Back Pain – Causes, Relief and Treatment

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Back pain symptoms needs to be treated, the treatment starts with bed rest with analgesics and physiotherapy.  Any symptom which doesn’t get relieved by a general practitioner’s therapy for more than 2 weeks need to be attended by a specialist Spine Surgeon. If this also do not respond, if this conservative management do not respond then there are likely chances that further investigation need to be done.

Now, the investigations which are done are routine x-rays of that region, certain blood tests, MRIs, CT scans, and if need be PET scans.  With all these, if it is concluded that the patient requires surgery then only surgery is warranted.  When sufficient conservative management trials are given and still there is no relief in the symptoms, patients are considered for surgery.

The 3 main reasons why surgery is performed is either you have a nerve root compression which is not relieved by any conservative management, cord compression not relieved by any conservative management, or instability not relieved by any conservative management.  This needs to be addressed surgically by doing nerve root decompression, cord decompression, and fixation of the spine by putting screws in the pedicles.  Once the unstable spine is made stable, symptoms disappear.  Once the compressed nerve root and the cord is decompressed, the symptoms disappear.  That is why majority of the times, conservative management trial has to be given till the utmost; when it fails then only operative management is done.

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