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Slipped Disc


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Surgery. Either by a simple repair of the affected vertebra(e) or to the more complex fusion and/or rodding of the spine.

 

Both procedures are expensive. I am not sure which hospitals/MD in the RP can do this procedure. Which is expensive I might add but well worth it if done by well trained hands.

 

Kung short term pain relief lang you may have steroid injections on the area.

 

<<<BTW, I'm not a doctor so it's still better to consult one. B)

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hi guys, am not a doctor but here's something i found useful from the NHS direct health encyclopedia:

 

Treatment

In 90% of cases the pain from a slipped disc gets better on its own and does not require surgery. However, the process may take some time. For most people the condition gets a lot better within about six weeks.

 

The first step to treating a slipped disc is to make sure that you do not make it any worse. You should avoid any form of lifting for three months to allow the disc to heal and you should take care not to strain or bend. You should stay active instead of lying in bed, as most doctors no longer recommend bed rest for back pain. However, you may need to rest on whatever surface is most comfortable until the initial intense pain of the injury has subsided.

 

Your GP may prescribe a painkiller or recommend one you can buy from the chemist, such as paracetamol or ibuprofen. Ibuprofen is not recommended if you have a history of asthma, kidney, or liver disease.

 

Physiotherapy, exercise and massage can all be considered. Studies so far on the subject have not been very conclusive but it is thought that spinal manipulation from a chiropractor, physiotherapist, or an osteopath may help take the pressure off the nerves that are being pressed by the damaged disc.

 

If healing does not happen on its own within a reasonable time, usually not less than six weeks, surgery may be considered. The aim of surgery is to remove the portion of the disc that is bulging out and causing the pressure on the nerves in your back. The procedure gives fast relief for most people who have lower back pain and sciatica caused by a slipped disc, but about half of those who have surgery will need a repeat operation at some time in the future.

 

here's another one from a UK health institute:

 

CONNECTIVE TISSUE MANIPULATION

 

Connective Tissue Manipulation is performed by the Physiotherapist using the soft pads of the fingers to move one layer of skin on the layer below. This movement creates a short, sharp, stretch reflex, creating an impulse, which spreads out through the connective tissue. The patient's brain translates this impulse as if it were a 'cut' or a 'scratch'. The tighter the connective tissue the bigger the stretch reflex and therefore the sharper the 'cut' feels to the patient. The reflex is a small impulse which passes through the fluid in the connective tissue and releases tension. The reduction in tension around the blood vessel walls allows more blood to flow into the damaged area and so reduces the inflammation. Softening the connective tissue also allows more movement to occur without causing irritation and therefore pain. Treatment often starts at a distance from the injured part gradually working closer to the source of injury.

 

The benefits of Connective Tissue Manipulation are cumulative. Once the tension has been lowered by treatment the reduction is maintained. Further reduction in connective tissue tension occurs with each additional treatment. The degree to which the reduction in connective tissue tension is maintained is conditional upon the level of stress added to the system by the patient's lifestyle. Connective Tissue Manipulation is a technique learnt at postgraduate level in the UK and because of this it hasn't spread very rapidly around the country. At the last count, there were something like two dozen Physiotherapists in the UK actively practising Connective Tissue Manipulation.

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hi guys, am not a doctor but here's something i found useful from the NHS direct health encyclopedia:

 

Treatment

In 90% of cases the pain from a slipped disc gets better on its own and does not require surgery. However, the process may take some time. For most people the condition gets a lot better within about six weeks.

 

The first step to treating a slipped disc is to make sure that you do not make it any worse. You should avoid any form of lifting for three months to allow the disc to heal and you should take care not to strain or bend. You should stay active instead of lying in bed, as most doctors no longer recommend bed rest for back pain. However, you may need to rest on whatever surface is most comfortable until the initial intense pain of the injury has subsided.

 

Your GP may prescribe a painkiller or recommend one you can buy from the chemist, such as paracetamol or ibuprofen. Ibuprofen is not recommended if you have a history of asthma, kidney, or liver disease.

 

Physiotherapy, exercise and massage can all be considered. Studies so far on the subject have not been very conclusive but it is thought that spinal manipulation from a chiropractor, physiotherapist, or an osteopath may help take the pressure off the nerves that are being pressed by the damaged disc.

 

If healing does not happen on its own within a reasonable time, usually not less than six weeks, surgery may be considered. The aim of surgery is to remove the portion of the disc that is bulging out and causing the pressure on the nerves in your back. The procedure gives fast relief for most people who have lower back pain and sciatica caused by a slipped disc, but about half of those who have surgery will need a repeat operation at some time in the future.

 

I am a doctor and I agree with hitomi's quote regarding the treatment. It is always best to explore and optimise conservative treatment first because the majority of patients with back pain usually do get better after 2 to 6 weeks of conservative management consisting of pain medication and physical therapy. I believe that surgical intervention should only be done if significant pain persists despite optimal conservative management and it has already affected the person's lifestyle and career. Surgical treatment may range from a laminotomy and diskectomy (whereby the surgeon just excises a "slipped disc") to an instrumented fusion (screws are placed through the vertebral bodies and rods are attached then the disk is removed and all defects are filled with bone graft so that the affected level is fused) depending on what exactly is causing the back pain and on the amount of instability [either before or after the surgery] present at the area where the pain originates from). These procedures can be done by a competent orthopedic surgeon with spine surgery training and is usually done regularly in all the major private and public hospitals in the Philippines especially in Manila and the other major cities, even in the provinces - I know people who do it in Cebu and Davao.

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im currently undergoing physical therapy.my PT med scheduled me for 6 sessions. Im on my 4th one and so far the tingling sensation comes on and off on my left leg.

can anyone comfort me and give me hope..im not that afraid from any operation but rather what how it will cost me and my family.

pls communicate docs and guys.

thanks alot..

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im currently undergoing physical therapy.my PT med scheduled me for 6 sessions. Im on my 4th one and so far the tingling sensation comes on and off on my left leg.

can anyone comfort me and give me hope..im not that afraid from any operation but rather what how it will cost me and my family.

pls communicate docs and guys.

thanks alot..

 

 

I am assuming your problem is purely because of a slipped disc. Your best option would be to have a heart-to-heart talk with your doctor. One thing to consider is if the sessions are done regularly enough and if oral antiinflammatory medication and meds like Neurontin or Lyrica are optimized (Neurontin and Lyrica are only to be given under the guidance of a physician!). If physical therapy and oral medication is already optimized and no significant relief (take note: keyword here is SIGNIFICANT. Do not expect TOTAL relief at the end of 2 weeks - it can happen but that is not always the case, but more or less, in 2 weeks you can tell is conservative management is having an effect or not), then the next step short of surgery would be an epidural steroid injection. If you still have no relief and the pain significantly affects your lifestyle, espcially after 4 to 6 weeks of optimal conservative treatment then maybe you should think about having surgery.

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I am assuming your problem is purely because of a slipped disc.  Your best option would be to have a heart-to-heart talk with your doctor.  One thing to consider is if the sessions are done regularly enough and if oral antiinflammatory medication and meds like Neurontin or Lyrica are optimized (Neurontin and Lyrica are only to be given under the guidance of a physician!).  If physical therapy and oral medication is already optimized and no significant relief (take note: keyword here is SIGNIFICANT.  Do not expect TOTAL relief at the end of 2 weeks - it can happen but that is not always the case, but more or less, in 2 weeks you can tell is conservative management is having an effect or not), then the next step short of surgery would be an epidural steroid injection.  If you still have no relief and the pain significantly affects your lifestyle, espcially after 4 to 6 weeks of optimal conservative treatment then maybe you should think about having surgery.

 

 

how much would that cost me doc..?pls estimate..cold my hmo cover it..?

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how much would that cost me doc..?pls estimate..cold my hmo cover it..?

 

Some HMOs (not all unfortunately) cover for spine surgery, but you have to check yours out to be sure. It is quite difficult to give you an estimate because I do not know for sure your specific problem (in other words - what exactly is causing the back pain - a slipped disc, a degenerated disk, an arthritic spine and any number of other causes of back pain) because each specific problem has a specific type of surgery indicated and each type of surgery will definitely incur a different amount in cost. Add to this the variations in hospital fees for the various hospitals in the country.

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  • 2 weeks later...
im currently undergoing physical therapy.my PT med scheduled me for 6 sessions. Im on my 4th one and so far the tingling sensation comes on and off on my left leg.

can anyone comfort me and give me hope..im not that afraid from any operation but rather what how it will cost me and my family.

pls communicate docs and guys.

thanks alot..

try me

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Discs Can Heal

Disc injury is not a life sentence. Disc degeneration or slippage (herniation) can heal - if you let it, no differently than a sprained ankle. Stop damaging your discs with bad bending, standing, and sitting habits and the discs can heal. It takes years to herniate a disc, and only days to weeks to heal it by stopping bad habits.

 

Muscles Can Heal

When you over-tighten muscles with hunching and bad habits, they can remain too shortened to let you stand properly. Or they stay tightened in “knots” or spasm. This changes their muscle chemistry. When you slouch, you keep muscles overly stretched, which weakens and strains them. Stop straining your muscles and they can heal.

Edited by Maribel-R18
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Exercises to Strengthen and Retrain Muscles

When you stop bending wrong and injuring your back dozens of times each day, it can begin healing with good exercises.

 

Back pain exercises are misunderstood. People often injure their back all day then hope to fix it with a few exercises. They don't understand when this does not work. They lie on the floor to do exercises, then stand up and walk away with no use of the positioning or strength they just practiced. It is like eating butter and sugar all day, then doing 10 minutes of exercises and wondering why it doesn't "work." The key is what you do all day.

 

Try a small number of these exercises slowly. See how you feel the next day, then increase. Use these back exercises to retrain how to stand, sit and move all day.

 

- Lunge. You know not to bend wrong to pick things up, but you do it. Every day. Hundreds of times a day. Instead, bend your knees. You already know that. But most people don't do it because their legs are too weak. The lunge exercise retrains bending habits and gives you free leg and back exercise at the same time:

 

Stand up, feet apart. Slide one foot comfortably back, keeping foot straight not turned out. Tuck hip under to remove back arch and stretch back hip. Bend knees to dip to the floor without touching the floor. At least dip down a few inches. Don't let your front knee come forward. Keep front knee over ankle. Don't arch your back. Tip your hip under to prevent arching and straighten your posture. Don't lean back. This is a great exercise to strengthen your legs and practice proper bending and lifting posture. You already know you should use your legs like this to bend and lift. Now you will be strong enough to do it.

 

 

Bend properly using the lunge for all the many dozens of times you bend every day.

Keep front knee over ankle (left) not forward (right).

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Edited by Maribel-R18
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Upper back extension. Most people stretch their back by forward rounding but never strengthen the back muscles that hold the back upright. Upper back extension is an important exercise to strengthen at the same time that you practice moving your back in the other direction. Discs spend so much of the day being loaded by forward bending. Extension unloads the discs, not compresses them the way previously thought.

Lie face down on the floor, (or even a bed or bench if that is easier) hands and arms off the surface. Gently lift upper body without hands. Don't force. Don't crane your neck, keep it straight, just lift using upper body muscles. This exercise does more than the standard "hands and knees lifting arm and leg." It strengthens back muscles in a functional way, without additional pressure to the discs.

 

Upper back extension

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- Lower back extension. This is another important exercise to strengthen the back and practice extending the hip. Extension is an important exercise to strengthen without loading the discs. Discs are pressured by forward bending. This backward lifting unloads them. It is better than bending forward to lift.

 

Lie face down, hands under your chin or wherever comfortable. Gently lift both legs upward, knees straight. Don't yank or force. Don't pinch the low back, just use lower body muscles.

 

 

Lower back extension

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- Lower back extension. This is another important exercise to strengthen the back and practice extending the hip. Extension is an important exercise to strengthen without loading the discs. Discs are pressured by forward bending. This backward lifting unloads them. It is better than bending forward to lift.

 

Lie face down, hands under your chin or wherever comfortable. Gently lift both legs upward, knees straight. Don't yank or force. Don't pinch the low back, just use lower body muscles.

 

 

Lower back extension

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- Isometric abs. A major purpose of your abdominal muscles is to hold your back in position when you are standing up. But many people allow their back to sway or arch too much. They may do "exercises" for this by lying on the floor or standing against the wall and pressing the low back (pelvic tilt) to reduce the curve. But that does not change your positioning the rest of the time, and so, does not heal the back pain. You are supposed to use the tilt when standing to keep your back in position - preventing arching. This exercise strengthens your abs and back at the same time you retrain how to hold your back without arching the rest of the day:

 

Lie face up, arms overhead on floor, biceps by your ears. Press your low back toward the floor to remove the arch. You will feel your abdominal muscles working to prevent your back from arching. Hold hand weights an inch above the floor, without arching your back. Keep your low back against the floor by using ab muscles to straighten your spine. This is how your abs should work all the time, when standing up, to prevent too much arching. Notice that you don't need to tighten your abs to do this. Just use abdominal muscles, like any other muscles, to move your body to healthy position. As you get better at this, do this with your legs so straight that you can practice your spinal posture the way you need it for standing up - spine held at healthy position without bending knees.

 

Don't tighten anything, just move your spine and learn how to move it when standing into healthy straighter posture. This exercise is one of hundreds of The Ab Revolution™ exercises that teach how to use abdominal muscles to position the spine.

 

Learn to use your abs to control the posture of your back -

keep your low back from arching even against moving resistance, simulating real life activity when standing up.

Then try this with straight legs. It is not true that you need to bend knees to protect the spine.

You control the position using ab muscles.

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Edited by Maribel-R18
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Hold a push-up position. In a push-up position (hands and toes, not on knees) tuck your hips under so that your back doesn't arch. You will immediately feel your abs working when you do this. You will also immediately feel the pressure in your back disappear, that was caused by arching. The purpose of this exercise is to train your abs at the same time you relearn how to hold your back when you are standing up. Keep your back straight, not letting it sag into an arch like a hammock. Tuck hips as if you were starting a crunch, but don't hike your behind up in the air or drop your head. Make your posture as straight as if you were standing up. Use a mirror, if available, to see yourself and learn what healthy position feels like. Use this new healthy position all the time, particularly when you stand and reach overhead. Don't let your back arch to reach overhead. Use the principle of this tuck exercise.

 

 

Tuck your hips under to remove the low back arch. You will immediately feel your abs working and pressure gone from your back

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Edited by Maribel-R18
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Upper Back and Neck Pain

Poor neck posture is a common cause of numb shoulder, upper back pain, and headache. The neck should be on a straight vertical line. Many people let their head and neck tilt forward. This is called a "Forward Head."

 

A forward head can eventually damage neck and upper back structures, as they bend and rub at angles they were not built for. Chronically holding neck muscles in an overstretched position weakens them. The forward head creates shortened, contracted muscles in front, and a stretched, weakened back. Cervical discs are pressured outward, eventually creating herniating force.

 

But most standing, sitting, activity, and exercise is done with a forward head. Look in any fitness magazine. Most “ab” exercises lift the body by the head – encouraged by "fitness" magazines, videos, gyms, and advertising. Look at how people eat. Look at how they carry backpacks and bags - hunching forward against the load instead of using muscles to hold their spine in healthy position. The average person overstretches, and unequally stretches, their back and neck so much, that it is amazing they don’t hurt more.

 

The result is that the average person is too tight to stand up straight. Because of simple bad posture habits that tighten muscles on one side and overstretch them on the other, many people stand, walk, and do activities at joint angles that impinge, grind, rub, and stress. Much back and neck pain is ordinary mechanics.

 

 

 

Many people are too tight in the upper chest and shoulder to stand properly.

The forward head (left) commonly results in sore shoulder, neck, and upper back. Such pain is easily fixed.

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Edited by Maribel-R18
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Try This To See What Stretches You Need to Fix Upper Back Pain

- Stand near a wall, with your back to it, but not touching the wall.

- Back up until something touches. Your behind? You may stand "booty out," flexed at the hip.

- Did your upper back touch first? You may stand slouched backward.

- Stand with your heels, hips, upper back, and the back of your head against a wall. Bring the back of your head against the wall without raising or dropping your chin, or arching your back.

- If you can't do this comfortably, you are too tight to stand up straight. Pain results from the resulting bad positioning. This is common. Here is what to do about it:

 

 

Two Easy Stretches

Tight pectoral (chest and front of shoulder) muscles rotate your arms inward. To see if you do this, put your arms at your sides, look in the mirror and note direction of your thumbs. Do they face inward – toward each other? To restore this muscle group to functional resting length do these two stretches:

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Upper Back and Neck Pain

Poor neck posture is a common cause of numb shoulder, upper back pain, and headache. The neck should be on a straight vertical line. Many people let their head and neck tilt forward. This is called a "Forward Head."

 

A forward head can eventually damage neck and upper back structures, as they bend and rub at angles they were not built for. Chronically holding neck muscles in an overstretched position weakens them. The forward head creates shortened, contracted muscles in front, and a stretched, weakened back. Cervical discs are pressured outward, eventually creating herniating force.

 

But most standing, sitting, activity, and exercise is done with a forward head. Look in any fitness magazine. Most “ab” exercises lift the body by the head – encouraged by "fitness" magazines, videos, gyms, and advertising. Look at how people eat. Look at how they carry backpacks and bags - hunching forward against the load instead of using muscles to hold their spine in healthy position. The average person overstretches, and unequally stretches, their back and neck so much, that it is amazing they don’t hurt more.

 

The result is that the average person is too tight to stand up straight. Because of simple bad posture habits that tighten muscles on one side and overstretch them on the other, many people stand, walk, and do activities at joint angles that impinge, grind, rub, and stress. Much back and neck pain is ordinary mechanics.

Many people are too tight in the upper chest and shoulder to stand properly.

The forward head (left) commonly results in sore shoulder, neck, and upper back. Such pain is easily fixed.

1. "Pec" Stretch (Pectoral muscles in the front of your chest)

- Face a wall and lift one arm up as if "in a stickup." The inside of your

- Pull your elbow back so that you feel the stretch in your chest, not shoulder capsule.

- Turn away from the wall. Use the wall to gently pull your elbow back.

- Keep head and back posture in line. Don't let your back arch, or jut your chin jut forward.

- Hold just a few seconds, then switch arms.

- Drop your arms and look at your thumbs again. Thumbs should face forward now.

- Try the wall stand again. It should be easy to stand straight now.

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1. "Pec" Stretch (Pectoral muscles in the front of your chest)

- Face a wall and lift one arm up as if "in a stickup." The inside of your

- Pull your elbow back so that you feel the stretch in your chest, not shoulder capsule.

- Turn away from the wall. Use the wall to gently pull your elbow back.

- Keep head and back posture in line. Don't let your back arch, or jut your chin jut forward.

- Hold just a few seconds, then switch arms.

- Drop your arms and look at your thumbs again. Thumbs should face forward now.

- Try the wall stand again. It should be easy to stand straight now.

2. Next, stretch the top of your shoulder (Trapezius stretch)

- Tip one ear down toward your shoulder. Don't round or hunch forward, or drop or raise your chin.

- Breathe in, then while breathing out, slide your hand down the side of your body toward your knee. Feel a nice stretch along your entire side.

- Hold only a second or two then switch sides.

- Try the wall stand again and note that it is now easier to stand straight.

 

 

 

Do these two stretches many times a day to keep upper body posture healthy so your upper back and neck don't hurt and to stand properly without forward rounding.

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What To Do Every Day To Prevent Back and Neck Pain

To restore proper muscle length to allow healthy posture:

 

- First thing in the morning, don't sit on the bed. Instead of sitting and rounding your back first thing, turn over and lie face down. Prop gently on elbows, but not so high that it strains. It should feel good and help you straighten out first thing. Get out of bed without sitting.

- Don't droop your head forward when sitting and standing. Remember that posture is a voluntary muscular exercise.

- Pec stretch - described above.

- Trapezius stretch- described above.

- Wall Stand - described above.

- Lie on the floor (diagnostic for tightness and repositioning).

- Keep chin in, not stiffly or so tightly that it hurts, but easily so that your ear is above your shoulder, not forward of it. Remember that "the double chin" exercise is not something you "do 10 times" then stop. It is something you do once. Use it to relearn proper head position then keep it there. Stand with your back against a wall often during the day, to see if the back of your head touches as it will when you are standing in a healthy position.

 

 

More Things To Do Every Day to Prevent Forward Rounding from Ruining Your Back

- Sit without rounding.

- Stand and carry loads without forward head, or arching low back (exaggerating lumbar curve to the back or side).

- Count how many times you bend each day. Imagine the injury to your back by bending wrong that many times each day.

- Lift using the lunge, not bending over.

- Raise computer monitor off the desk - use a low shelf or phone books.

- Move your television up higher. Stop curling down and forward to watch.

- Move desk and car seats closer to sit back not forward (don’t worry about having to keep feet on floor or “flat thighs”).

- Move keyboard off “below desk” tray, and back up on the desk.

- Use lumbar roll (jacket or towel will do) to pad space in concave chairs. Sit up and lean slightly back. Don’t round against the lumbar roll.

- Use your muscles, not joints to hold you up. It’s free exercise.

- Upper back extension exercise

- Lower back extension exercise

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  • 2 months later...
how much would that cost me doc..?pls estimate..cold my hmo cover it..?

 

 

Try to make an appointment with Dra. Tanchuling / Dr. David Cabatan / Dr. Tony Rivera / Dr. Leagogo at Philippine Orthopedic Institute, behind Makati Medical Center. These are some of the very best orthopedic surgeons in the country.

Having served under them, and having been treated by them, I can tell you that they are not the type to be quick to the knife (hindi sila opera kaagad - oopera nalang sila if it is really required)

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  • 2 weeks later...
BTW, I forgot to mention, avoid any massages...

they may make things worse, lalo na yung mga hard massage

 

 

I would like to add that neurosurgeons are also similarly if not better than orthopedic surgeons in managing back pains whatever the cause maybe. Be it medical or surgical in nature.

 

From Emiajamar

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