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Frequently asked questions

Diseases of the back and neck

Do I really need surgery if the medication I am taking is not enough to relieve me?

Not necessarily. There are also less invasive methods for treating the symptoms of back , sciatica and . If medication and fail, often local injection of anesthetic and cortisone into the joint or around the aching nerve in selected patients can effectively help improve symptoms.

Why should a doctor examine me if I have constant pain in the , which is not affected by my activities and gets worse when I rest or lie down?

These symptoms can sometimes be related to bone damage and even tumors that need to be diagnosed and treated early. In any case of suspicious symptoms such as these, it is advisable to seek the advice of your doctor.

I have a . Do I really need surgery?

No. Most people over the age of 50 have at least one slipped disk in their back. That alone means nothing. But if it causes symptoms such as severe sciatica (pain in the leg) or weakness or numbness that gets worse, then surgery may be necessary for proper .

The doctor told me I needed spine surgery but I was afraid I would be paralyzed

Modern spine surgery has evolved to the point that these surgeries are now extremely safe with a chance of permanent neurological damage of less than 1%. So these surgeries are now very safe, if needed.

How often does sciatica go away on its own?

In about 90% of patients, the sciatica will go away on its own, without requiring anything other than painkillers.

I had acute back pain / sciatica and was told I had to stay in bed for at least 4 days. Is this correct?

This has now proven to be a wrong tactic. Lying down weakens the muscles more and the improvement of the symptoms is delayed. The right thing to do is not to stay into bed, but to try to maintain, as much as the pain allows, our mobility and to walk as much as we can.

How much would it help if I lost weight to improve my back pain?

Very much. It is easy for the doctor to ask his patient to lose weight, but often this is very difficult, especially in older people. However, it has been proven that those who managed to lose weight, also improved in terms of back pain.

Why if I quit smoking can my back pain improve and if I need surgery, will I have a better chance of success?

It has been statistically proven that smoking has a negative effect on the natural course of back pain. Also, if someone has surgery, tissue healing is faster in non-smokers. Especially if spinal fusion is required, the success of the operation (good bone healing) is greater in non-smokers or those who quit smoking on the occasion of this operation.

I had back pain for many years. Now he is gone but my leg is numb and I think I have a little difficulty walking. Do I need to see a doctor?

Yes, because it seems that the possible slipped disc has now shifted to the side and is pressing on a nerve root. If this develops it can cause permanent neurological damage and an MRI scan must be done to determine the cause of these symptoms.

Do I have pain in my waist / neck? Should I go to an orthopedist or neurosurgeon?

Both specialties are sufficient for the initial treatment of these problems. The current trend is the specialization of some orthopedists and neurosurgeons in diseases of the spine. If a neurological problem coexists, the neurosurgeon can usually diagnose it more easily, although a good doctor, regardless of specialty, can direct the treatment of patients correctly.

My doctor recommended cortisone injections for low back pain. Is it dangerous and when can I repeat it?

There are two options: Many doctors, in cases of persistent back pain or sciatica, recommend cortisone, either orally or by injection. The value of this treatment is now in doubt, because in fact, it hides the problem and can mask significant clinical symptoms or diseases. If there are severe and persistent symptoms, which do not go away with painkillers and anti-inflammatory and AFTER MAGNETIC TOMOGRAPHY, there are indications to inject special mixtures based on synthetic analogues of cortisone. If this is done, it should be done for the safety of the patient by a specialized spine surgeon, using imaging guidance (radioscopy or, more modern technique with ultrasound). Patients should not be injected into the spine by palpation of the waist, blind. They are dangerous and can cause neurological damage!
If the infiltration helps relieve the patient, it can be repeated after a few months, in case of recurrence of symptoms. There are patients who have occasional symptoms that are successfully treated with filtration once every 6-18 months.
For more information, see here: Nerve infiltrations with ultrasound .

If I have pain in my back for 2 days do I have to have a direct x-ray or do I have to wait to see how it goes?

It is not necessary. The first treatment for such a situation is to take painkillers and rest our waist. Other important factors are whether the pain was caused by a sudden movement, or weight lifting, or injury or if it is accompanied by leg pain. These are the points that should lead us to seek medical advice. In case of injury, if there are signs of a back injury, or a history of osteoporosis, or if the pain does not subside with the usual painkillers, then in consultation with the doctor should be done an x-ray to rule out a fracture.

Can I do magnetic if I have metal materials from old surgery?

Usually yes. The materials used in spinal fusion, for the last at least 25 years, are compatible with MRI. In case of doubt, we ask the doctor who performed the operation, or we refer to the certificate of hospitalization of that operation.

What does the doctor see with the magnetic? Does it hurt like an exam?

MRI offers the best possible imaging of the nervous system and all the solid “soft” tissues, such as muscles, ligaments, intervertebral discs, etc. So, it’s an excellent diagnostic tool. However, it should only be done on the advice of a doctor, because it is an expensive test and should not be abused. It is a painless examination, but it requires us to stand still for a few minutes. Some people find magnet noise annoying. Also people with claustrophobia may find it difficult to do magnetic, especially brain and neck, because the distance of the machine from the patient’s face is short and there is no ease of movement. When a patient has a lot of difficulty with claustrophobia, we can give appropriate medication so that the examination can be done smoothly. It is very important to emphasize that MRI, unlike computed tomography or X-rays, does not emit radiation to the patient, so it can be done even in pregnant women without risk.

Did I have scoliosis as a child and is it still getting worse in my adult life? What should I do;

Scoliosis, like kyphosis, is measured in degrees. It does matter how many degrees is scoliosis and whether these degrees increase over . The radiological examination gives us valuable information. If the degrees increase, then you should consult a specialist spine surgeon. In most cases of increase in degrees, it is enough to apply the appropriate guardian to check the situation. However, there are cases when surgery may be needed, when the guardian does not correct enough or when the degrees increase, despite its use.

I have a sedentary job, how can I protect the strain on my spine?

Our spine, as a consequence of the evolution of the human species, is made to function in an upright position. So, the modern shift to a sedentary lifestyle, creates a lot of back pain problems. It is important in our workplace to sit in an ergonomically correct position, to take frequent breaks to get up and gently exercise our back and abdominal muscles. In our free time we should also exercise with walking, exercise equipment, cycling, swimming and running (the latter preferably up to 50-55 years). The combination of sedentary lifestyle, muscle inactivity and weight lifting with poor posture (heavy work at home, moving heavy objects, etc.), can be very bad for the health of our waist. In the case of the neck, the same applies. Frequent use of a computer screen, mobile phone, hurts the neck a lot, especially if there is no proper ergonomics. The basic rule here is that the screen should always be at eye level and there should be frequent breaks to relax the muscles of the neck, shoulder and upper limbs.

What exercises help to strengthen my waist?

Our torso strengthens with the exercise of the abdominal and back muscles. The ideal exercise for them is swimming. By swimming, the muscles work out better, due to the water resistance to movement. In addition, the waist is not strained with the whole weight of our body, due to the buoyancy of the water. Because this exercise is often difficult to do systematically, for practical reasons, the best alternative is brisk walking and torso muscle exercises with proper ergonomic means (gym). Cycling also helps a lot to all our muscles. What we should avoid is static standing and lifting weights in the wrong ways.

Can I use a support belt to prevent back injuries?

There are several types of lumbar spine. The most important support is offered by the waist belt with vanes. However, its use in healthy people is not necessary, except for extremely demanding tasks, such as lifting heavy weights. Its use in general can have negative effects, because it can cause inactivity in the back muscles. People who have had spinal fusion surgery should wear a lumbar belt. Also people who have spondylolisthesis or spondylolysis.

Brain

If a close family member has had a stroke, I'm in danger too

There are many causes for a stroke to occur. There are also many “types” of stroke: ischemic, hemorrhagic, from ruptured vascular dysplasia, from ruptured aneurysm in a vessel of the brain. Especially, if we have two people in our family who have undergone aneurysm rupture, ie subarachnoid hemorrhage, which is a type of stroke, we should do a cerebral angiography as a precaution. The preventive examination should be done as soon as the above diagnosis is made in two members of the family. It should be done on the other adult members of the family. However, because strokes are most often due to unregulated hypertension, blood clotting disorders, acquired vascular damage (eg atherosclerosis), smoking, diabetes, etc. It is important to pay attention to our health and eating habits to reduce the chances of such an episode happening to us.

How do I know if I got hit in the head?

A severe head injury is usually accompanied by severe symptoms of headache, dizziness, vomiting or a tendency to vomit, disturbance of the level of consciousness (eg drowsiness). Other neurological symptoms may occur. Pain and cramps are common symptoms of “innocent” head injuries. In any case of doubt, we contact the doctor, ourselves or ours. Obviously we visit the doctor when there is an open wound that is bleeding. After a head injury, we avoid exposure to the sun, overnight, alcohol consumption and long hours of work in front of a screen. Sometimes after the stroke, even when it has not caused anatomical damage (skull fracture or brain injury), dizziness, difficulty concentrating and headache may occur that can last for several days and the only treatment is rest and time. .

I have heard that it can be caused by an aneurysm stroke. Apply; Should I have gently tapped in the past should I be checked?

If you mean a brain aneurysm, it does not apply. Mild blows, apart from a small chance of post-traumatic “concussion”, do not cause any other damage. There is only one clinical scenario that is worth mentioning. People of the 3rd age who take , after 1-2 months after even a mild head injury may develop the so-called , a collection of blood between the brain and the meninges that surround it. This can cause neurological symptoms or a severe headache and may require surgical removal. So this group of patients is vulnerable and needs attention. .