Scoliosis is a medical condition in which a person’s spine is curved from side to side, shaped like an “s” or “c”, and the spine may also be rotated.
How is scoliosis diagnosed?
A rib “hump” or a prominent shoulder blade caused by rotation of the ribcage in thoracic scoliosis can be detected on physical examination. It is more prominent when the patient is bent forward. A special X-ray film called a scoliosis film will confirm the diagnosis.
Causes of scoliosis
There is no definite cause but most are due to developmental problems.
Prevention of scoliosis
Regular exercise and a good diet. Scoliosis is more likely to occur to low body weight patients.
There is no way to prevent idiopathic scoliosis. Early detection and treatment, if necessary, helps to prevent it getting worse.
If you have a history of scoliosis in your family, children can be checked regularly for scoliosis from the age of nine throughout their teens.
Treatments for scoliosis
Treatments include monitoring with regular medical check up to look for worsening of the curvature, bracing to help moderate cases and surgery may be necessary for the severe cases.
An epidural spinal injection is a non-surgical treatment option that may provide either short- or long-term relief of radiating back pain.
When spinal nerves become irritated or inflamed due to a degenerative condition in the spine that is causing nerve compression, such as a herniated disc or spinal stenosis, the result may be severe acute or chronic back pain, as well as pain, numbness and muscle weakness that extends elsewhere into the body, such as the hips, buttocks or legs. Before your doctor considers spine surgery to relieve these symptoms, he or she will most likely recommend one or more non-surgical treatment measures. An epidural spinal injection is one of these options.
What is an Epidural Spinal Injection?
An epidural spinal injection involves delivering anti-inflammatory medication—typically a steroid combined with an anaesthetic—directly into the area around the irritated spinal nerves that are causing the pain. This area is called the epidural space, and it surrounds the sheath-like protective membrane—or dura—that covers the spinal nerves and nerve roots. Steroids reduce nerve irritation by inhibiting production of the proteins that cause inflammation; the anesthetic blocks nerve conduction in the area where it’s applied, numbing the sensation of pain.
How does an Epidural Injection work?
An epidural spinal injection may be done either for diagnostic or therapeutic reasons:
By injecting medication around a specific nerve root, your doctor can determine if that particular nerve root is the cause of the problem.
When administered for therapeutic reasons, a spinal epidural injection may provide long- or short-term relief, anywhere from a week to several months. In some instances, an epidural spinal injection may break the cycle of inflammation and provide permanent relief.
How Is An Epidural Spinal Injection Administered?
An epidural spinal injection is generally done on an outpatient basis, either at our doctor’s clinic or local hospital or medical center, and the procedure typically involves:
Positioning the patient to give the doctor clear access to the area of the spine to be treated.
Wiping the skin with an antiseptic to clean the area where the epidural needle will be inserted;
Injecting a local anesthetic to numb the injection site;
Injecting the steroid/anesthetic medication into the epidural space; and
Removing the needle from the epidural space, wiping the injection site with an antiseptic and covering it with a bandage.
The procedure typically takes 15-30 minutes. After the procedure, you’ll be monitored for about 30 minutes in the recovery room. You should avoid any strenuous activities for the rest of the day following your procedure.
After your injection, you may experience some numbness in your arms or legs. This is a temporary side effect associated with the anesthetic component of the injection, and it typically subsides within 1 to 8 hours. Your pain also may increase over the following 24-48 hours; it generally takes 24-72 hours for the pain-relieving benefits of a spinal epidural injection to take effect.
Is Epidural Injection Safe?
It can be used to provide pain relief during childbirth, what’s more to say.
Back pain or discomfort is common during pregnancy and should be expected to some degree by most women. Back pain may be experienced during any point of your pregnancy; however, it most commonly occurs later in the pregnancy as the weight of the baby increases. Back pain can disrupt your daily routine or interfere with a good night of sleep. The good news is there are steps you can take to manage the back pain that you experience.
How Common is Back Pain During Pregnancy?
You are not alone if you are experiencing back pain during your pregnancy. The prevalence varies with reports, showing between 50 to 70 percent of all pregnant women having back pain.
What Causes Back Pain During Pregnancy?
Back pain during pregnancy is related to a number of factors. Some women begin to experience lower back pain with the onset of pregnancy. Women who are most at risk for back pain are those who are overweight or had back pain prior to pregnancy. Here is a list of potential causes of back pain or discomfort during pregnancy:
Increase of hormones – hormones released during pregnancy allow ligaments in the pelvic area to soften and the joints to become looser in preparation for the birthing process of your baby; this shift in joints and loosening of ligaments may affect the support your back normally experiences
Center of gravity – your center of gravity will gradually move forward as your uterus and baby grow, which causes your posture to change
Additional weight – your developing pregnancy and baby create additional weight that your back must support
Posture or position – poor posture, excessive standing, and bending over can trigger or escalate the pain you experience in your back
Stress – stress usually finds the weak spot in the body, and because of the changes in your pelvic area, you may experience an increase in back pain during stressful periods of your pregnancy
How can you prevent or minimize back pain during pregnancy?
Back pain may not be prevented completely, but there are things that you can do to reduce the severity or frequency. Here are a few steps you can take to help reduce the back pain you are experiencing:
Use exercises that we taught you that support and help strengthen the back and abdomen
Squat to pick up something versus bending over
Avoid high heels and other shoes that do not provide adequate support
Avoid sleeping on your back
Wear a support belt under your lower abdomen
Get plenty of rest. Elevating your feet is also good for your back
How can you treat back pain during pregnancy?
There are a number of things you can do to treat back pain during pregnancy. Some of the steps you take to avoid back pain may also be used to treat current back pain. Here are some other common interventions:
Ice or heat
Braces or support devices
Sleep on your left side and use a support pillow under your knees
Medications used to treat inflammation
When to contact your health care provider?
You want to contact us if you are experiencing any of the following:
Low back pain is one of the most common musculoskeletal ailments that afflict the population. Are you affected by back pain? In Februrary 2000, the Back Society of Singapore conducted a survey of 1,001 adults aged 15 years and above who were randomly selected and interviewed over the telephone.
The Back Survey showed that over the previous six months prior to the survey, 18% or one in five adults had suffered an episode of neck or back pain. Up to 50% of back pain sufferers had experienced an attack at least once a month or more frequently. Of those afflicted, 10% deemed it serious enough to have taken medical leave, 16% had sought help from a doctor and a further 4% had seen a specialist. Only 4% seeks specialist’s advise and that is a serious problem.
The magnitude of the problem is similar to that in other developed nations. In the United States, United Kingdom and Scandinavia, it is known that back and neck pain constitute one of the major causes of physical disability and is responsible for more visits to the doctor than any other medical condition except common cold.
Common conditions that present as backache
Simple back strain is probably the most common cause of low back pain. The pain is usually mild and of limited duration, often improving with very little treatment or spontaneously within several hours or a day. Back strain is commonly seen in office workers who sit for many hours of the day and then develop a sore back after a long day.
Prolapsed intervertebral disc (PID)
Prolapsed intervertebral disc is one of the most common causes of recurrent back pain in adults between the ages of 20 to 50 years. The history is usually long standing. The pain is typically episodic and mechanical in nature, with long pain-free periods in between attacks. In the early stages, the pain may be localised to the back, but as the prolapse becomes progressively more severe, radicular symptoms may arise. Upper lumbar disc prolapses may present as groin discomfort or pain down the anterior thigh. Lower lumbar prolapses are sometimes associated with the typical sciatica in full-blown cases of root impingement, but in mild cases of root irritation, may present as just vague aching discomfort around the lower leg.
Lumbar spondylosis describes the syndrome of disc degeneration coupled with loss of disc height, facet osteoarthritis, and osteophyte formation. The pain associated with lumbar spondylosis is typically facetal in nature, which is worsened on extension of the spine. Spondylotic pain tends to be chronic and may occur even on daily basis. The pain is typically worse in the mornings, and after prolonged standing or walking.
Spinal canal stenosis
Spinal canal stenosis is a condition in which part or all of the entire spinal canal stenosed. Symptomatic stenosis typically occurs in patients in the fifth to seventh decades of life. Degenerative spondylolisthesis has been found to be four times more common in women. Most patients report a long history of intermittent back pain with progressively leg symptoms, which are typically worsened by walking or standing and relieved by sitting or squatting. This is referred to as neurogenic claudication.
Isthimic spondylolisthesis occurs in approximately 5% of the population. Patients typically present with a long history of musculo-ligamentous strain, which eventually develops in many cases to eventual sciatica or neurogenic claudication as a result of progression of the spondylolisthesis.
There are of course many other causes of back pain, including ankylosing sponylitis, metastatic spine disease from cancers such as colon, breast and lung; primary tumours both benign and malignant; and spine infections such as tuberculosis. In such cases, the back pain tends to be more constant and progressive, and may be associated with other systemic symptoms.
Certain symptoms are “red flags” and when present, early medical attention is advised.
Back pain that is constant rather than episodic, with no significant relief even at rest
Back pain that is aggravated by bending in all directions, rather than worsen in mainly one direction of movement
Severe pain localisable to a single spot or focus on the back
Pain that is progressively severe over days or weeks
Back pain associated with persistent “nerve pains”, ie, pains or sensations of numbness, pins and needles, aching in one or both legs, that do not go away even with rest or treatment
Symptoms of weakness of the legs, difficulty in walking, unsteady walking
Symptoms of bladder or bowel problems that are associated with the back pain, such as difficulty in passing urine, or incontinence
Specialist Orthopaedic Surgeon – Dr. Kevin Yip Featured in Channel NewsAsia:
The magnitude of the problem is similar to that in other developed nations. In the United States, United Kingdom and Scandinavia, it is known that back and neck pain constitute one of the major causes of physical disability and is responsible for more visits to the doctor than any other medical condition except for the common cold.