent of the time. These machines are found in well-equipped gyms. You should not try to work out your own routine on ordinary gym equipment unless you are a physical therapist or coach.
  • If you are exercising well enough to exercise and have not been given specific exercises to strengthen your back, exercise with a Swiss ball and rubber bands instead of machines, at least at first. Exercise lightly with minimal effort until you are sure you can exercise without causing pain.
  • If you play contact sports, going back to the game before an injury anywhere else on your body increases your risk of lower back injury. The problem is you can't respond to a hit, kick, or tackle fast enough to avoid stress on your spine. A first injury tends to lead to a second or third, says the sports injury specialist in west Delhi.

If there's good news about low back pain and all the conditions discussed here, it's that they usually go away eventually even without treatment, if you can avoid injuring your back again. It can take weeks, months, or even a year or two, but almost all of them eventually get better.

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