Danuska Da Gama
The number of people complaining of back and neck pain is on the rise in current times. And indeed, pain in the back, derrière, leg, calf, and thigh are symptoms to look out for and shouldn’t be overlooked. Sometimes there can be numbness and weakness in the entire leg that restricts walking. Neck pain, arm pain shooting down to the hands including numbness or weakness and loss of balance in the hands are all symptoms of a spinal injury.
Consultant Orthopaedic Surgeon, Ismail Shaik at North Goa District Hospital (NGDH, Asilo), Mapusa who is a fellowship trained spine surgeon practicing for the last six years tells us that while about 160-180 patients are examined daily at the Orthopaedic Outpatient Department (OPD) in NGDH, a majority of them have non traumatic degenerative cause (normal age related wear and tear) and others have symptoms pertaining to the spine (that is either neck or back pain).
Pain in the spine, he says, is a common complaint among 60 per cent to 70 per cent patients visiting the OPD, and most of the causes are lifestyle related, which means that they are completely preventable. “Weight gain/obesity, poor posture at work and at home, lack of exercise, excessive use of mobile phones (for neck complaints) and injury or trauma are some of the causes that result in pain and damage,” he says.
And while medical bills can burn a hole in the pocket, Shaik says that the good news is that 80 per cent of spinal problems can be treated with just rest and medications followed by good Core Strengthening Physiotherapy (without surgery). “However, the rest need further evaluation with MRI scans and depending on the cause will need pain management procedure (nerve root blocks) or spinal surgery,” says Shaik.
These disorders are treated differently after ascertaining the damage and intervention needed. “Firstly the patients undergo a detailed clinical examination and then in indicated cases we get X-rays and MRI done,” says Shaik, adding that pain medication, core strengthening exercises and physiotherapy help in most cases. Pain blocks are suggested for moderate cases and only if severe, spine surgery is suggested.
In over one year, Shaik has successfully performed nine such spinal interventions including two spine surgeries. Interventions generally include pain management techniques like selective nerve root block and spine surgery which were started in 2018.
However, most people have a huge fear when it comes to surgeries to be conducted on the spine. Indeed, many love pain killers but aren’t ready to get a surgery for they believe that if the surgery fails, they will be crippled for life.
Speaking about this Shaikh says that a spine surgery is like any other surgical procedure having its due risks and needing a fair amount of expertise.
“However, in indicated patients when done in timely manner (without delay) the long-term results are excellent,” he says. The patients post surgery can be seen on a Thursday at the NGDH Asilo, following up and giving other patients the much needed motivation and moral boost at OPD 6.
Government or private hospital?
A patient and a family go through a lot before approaching a medical practitioner, or visiting a hospital. While it is generalised that people from the middle and low class use government hospitals so that expense in minimised, there are also people who consider private hospitals for want of better facilities, patients being in safer hands, and overall expectations that in private hospital nothing can otherwise go wrong.
However, off late, several people, young and old, including the rich and influential prefer going to a government hospital and consulting doctors there, and orthopaedics is one such area too. Speaking about the same Shaik says: “We are trying to develop a comprehensive spine care unit in our setup and these are our first steps which have shown promising results.”
He believes that irrespective of the setup at hospitals whether government or private hospitals, patients should consider getting treatment from a doctor whom they trust most as it helps a lot in their recovery and successful outcome ultimately.
Back on track
The first spinal surgery was conducted on a 26-year-old factory worker who was involved in heavy manual work. Having come to the hospital in March 2019 with pain in both legs, and a much more excruciating back pain, she wasn’t able to walk. What was worse is that she bore these symptoms for 12 months. After exhausting all options, she underwent a conventional lumbar discectomy (spine surgery) in April 2019 which relieves the pressure over pressed/pinched nerves. Nine months post surgery she has complete relief from her pain.
Speaking to NT BUZZ her brother tells us that today his sister has got a new lease of life. “From not being able to sit for two minutes, to being able to walk on both her feet, two days after surgery is a blessing and a miracle. God has worked through the doctors and we are amazed at seeing the results though we were initially nervous, but Shaik gave her so much of positivity.”
The second patient on whom surgery was conducted was a 35-year-old painting contractor who first came to the orthopaedic OPD in January 2019 with long standing back pain and recent onset left leg pain. The MRI showed a spinal problem that indicated abnormal spine movement – instability.
After being counselled regarding further management options, he opted for a less invasive trial of nerve root block. While he was symptomatically better for 15 days post block procedure, there was a relapse, and this time with instability and pain. Again, after reposing faith in his doctor and with no much options left, he underwent lumbar decompression for nerve, which is root compression, where pressure over pinched nerve was relieved and abnormal spinal movement was fixed along with Spinal Fusion (TLIF – interbody fusion) in September 2019. Again, there is over 90 per cent relief.