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Back pain - Disc prolapse

Q: My 52 year old mother has severe back pain since last 10 years. Consultation with various doctors has shown no result. Once in her childhood she got hurt at the back by a concrete structure. This started hurting about 15 years ago: The details of the back pain are: It is exactly on the backbone. It gets worse in winter. She can not bend fully to lift anything from the floor. If unconsciously she does so, the pain aggravates. She cannot bear the jerk on a speed breaker. I will be obliged if you can let me know the following : a) Short term treatment, which gives her instant relief. b) Long term medication c) Exercise

A:I think your mother has a disc prolapse, or canal stenosis. I am not sure whether she has symptoms in her legs, though. Well the correct diagnosis can be had by an X-ray first followed by an MRI. The X-ray will show the vertebra (bones) and the MRI will show the soft tissue structures (spinal cord, intervertebral disc). I think it is really important to have a correct diagnosis prior to having any definitive treatment. Medical treatment and exercises work remarkably well in a number of patients. Those who are not relieved by medicines and exercises undergo surgical procedures to remove the prolapsed disc. Medical treatment consists of drugs that are analgesic (pain relievers) and anti-inflammatory. You can also use muscle relaxants for acute muscle spasms. No long term medicine is advisable cause all medicines have side effects. The only long term treatment is exercises, improving posture and other habits, avoiding certain positions, etc. Yoga is a good and encouraging way. Ayurvedic medicines can be taken for a longer time but their benefits are not proven scientifically. I think your mother needs to take the following precautions: 1) Avoid lifting any weight. 2) Avoid bending, twisting, sitting on the floor, stair climbing and running. 3) Walking is encouraged within the limits of pain. 4) Take pain killers and muscle relaxants only for short time when you have sudden pain. 5) Do not massage very hard. You can apply analgesic ointment softly. 6) Belt can be worn when walking or travelling. Its not harmful and may benefit certain patients. 7) Physiotherapy is the mainstay of treatment. Try to build up your back muscles by gradual strengthening exercises. You can have hot fomentation. Traction maybe helpful in certain cases. All this has to be done under supervision of a physiotherapist.

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