Who should you consult first regarding back and neck pain?
Treatments for neck and back pain
are offered by many specialists such as Orthopaedic surgeons, Neurosurgeons, Physiotherapists, Chiropractors and so on. There are a range of treatment options available for these problems including Physical therapy, Traction, IFT, Ultrasound, Laser therapy, TENS machine, Acupunture, Yoga therapy, various Injection therapies, Ozone therapy, Coblation Nucleoplasty, Surgical treatments etc. The fact that so many therapies exist tells us two things about this problem.
- 1. These are very common problems and a big market exists in trying to treat these.
- 2. There is no single treatment available to treat all of these type of pains.
Different specialists offer different treatments for these conditions. So, the question comes… if you have back or neck pain, who should you see first?
The obvious answer would be… that the person you are going to see should understand your problem properly to make the correct diagnosis first, as back or neck pain is not a diagnosis. The possible diagnosis for back and neck pain range from simple muscle pain to arthritic joint pain to disc prolapse pain to spinal infection pain to pain due to spinal tumours. So, it is essential to make a proper diagnosis first. Again, the procedure for making a diagnosis could be just an examination of the patient by a trained person to more expensive methods such as an MRI scan.
Thus, experience and knowledge of the examining person becomes a very important part of dealing with the problem. There are specialist surgeons nowadays called Spine surgeons who are basically an Orthopaedic or Neuro surgeons who have acquired specialist knowledge regarding spinal problems and undergone further training in treating these conditions. It is also important that these surgeons should not just concentrate on treating patients with surgery but has a wholistic approarch using many of the available modalities in dealing with these problems. This is very important as a specific diagnosis will require a specific treatment. At our ASTRA Ortho n Spine Center we take pride to have made such a facility available which encompasses most of the above mentioned modalities of treatment for these problems. We also have Spine surgeons who beleive in this wholistic approach and have all the necessary knowledge and training to deal with these comlex conditions.
Is Total Joint Replacement the solution for arthritis?
To answer this question, we need to understand what arthritis is. Arthritis means ‘Inflammation of a joint’. There are many causes for arthritis including wear and tear, injury, infection and immunity related inflammatory conditions like rheumatoid arthritis. Different types of arthritis can have different types of symptoms and signs. It is important to identify the specific type of arthritis one suffers from to deliver the correct type of treatment. So, it is imperative to consult a well trained Orthopaedic surgeon early to make a proper diagnosis, as some arthritic conditions if identified early, can be treated by medicines and other therapies alone and will not require surgery.
In the days gone by, treatment of arthritis used to be treated with medications or surgery. Recent advances in the medical field has now given us many options in treating arthritis. Non-operative treatments for arthritis include medications which can be simple or potent painkillers, anti inflammatory and disease modifying medications, anti inflammatory steroid joint injections, disease modifying joint injections, physical & yoga based exercise therapies, Laser, IFT & other pain therapies. Choice of non-operative treatment depends on the specific type of arthritis and the severity of the problem.
Operative treatment used to be Total joint replacement alone, until very recently. Nowadays, we have developed many surgical techniques to deal with specific types of disease. Arthritis due to wear and tear is by far the commonest type of arthritis. Wear typically starts at one part of a joint and so it makes sense to repair that part of the joint and realigning the joint or replace only the part of the joint that is worn out, provided the arthritis is diagnosed early. This gives much better surgical outcome in general as the patient’s own joint is preserved by these techniques. These newer surgical techniques include cartilage replacement using patient’s own stem cells, cartilage and ligament reconstructions and repairs, bone realigning osteotomies and partial joint replacements. We recently conducted an International conference with live telecast of surgeries at our ASTRA Ortho n Spine Center to educate and train our surgeons in these techniques, which was very well received.
So, to conclude, Total joint replacement is not the only solution in the treatment of arthritis. It is certainly a tool in the management of arthritis, but it should be considered only when all other non-operative and above mentioned newer surgical techniques are not going to correct the problem. It is essential to seek advise from a surgeon who understands and considers all of these options.
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