Charles Triay (General Practicioner) gives expert video advice on: What should I do if I have back pain?; What is a slipped disc?; What are the symptoms for sciatica? and more...
What should I do if I have back pain?
Well, the first thing you need to do if you have back pain is that you need to consider what the causes of back pain are. In the vast majority of cases, back pain is going to be caused by a lumber spine problem, but one just needs to consider that back pain can be caused by a kidney problem, for example a kidney infection. Back pain can be caused by a stomach ulcer or back pain can be caused by a pancreatic or even an aortic problem. Those are the rarer conditions, but you need to know about this so that if you have a significant degree of back pain, you need to go and see your doctor. Having said that, I think the vast majority of causes of back pain will be lumber spine pain and therefore you need to consider, firstly, that you need to relieve pain and you can do that simply by taking some mild analgesics which you might have at home. In the vast majority of cases, if it's not a severe episode after two or three days the back pain will be relieved.
What is a slipped disc?
A slipped disk is a common term used for an intervertebral disc herniation. That's just a long expression to explain that the vertebral disk, which is a cushion sitting between the vertebral bodies in your spine, has protruded in a particular direction to cause pressure on either the spinal cord or one of the nerve routes coming out of the spinal cord. Intervertebral discs may slip as a result of either repeated exertion or strain on the back, in particular professions that are lifting heavy objects continuously. Or one particular movement, which might be sudden and produce this sudden bulge of the intervertebral disc.
What are the symptoms for sciatica?
The symptoms for sciatica are essentially pain. What makes us diagnose it as sciatica is the type of pain and the distribution of that pain. The pain is usually a sharp, often severe lancing type pain which usually starts in the lower back in the lumbar spine and radiates to a buttock and often down the back of the thigh and calf all the way down to an ankle or even a toe.The reason for that is because if there is pressure on the nerve root that supplies that part of the body and arises in the lumbar spine, the pain will radiate in that direction and all the way down that nerve.
How can sciatica be treated?
Sciatica can be treated either medically or surgically. Inevitably, we would much prefer to treat it medically, because surgical intervention is typically avoided if and when possible. And the medical treatment of sciatica involves (a) relieving pain, and that obviously means analgesics, (b) relieving the muscle spasm which is often caused by that pain, and that means administering muscle relaxants, and then thirdly, trying to reduce the inflammatory response caused by that pain, which often causes fluid and therefore more swelling of those areas. That is dealt with by using anti-inflammatory medication and, in the more severe cases, steroidal medications. Surgical treatment of sciatica really means that a surgeon needs to relieve whatever is causing pressure on that nerve causing the sciatica, which in many cases will be a disk hernia or in some cases can be arthritis which has progressed to press on the nerve as it comes out of the spinal cord.
Is taking painkillers for a bad back beneficial?
I think that it is important to relieve pain when you have back pain associated with a bad back the reason for that is because pain induces a number of other problems which will perpetuate the back problem. For example: muscle spasm and inflammatory fluid and swelling, so when you have back pain associated with a bad back it is important to break the pain cycle- therefore I think it is beneficial to relieve pain. However, one has to be careful that by relieving the pain you don't expose yourself to an excessive amount of exertion or movements which would make your back problem worse. So pain is to be relieved but with caution and under medical supervision