Back pain – Part III. Operational possibilities

Not infrequently, the treating physician of a “back patient” after unsuccessful conservative pretreatment also need to inform about a necessary and more extensive “invasive and / or surgical procedures” and decide on further measures with his entrusted patient.

When a layperson hears about spinal surgery, at first, there is usually a strong and legitimate discomfort. The general idea that these are high-risk interventions is still widespread. In contrast, spine surgery has made tremendous progress over the last decade. While in the eighties and nineties stiffenings with large surgical scars and long hospital stays were the order of the day, today most interventions can be performed on an outpatient basis with surgical scars. under 1cm.

This is especially due to two facts. On the one hand, new biomaterials, surgical techniques and implants have come on the market, on the other hand, interdisciplinary centers have increasingly emerged outside hospitals, offering the full range of conservative treatment and minimally invasive surgery. From diagnostics to the right therapy, practically everything is in one hand and targeted individualized step therapy can be carried out.

For example, today many herniated discs can be shrunken in an outpatient setting after a few minutes of local anesthesia in case of conservative therapy failure. The success rates are higher here than with conventional open therapy. If there is a major herniated disc with nerve failures, using a microscope this is also often removed on an outpatient basis. At the same time, a protective film is placed around the nerve, which reduces scarring and pain and prevents the risk of a new herniated disc. Even simple fractures of the spine, which used to be tediously treated with corsets for 3 to 6 months, are stabilized today by an outpatient procedure in which a biomaterial is injected into the vertebra under local anesthesia.

Patients are immediately fit for work and sport. Also in chronic problems of the spine such. Nerve narrowing in the cervical or lumbar spine areas makes it possible today to avoid major surgery and stiffening, and to insert implants that correct the problem and preserve the mobility of the spine. The principle here is the following: Not by a stiffening, but by targeted treatment of the cause of pain with the smallest possible intervention to treat the pain. Of course, it can happen that the corresponding segment has to be stiffened if there is a significant amount of eddy gliding. However, there are also keyhole techniques today that allow for immediate mobilization and early release, often after a few days. Furthermore, a better interdisciplinary networking in special centers ensures that other causes of spinal complaints are recognized in good time and specifically treated. This avoids unnecessary surgery and overall allows for the success rate of spinal surgery (which is properly selected today at up to 90%).

In summary, modern spine surgery has lost much of its horror. The old saying, “stiffen is better,” has been replaced by the finding “less is more” to maintain mobility, to restore work and sports ability through a possible outpatient or short-term surgery and, above all, the potential risks minimize.

Here once in short form some of the most important vertebral column interventions.

I. The Minimally Invasive Methods: Facet Infiltration / Nerve Root Blocking / Peridural Injection and Catheter Techniques with Anti-inflammatory / Analgesic Materials

II. Intervertebral disc procedure: minimally invasive / endoscopic with and without additional concomitant surgical procedures / means.

III. Stiffening operations / intervertebral disc prostheses and other movement segment affecting surgical procedures

But even with surgical procedures is usually a fundamental change of the so-called.
“Back consciousness” in the sense of a so-called “back school” very important and necessary for sustainable therapeutic success. And despite or even because of a successful spinal surgery, it is imperative to “always do something yourself” for his back.
And IMPORTANT: to find the right therapeutic method at the right time individually is the high art of the supervising physician / therapist and above all the order “to look after” his / her patient / customer optimally even without economic constraints.

Microimmune therapy Mallorca

Doctor Seita -MSM-extends his practice concept and can be trained to become a microimmunotherapist by the MeGeMIT.

This immunomodulatory treatment, which works with the same messengers as the immune system (eg cytokines, hormones, growth factors, nucleic acids), aims to send the best possible information to the organism and to correctly “tune” a positive immune response to an existing pathological situation To support self-healing.

And in a holistic medical concept, this procedure is more than justifiable even when it comes to orthopedic-pain management issues.

 

Cycling – More than just a trend sport with a lot of health and danger potential

The bike is number one as a means of transport and runs other means of transport from the rank. In Germany alone there are approximately 80 million bicycles estimated. Tendency increasingly increasing. Cycling is known to be healthy and therefore fully in the health trend.

And the conditions are optimal for this. The saddle carries a large part of the weight and with the correct position on the wheel, joints, ligaments and tendons are spared. At the same time, the muscles gain momentum through the smooth movement, the cardiovascular system is required and the condition is trained. The quality of life is sustainably improved and it helps to “general recovery”. Cycling thus improves endurance, strength, flexibility, balance, responsiveness and offers the experience in a change of relaxation and physical challenge and then all in the wild. Read More

– Back pain – I. The conservative procedures – inject –

Usually the short stay in draft, the too heavy shopping bag or the famous “wrong movement”, and already the pain is there. In such a situation, most people want only one thing: to move as quickly as possible without pain. If then the emergency medication, the hot water bottle and the “always good special tip of the neighbor” does not help any more or the complaints deteriorate even goes to the specialist. And not infrequently, the doctor can do just that with a targeted syringe in the “right place and at the right time”, and interrupt this pain cycle. The injection is actually not as bad as their reputation. If they do not, like many others, know of good and bad experiences from the past, it replaces a causal and fundamental necessary treatment concept. However, not every syringe is the same, even if this is often generalized with the patient and also the doctor. Is it a muscle hardening, tendon tension or rather a nerve root irritating disc herniation? Do the pain out or are they restricted to a particular area? Is the pain dull, piercing, or rather tearing? These and many other questions will make a good doctor and also take into account other necessary aspects (illnesses / injuries / medicines, etc.) before he canal the cannula. As a rule, a general, systemically effective “universal syringe” with pain relievers, muscle relaxants and anti-inflammatory agents is often successfully used by the GP. But not only the ingredients, but also the location and type of injection, vary according to the medical indication. The four most important “targeted special injection forms” are compiled here briefly and informatively.

Neuraltherapy – After physical exertion / maladjustment or even unusual cold / drafts, a muscular hardening of the muscles can occur, which can not be overcome by careful movement (eg acute skew). Through the targeted injection of a local anesthetic into certain skin points or in the vicinity of muscle and nerve cords, a pain-alleviating and muscle-relaxing effect is achieved. Also, specific other additives may be added to potentiate / stabilize the effect. When the effect of the syringe decreases, the trigger of the direct complaints usually disappears, so that no further causative therapy is necessary.

The nerve root blockade- A nerve root blockade is performed, for example, in patients with (sub) acute lumbar disc disc prolapse. In this case, a local anesthetic or cortisone is sprayed directly onto the nerve root, which is impacted by the preceding intervertebral disc tissue. The pain usually occurs immediately, but short-term deafness in the leg may occur (depending on the location of the affected nerve root). The cause of the complaints is however not eliminated; There will almost always be a need for intensive, conservative treatment, as well as surgery.

The epi (peri) durale injection- An injection into the space between the spinal cord skin. It is used for the treatment of such disc disc protrusions or incisions, in which a constriction of the spinal canal arises due to the inflammation-induced swelling of one or more nerve roots. In addition to a local anesthetic and cortisone, a saline solution is often injected, which also reduces the swelling due to the natural osmosis effect. Depending on the location of the symptoms, the epidural injection is either directly between two vertebrae or as a sacral injection through a natural opening at the coccyx.

The Facet Infiltration – Sometimes it is not the nerve roots, but the small vertebral joints (facets), which are innervated with a lot of nerves, from which the pain emanates. The reason for this can be a wear-induced osteoarthritis, but also irritation due to too great mobility of the vertebrae, caused by a loosening of the capsule / tape apparatus. The facets themselves can then be sprayed with an anesthetic or cortisone. This injection is carried out by an anatomically well-trained and experienced physician also “freehand” with orientation to anatomical “landmarks”, ie well palpable parts of the spine. Sometimes, however, the injection of the syringes also requires targeted placement under ultrasound / CT / X-ray control.

As already mentioned, the so-called rapid syringe “does not treat the cause, but usually only, but often very successfully, the main symptom: the pain. And with pain, most of the necessary measures can not be properly and adequately addressed. The causative therapy should always be kept in mind by the patient and also by the physician, and then promptly and qualitatively in the short / medium term. In the case of a simple blockage / tension, the massage, chirotherapy and / or manual therapy can be used; in the case of more extensive problems, the general and special physiotherapy is used as basic therapy. But also various electro- / thermostimulative measures and special associations (Kinesiotape, etc) can support the applications. But usually a basic holistic change of the back consciousness in the sense of a so-called “back school” is absolutely necessary to become long-term complaint-free.

Back pain – Part II

Conservative-non-operative therapy options

Most back pain is harmless and often disappears spontaneously and without treatment after a few days. However, if the doctor is needed, it should always be decided as part of a step treatment concept on the “actual state of health” and the individual requirements with his patient together, which other different acute therapies are possible and timely. However, the principle always applies from simple to severe, and from uncomplicated to more risky treatment. Often, various measures are combined or affiliated. Here are some of the so-called “conservative spine procedures” once put together very briefly and orienting.

I. The massage is available in various techniques and applications. It comes by means of a mechanical influence of the skin, connective tissue and muscles by stretch, tensile and pressure stimulus to alleviate the symptoms. The effect of the massage extends both from the directly treated place, as well as over the entire organism including the psyche.

II. Manual Therapy / Chiropractic: – By means of certain grip and impulse (manipulation) techniques and special relaxation exercises, “movement restrictions” of the joints and muscles are to be solved, which may be responsible for pain and other symptoms.
III. The electrotherapies: – Metabolic processes are activated on cellular levels by means of different DC or AC procedures, which flow through the body or body parts. But also by means of special magnetic fields energy fields can be generated, which also have regeneration / activation potential.
IV. Balneo-physical measures: means the most varied therapeutic treatments of water and temperature applications of any shape and intensity to support regeneration / healing phases

V. Osteopathy: -there are judged and treated under the conceptual assumption of philosophical and not quite scientific concept of thought physical disorders. Here, the body is considered as a functional unit, which is basically capable of self-regulation. By means of manual technology, a series of manipulative techniques are developed to recognize disturbed functions and to apply them therapeutically to activate and promote the individual self-healing powers.

VI. Other regulation therapies such as “craniosacral therapy, acupuncture / acupressure and other methods” also use different techniques to detect the causes of the malfunction occurring and then to directly / indirectly regulate the respectively disturbed function back to a “normal state”.
VII. Yoga / Pilates / Callenetics, and Others: Related forms of exercise also have many therapeutic spine & core stabilizing exercises where the positive effects of physical exercises have a direct impact on muscle / joint status and, indirectly, on the overall well-being of the individual.
VIII. Medical strengthening therapies such as MedX / Kieser / EMS-Miha and other forms of training try to eliminate pain through targeted strengthening of the musculature and improvement of body perception.

IX. Autogenic training / Progressive relaxation techniques / hypnosis and psychosomatic treatment procedures are also justified in the overall concept of the “back”.
But in most cases a fundamental change in the awareness of the back in the sense of a so-called “back school” as a basis of long-term sustainable success is imperative. Here, in addition to the long-term successful integration of a back-specific movement and action awareness, also to regain his sense of body awareness in order to adapt his current work and leisure environment accordingly. And despite or even because of a variety of successfully established spine surgery, it is still imperative to do what is crucial for his back as the center of the musculoskeletal system and for his general health.
But please: beware of the many better / know-alls or “omnipresent” among the “specialists”. The right choice of therapy at the right time is and will remain the central theme.

Promotion back course Medisport-Mallorca

-back school Mallorca- 2018

As of March, once a week a Dr. Seita -Orthopedic & sports-doctor and Frank-Andre Berkel -trainer Bodyart- holistically conceived certified course around the topic back instead.
Almost exclusively practical exercise elements for strengthening the back muscles and improving body awareness are also trained and trained by teaching basic knowledge on back and back-friendly behavior.

When: every Tuesday afternoon
Time: 13-14h
Location: Medisport-Mallorca
Sequence: Course 1.-4. every Tuesday and repeating each following month
Part 5. & 6. as additional special unit on one extra day per month.
Failed units can be repeated.

Entry into course at any time possible !!!
This 6-part continuous monthly course / training session will also be rewarded with the participants’ certificate.
The costs of 145, – € can be submitted to the health insurance companies for the settlement of a qualified preventive measure.
The number of participants is limited and therefore requested a timely registration.
More information and registration at:
661939395
or
mseita@medisport-mallorca.com