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Back Pain

What are the causes of back pain

In most cases, it is difficult to pin-point a single reason for back pain. It is usually a combination of factors. That being said, the usual causes of back pain are

Injury or overuse of muscles, ligaments, and joints.

Pressure on nerve roots

Spinal deformities

What is a slipped disc

Our spinal disk (Inter Vertebral Disc) is like a jelly donut, with a softer center encased within a tougher exterior. A herniated disk (also referred as slipped disc) occurs when some of the softer “jelly” pushes out through a crack in the tougher exterior.

A herniated disk can irritate nearby nerves and result in pain, numbness or weakness in an arm or leg.

Disc herniation is usually due to age related degeneration, although trauma, lifting injuries and straining may also contribute to the problem.

Can Osteoarthritis cause back pain

Osteoarthritis is a condition in which the cartilage that protects and cushions the joints breaks down over time. Eventually, the bones-formerly separated by the cartilage-rub against each other, resulting in damage to the tissue and underlying bone and causing painful joint symptoms. When osteoarthritis affects the small joints in the spine, it can lead to back pain. Osteoarthritis in other joints, such as the hips, can cause us to limp or to change the way we walk. This can also lead to back pain.

What is Acute Back pain?

Acute back pain comes on suddenly and usually lasts from a few days to a few weeks (maximum up to six weeks). Most cases of Acute Back pain will clear up in a few days without medical attention, although recurrence after a first attack is common

What is Chronic Back Pain?

Chronic back pain is typically described as lasting for more than three months. It may result from a previous injury, or it may have an ongoing cause, such as nerve damage or arthritis. In some cases, the exact cause of pain cannot be identified.

Will exercise help relieve my back pain or prevent it returning?

Yes. Doing regular exercise can help to reduce and relieve back pain, and even prevent it from returning. There’s a whole range of physical activities to keep our back healthy. Research suggests that exercise may help if you have back pain that lasts for longer than six weeks. You may be able to try:

walking

yoga

swimming

cycling

hydrotherapy (exercises in water)

(Note: Exercises should be undertaken only after consulting with your Physician)

Is obesity a cause for back pain?

Yes. The chances are more for obese people with big tummy to get back pain. Overweight people invariably adopt a very poor posture .They carry their excess weight in front of them, which throws their backs into an uncomfortable hollow. This overstretches certain spinal ligaments and reduces the diameter of the foramina (holes) through which the spinal nerves emerge, increasing the risk of nerve root compression. Pregnant women are also prone to backache because they carry the weight of their babies in front of them. This forces their spines into a painful backward bend. Exactly the same is true for a obese person with big tummy.

Does my Mattress have a role in causing back pain?

Yes. The wrong mattress can be a reason for causing back pain. Lack of support from a mattress reinforces poor sleeping posture, strains muscles and does not help keep the spine in alignment, all of which contribute to low back pain.

Recent studies show that a medium-firm mattress greatly improves the sleep quality in people suffering from chronic lower back pain. A mattress that provides both comfort and back support helps reduce low back pain, allowing the structures in the spine to really rest and rejuvenate during the night.

Varicose Veins

What are the options for non-surgical treatment of Varicose Veins

Following are the non-surgical treatment methods adopted in the treatment of varicose veins,

  1. Leg elevation & exercises
  2. Wearing Graduated Compression Stockings
  3. Ultrasound guided foam Sclerotherapy
  4. Endovenous thermal ablation
  5. ClariVein®

1. Leg elevation & exercises: Leg elevation and exercise often provides temporary symptomatic relief.

2. Wearing Graduated Compression Stockings: Wearing graduated compression stockings with variable pressure gradients (Class I, II & III) has proven to reduce swelling and improve blood circulation thereby stops the progression of the condition. The pressure grades and the styles (below knee or above knee) should be selected under the supervision of the doctor. Varicose vein patient are advised to wear graduated compression stockings even after any surgical or non-surgical treatment methods. Apart from controlling the progression of varicose veins compression stockings will prevent the re-occurrence of varicose vein problem.

Comprezon is one of the largest selling Varicose Vein stockings in India and has been trusted and prescribed for doctors for almost two decades.

3. Ultrasound guided foam Sclerotherapy The procedure involves injecting foam into the affected veins to inject and destroy the affected veins. The procedure is usually done on either the long saphenous vein on the inside of your thigh or the short saphenous vein on the back side of the calf muscle. After the procedure the patient will be advised to wear a graduated compression stockings. Endovenous thermal ablation The procedure involves passing a probe into the affected vein to heat up and seal the vein from inside using Laser rays or Radio Frequency waves.

4. Endovenous Thermal ablation done using Laser rays is known as Endovenous Laser Ablation and that using Radio Frequency is known as Endovenous RF Ablation. Patient is advised to wear graduated compression stockings for a certain period.

5. ClariVein® Clarivein is minimally invasive methord used to treat varicose veins using anesthetic. The procedure involves inserting a rotating catheter into the vein and releasing a drug to seal it from inside. After the procedure compression stocking will be applied to the leg.

Surgical Treatment of Varicose Veins

The following options are available for Surgical Treatment of Varicose Veins.

1. Phlebectomy:

Phlebectomy is a minimally invasive surgical procedure to remove the varicose veins.

There are two basic types of Phlebectomy – Ambulatory Phlebectomy and Transilluminated Powered Phlebectomy (TIPP).

1(a). Ambulatory Phlebectomy: In Ambulatory Phlebectomy using a scalpel or needle doctor punctures the skin near to the varicose vein and inserts a small hook into the hole and grasps the vein and remove it. The area is covered with a compression bandage or a compression stocking (varicose vein stocking).

1(b). Transilluminated Powered Phlebectomy: Transilluminated Powered Phlebectomy is slightly more invasive compared with Ambulatory Phlebectomy. After making two small incisions, the surgeon inserts a tumescent canula illuminator that contain a fiber optic light which illuminate the vein and makes it easily visible. Fluid containing local anesthetic is infused under the skin loosening the vein from the surrounding tissues. A vein remover instrument is guided to the vein, which is suctioned into the instrument where it is cut into small pieces and removed.

2. Venous stripping: Venous stripping procedure is similar to Phlebectomy, where all parts of the saphenous vein main trunk is removed through the incision made near to the varicose vein.

3. Vein Ligation: In this surgical method incisions are made above the problematic vein and the vein is tied off, to cut off the blood flow to the varicose vein. This vein gradually becomes less visible.

What are varicose veins?

Varicose veins are dilated, swollen, tortous veins of the superficial venous system of lower limbs which are seen bulging from the under surface of the skin. They are most commonly seen in the lower limbs and can be cosmetically deforming.

Who are at high risk of developing varicose veins ?

Though the causes of varicose veins are many, the following groups are at higher risk.

Age – Adults above the age of 40 are at higher risk
Gender – Women are at higher risk than men
Obesity – Over-weight people are at higher risk
Family History
Sitting or standing for long time at work e.g teachers, policemen etc
Lack of movement or low physical activity
Pregnancy – due to the increase in blood flow. Also the enlarged uterus puts pressure on the veins.

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