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Conservative Treatment

MEDICATION PHYSICAL THERAPY BRACES EXERCISE

MEDICATION
Mild pain medications can reduce inflammation and pain when taken properly. Medications will not stop wear-and-tear, but they may control pain.

Aspirin
The main potential side effect of aspirin is stomach problems, particularly ulcers.

NSAIDs
It includes ibuprofen, acetaminophen, and naproxen. They are very effective in relieving the pain associated with muscle strain and inflammation. Long term use of NSAIDS can lead to kidney and liver problems.

Non-Narcotic Pain Medication
They are used for treating mild to moderate chronic pain. Non-narcotic analgesics that require a prescription from the doctor include NSAIDs such as, carprofen, fenoprofen, ketoprofen, and sulindac.

Narcotic Pain Medications
If you have severe pain, your doctor may prescribe a narcotic pain medication such as codeine or morphine. Narcotics relieve pain by numbing the central nervous system. Narcotics can cause side effects such as nausea, vomiting, constipation, and sedation or drowsiness. Remember — narcotics can be addictive if used excessively or improperly.

Muscle Relaxants
It can help relieve pain from muscle spasms. Muscle relaxants should typically only be taken for three or four days. Long-term use is not recommended.

Antidepressants
It can relieve emotional stress that leads to symptoms of back pain. Some antidepressant medications are believed to reduce pain by affecting this chemical reaction in the nerve cells. Antidepressant also helps you get back to a normal sleep routine. Antidepressants can have several side effects such as, drowsiness, loss of appetite, constipation, dry mouth, and fatigue.

Note: If you are pregnant or breast feeding do not take any medication without asking your doctor

PHYSICAL THERAPY
If physical therapy is recommended, your physiotherapist (PT) will start by asking about your spine condition. Your answers will help your PT focus on the source of your problem and what he or she will need to do to help relieve it.
To control pain and symptoms, your PT may recommend the following physical therapies:
Rest :
Resting painful joints and muscles helps calm soreness, giving your spine time to heal. If you are having pain with an activity or movement, it should be a signal that there is still irritation going on. You should try to avoid all movements and activities that increase the pain
Positioning:
your PT will help you find positions for your spine that are most comfortable while sleeping or resting. He or she may also suggest positions to reduce stress on your spine while you are at work.
Ice:
Ice makes blood vessels constrict or get smaller, which decreases the blood flow. This helps control inflammation, muscle spasm, and pain.
Heat:
Heat makes blood vessels dilate or get larger, which increases the blood flow. This helps flush away chemicals that cause pain, and also helps bring in healing nutrients and oxygen.
Ultrasound:
Ultrasound uses high-frequency sound waves to reach sore muscles and other tissues that are over two inches below the surface of your skin. As the sound waves pass through your body they vibrate molecules, causing friction and warmth. This heating effect helps flush the sore area and brings in a new supply of blood that is rich in nutrients and oxygen.
Electrical Stimulation
Electrical stimulation gently stimulates nerves as the current passes through pads applied on the skin. Electrical stimulation can ease pain by sending impulses to your brain that are felt instead of pain. Once the pain eases, muscles begin to relax, letting you move and exercise with less discomfort.
Soft Tissue Massage:
Massage has been shown to reduce pain and spasm by helping muscles relax, by bringing in a fresh supply of oxygen and nutrient-rich blood, and by flushing the area of chemical irritants that come from inflammation.
Joint Mobilization:
your PT may apply changing pressures and movements to your joints to help lubricate joint surfaces. This will ease stiffness and help you begin moving with less pain.
Traction:
sore joints and muscles often feel better when traction (pull) is used. PTs apply traction with their hands or with a traction machine. The amount of pull that is needed will depend on your condition. A gentle on/off pressure may be better early on to help control arthritis pain.

Once your pain is controlled, your range of motion has improved, and your strength is returning, you will be able to continue your physical therapy on your own at home. You will be given instructions to help you keep working on your range of motion and strength TOP

BRACES
If you are diagnosed with a spinal disorder, deformity, or potential problem that can by helped through the use of external structural support, your physician may recommend the use of a neck or back brace. Neck and back braces are most often used to treat low back pain, trauma, infections, muscular weakness, neck conditions, and osteoporosis. They immobilize and support the spine when there is a condition that needs to be treated.

They offer a safe, non-invasive way to prevent future problems or to help you heal from a current condition. Though the effects of bracing are primarily positive, they can lead to a loss of muscle function due to inactivity. Bracing can sometimes lead to psychological addiction.TOP

EXERCISE
Spine experts agree that physical activity is important for people with low back pain. Consider it part of long-term health management and risk reduction. Regular exercise is the most basic way to combat back and neck problems.
Exercise helps strengthen the muscles in your back that connect to your spine. It can also strengthen your abdomen (your belly), arms, and legs, which reduces back strain. Stretching reduces risk of muscle spasms. In addition, weight bearing exercises help prevent loss of bone mass caused by osteoporosis, reducing your risk of fractures.

WHAT KIND OF EXERCISE SHOULD BE DONE
So how do you stay physically active without making your pain worse?

Many people are surprised to learn that carefully selected exercises can reduce pain. Some of the exercises in this brochure can provide quick and significant relief, speeding recovery. Once pain lessens or disappears, other exercises can help restore back movement and muscle strength. These will help you reach full recovery and protect against recurring pain. Many doctors think an increase in pain during activity is okay as long as that increase doesn’t continue after completing the activity. So try to stay active. Remember, this is only a guide. Not all exercises are appropriate for everyone. If you experience substantially more pain while exercising, discontinue and let your health care provider know.

Monitoring your pain while selecting your exercise
It is important to choose exercises carefully to avoid making your back pain worse. One way to know if your back is getting worse is when symptoms spread:
• Away from the center of your low back;
• Into your buttock; or
• Down into, or further down, your leg(s).

This can happen during exercise and activity or even in certain positions. The good news is that the opposite is also true! Symptoms can move out of your leg(s) or buttock so they are felt closer to the center of your low back (called “pain centralization”).
Posture is important, too
Along with proper exercise, good posture is essential, whether standing or sitting. When seated, avoid sitting for longer than necessary and avoid slouching. If your symptoms get worse when sitting, check your posture. For many people, sitting erect may help centralize and lessen pain. Once pain-free, sitting erect often keeps symptoms from returning. When you must sit for a long time, it can be very helpful to put a firm support behind your low back to deepen its natural inward curve and keep your hips slightly higher than your knees. (See good sitting posture picture)

Body Mechanics
think of body mechanics as putting safe posture into action. It is one thing to sit or stand with good posture, but another to keep safe posture as you actually move with activity. You want to keep your body in its safest alignment, maintain the 3 curves of spine as you go about your daily tasks, such as getting out of a chair, taking out the trash, getting clothes out of the dryer, brushing your teeth, and lifting. Safe body movement is especially important during lifting. To avoid extra spine strain when lifting, use these safety tips:
-> Plan and prepare for the lift
-> Make sure you have good footing
-> Straddle your feet with a wide base of support
-> Keep the load close to your body
-> Keep your spine stable and aligned
-> Do not twist or pivot with your feet (see picture of lifting technique)

Ergonomics
Ergonomics looks at the way people do an activity. It is possible that even minor changes in the way you do your work or hobby activities could keep your pain and symptoms in check, while protecting your spine from further injury. Ergonomics doesn't usually involve expensive changes. Even minor adjustments in the way you do your activities can make a huge difference in easing your pain and preventing further problems.

Exercising once pain has lessened
In many cases, it may take only one or two days to control or eliminate symptoms. Once your pain is much better, gradually and carefully increase your range of motion, starting with some simple forward-bending exercises. Continue as long as your symptoms do not return, get worse or move away from the center of the back.TOP

* " The information contained here is not intended as a substitute for professional medical evaluation and management. It should be used only as a starting point for further research. A physician should always be consulted for any health problem. "

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