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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 33069
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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I have never visited this site. What is the charge and how

Customer Question

I have never visited this site. What is the charge and how is it paid?
Submitted: 1 year ago.
Category: Health
Customer: replied 1 year ago.
What does this report mean? What type of doctor manages my care for this situation (Neurologist, Internist?) What type of surgeon goes in to clear space for the nerve (Orthopedic or neurosurgeon)? Is 'damage' permanent? If I try to walk 'throgh the pain' am I making this worse? This all started when I bent over to pick up a light chair. No pain in back at all. Pain is from left hip down to foot, varying all over the place and at different level of pain. Can sit in chair. Can sleep on side. Cannot walk more than 20 ft without pain. Cannot stand in place for any period of type without pain. In both cases, pain gradually gets worse.
Customer: replied 1 year ago.
Why does the website talk in terms of "counselors/therapists"? I am under the impression the issues are reviewed by MS's, no?
Customer: replied 1 year ago.
more data
Expert:  Dr. Arun Phophalia replied 1 year ago.

Hello, The damage is not permanent.

Expert:  Dr. Arun Phophalia replied 1 year ago.

Following measures would be helpful;

1) Back care in the activities of daily living, which is an integral component of the treatment of back problems. Back education is one of the most important thing which teaches the basic body mechanics, like correct posture for standing, standing at a desk or drawing board, sitting, brushing teeth, washing the face, pushing and pulling a weight, lifting a weight, getting in and out of bed, sleeping, getting into and sitting in a car. The training for these routine activity helps in preventing the spasm of the muscles. One needs to consult an occupational therapist or physical therapist which can educate about the proper and improper behaviors when back is painful in case they have to sit, bend forward, lie down, walk, cough, or sneeze. Following more need to be done:

a) Avoid activities which increases the pain.

b) Rest intermittently

c) Avoid bending at 90 degrees

d) Pushing and pulling should be avoided till pain subsides

f) Avoid prolonged sitting and standing

g) Avoid sitting or sleeping on floor

2) Anti-inflammatory analgesics like ibuprofen, other analgesics and muscle relaxants

3) Local analgesic gels or sprays / ointment

4) Hot fomentation

5) Electrotherapy like trans cutaneous electrical nerve stimulation: done by physical therapist. Other thing are ice packs, heating pads, electrical stimulation, phonophoresis, iontophoresis, relaxation, and biofeedback.

6) Good supervised physiotherapy: The exercises consist of abdominal bracing, modified sit-ups, double-knee-to-chest or low back stretches, seat lifts, mountain and sag exercises, knee-to-elbow exercises, hamstring stretches, extension exercises, and extension flexibility exercises. Swimming exercises (pool exercises) are best for back pain. Initial stretching and later strengthening exercises are taught.

7) Lumbosacral corset or support or brace

8) If obese or over weight, reduce weight for long term benefit.

9) Epidural steroid shots

10) Surgery is usually last resort, when the above conservative measures fail. You can start the following exercises;

1) Straight leg raising: Lie on the bed with your back and remain in a relaxed position. Slowly raise one of your legs upward and keep it as straight as possible. Count up to ten, and slowly bring down the leg. Do the same with the other leg. Repeat this exercise ten times.

2) Curl ups; lie on the back with knees bent, fold arms across the chest, tilt the pelvis to flatten the back, and curl-up lifting the head and shoulders from the bed / couch. Hold for ten seconds, then slowly lower to starting position. As strength builds, aim to complete one sets of ten curls. The exercise should be done twice a day (both the sets).

This is a slide show for the exercises (you can pick up your own set, which suits you);

http://www.mayoclinic.com/health/back-pain/LB00001_D

You can consult following specialists (apart from your GP);

a) Orthopedist

b) Neurologist

c) MD in Physical medicine and rehabilitation

It is privilege assisting you.

Please let me know if you have further queries or unanswered questions.

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Thank you.

Wishing you all the very best in life.

1

Expert:  Dr. Arun Phophalia replied 1 year ago.

The surgery can be done by the orthopedic surgeon specializing in spinal surgery or a neurosurgeon. This may not necessarily go worse, but one needs to respect the symptoms. This means that any activity which is causing pain or discomfort should be avoided. Pain is a protective phenomenon and indicates that activities which cause pain should not be done.

Your report point that you have pinched nerve. Pinching may not be necessarily progressive.

Thank you for the opportunity to answer completely your Question. Please make sure to rate me because that is how I am credited for my work.

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Thank you.

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