1. Overview of neck and low back pain and current diagnosis and treatment
Neck pain and low back pain are the most common symptoms in the adult population. According to statistics, about 70-90% of people suffer from neck pain or low back pain at some point in their lives. Neck and low back pain ranks as the number one reason for orthopedic visits. The annual prevalence of neck and low back pain in the United States is about 30-40%. Low back pain is also the leading cause of workforce loss in people under the age of 45. In developed countries, the cost of treating neck and low back pain and the economic loss due to lost work accounts for 1.7 percent of the gross national product. Nowadays, as work pressure increases and the pace of life accelerates, the incidence of neck and low back pain is becoming younger and more serious. Young white-collar office workers, drivers who drive cars for a long time, heavy manual workers, and elderly people with osteoporosis are all the groups with high incidence of neck and low back pain.
For a long time, there are misunderstandings about neck and back pain series of diseases among the general public: some patients adopt a negative attitude, take painkillers or topical creams by themselves, and wait for the symptoms to heal on their own while enduring the pain. There are also patients who overdo pushing for a long time, or repeated warming and so on, resulting in excessive muscle congestion, and there are even cases of paraplegia caused by violent pushing under the cervical spine. “Most patients and even some non-specialist physicians do not pay enough attention to the symptoms of cervical and lumbar pain and simply attribute them to local symptoms of muscle strain or osteophytes (osteoporosis), and uniformly adopt conservative pain relief or bed rest, which delays the diagnosis and treatment of certain diseases of visceral origin and aggravates the symptoms of nerve compression progress, leading to serious consequences.
2.Special cases of cervical and low back pain
The diagnosis of cervical and lumbar pain symptoms should first exclude pain caused by visceral organs. Cervical angina, lung tumor, and neck hemangioma may lead to neck pain symptoms. And in low back pain, kidney stones, pyelonephritis, prostatitis, inflammatory diseases of the pelvis, endometriosis, abdominal aortic aneurysm, and retroperitoneal tumor are the diseases that need to be excluded.
3.Cervical and low back pain conditions that require surgery
The diagnosis of cervical and lumbar pain requires a comprehensive and detailed examination of neurological symptoms, and detailed imaging examinations of the cervical and lumbar spine including CT, MRI, etc. are required for those who have nerve root pain, weakness and numbness of the limbs, or tightness of movement. In cases where there is clear nerve root and spinal cord compression, surgery is the first option.
Patients with cervical and lumbar pain also have vertebral instability and lumbar spine slippage and displacement, which also require surgery in severe cases.
The incidence of spinal tumors, infections, or tuberculosis is very low, but the prognosis is serious and surgery may be indicated.
4.Orthopedic intervention for cervical and lumbar pain
Most of the cervical and low back pain syndromes do not require surgery, but in cases of cervical synovial joint osteoarthritis, posterior cervical nerve pain, lumbar small joint disorder synovial impingement, posterior lumbar nerve pain, sacroiliac joint dysfunction, discogenic low back pain, third transverse process syndrome, etc., it is not necessary to be conservative, and active orthopedic minimally invasive interventional treatment can be tried. Especially for discogenic low back pain, there are various methods such as plasma, ozone, laser, etc.
In elderly people with osteoporotic low back pain, such as fresh compression fractures, painful activities can not be tolerated, which used to require long-term bed rest, greatly affecting the normal physiological functions of the elderly and increasing the burden of care. At present, minimally invasive vertebroplasty is feasible to achieve maximum pain and functional improvement.
5.Specialized cervical and low back pain outpatient clinic features
Minimally invasive interventional treatment for cervical and lumbar pain includes painful point block of spinal synapses, ablation of posterior branch of lumbar nerve, minimally invasive plasma ablation of cervical and lumbar intervertebral discs, ozone ablation, etc.
6.Prevention and rehabilitation of cervical and lumbar pain
(1) Daily sitting posture should be correct, long-term use of computer and desk workers need to reasonably design the height and tilt of the workstation, regularly change the head and neck position, 45 minutes to one hour in a sitting position need to stand up and activities, regular far-seeing. Driving should not be too long, and regular activities.
(2) Improve and adjust the sleep state, the pillow should not be too high or too low, pillow on the head and neck, to the physiological position is better. The ideal sleep should be to make the entire spine in a natural state, hip and knee flexion, the whole body relaxed. You can lie on your back or side, not on your stomach. If you feel neck and lumbar discomfort in the morning, you need to adjust your sleeping position in time. Beds should be chosen hard mattress to soft pad.
(3) Prevent trauma to the neck and lumbar region. Acute braking head and neck shaking, bending over to hold heavy objects, inadvertent pushing and so on can produce trauma to the neck and lumbar region, and over time aggravate the degeneration of the spine.
(4) sports and exercise need to be moderate. Swimming is the most suitable exercise. Low back muscle exercise is also feasible. Do not carry out too fast, excessive, too long cervical and lumbar activities.
(5) Moderate bed rest or braking. Prolonged sick leave rest is not beneficial to the recovery of cervical and lumbar pain. A healthy life pattern and moderate social activities have good effects on the psychophysiology of patients.
(6) Traction of cervical and lumbar spine has good effect on patients with mild cervical and lumbar pain. Cervical and lumbar spine brace can be temporarily braked for protection, but it cannot be used for a long time.