Our fondness for driving goes hand-in-hand with our tendency to shy away from exercise. Often, we will hop in the car, rather than walk down to the shops or to school or work. Whilst this may save us time, in the long term it may also increase our chances of developing back problems and other health problems  It is well known that people who lead active lifestyles are less likely to die early, or to experience major illnesses such as heart disease, diabetes and colon cancer.

Unfortunately for some people, spending long periods of time sitting in a car is unavoidable (e.g. taxi drivers, bus drivers, salespeople). The constant vibration of the wheels on the road, hunching over or gripping the steering wheel, sitting in the same position and stretching to depress the clutch or see out of the mirror, all take their toll on your back. It;s not just the driver who can stiffen up in a car either – passengers are often seated for long periods of time in a fixed position.

If you do spend a lot of time in your car, there are a number of things you can try to make yourself more comfortable:

  • bring your seat forward so that you can depress the clutch without having to stretch
  • adjust your mirrors properly
  • take regular breaks, ideally once an hour
  • try to avoid twisting when getting into or out of the car
  • keep a small cushion in the car to support your lower back
  • choose a car that is suited to your needs.

Choosing the Right Car

The Praying Test – Place both hands together, pointing forwards. You should be pointing straight at the centre of the steering wheel.

The First Test – Make a fist with your left hand, keeping the thumb to the side of the index finger. If you have sufficient headroom then it should be possible to insert the fist on the crown of the head.

The Right Leg Test – After driving the car for a short while, look down and examine the position of your right leg. Your right foot should still be roughly in line with your right thigh.

The Kerb Height Test – Swing your right leg out of the car as though you are getting out, and place your right foot on the ground. The surface of your right thigh should be sloping downwards (not upwards) towards your right knee.

These tests should only be performed then the are is stationary and carefully parked.

What is Decompressive Laminectomy for Lumbar Spinal Stenosis?

Decompressive laminectomy is the most common type of back surgery done to treat low back – spinal stenosis. Laminectomy is done to relieve pressure on the spinal nerve roots caused by degenerative changes in the spine. It is also done to treat other spine conditions such as, spine injuries, slipped disc, herniated disc or tumours. The aim of the surgery is to reduce the pressure to the nerve roots so as to relieve your pain and allow you to return to your normal daily activities.

Laminectomy removes parts of the bone or thickened tissue that is narrowing the spinal canal or pressing the spinal nerve roots. Laminectomy involves a small incision to the back.

What To Expect After Decompressive Laminectomy

Recovery of the surgery is gradual.

Why Decompressive Laminectomy Is Done

Decompressive laminectomy for lumbar spinal stenosis is considered when:

  • Severe back pain symptoms has affect your day to day activities.
  • Tried all conservative (nonsurgical) treatments but the symptoms persist. Numbness and weakness to the legs gets worse and not getting better.
  • You cannot walk very well.
  • Bladder and bowel control may be affected.

How Well Decompressive Laminectomy Works

The surgery has good results and you will see the result the next day of the operation. The symptoms will be reduced significantly.

What To Think About for Decompressive Laminectomy

You may want to exhaust all nonsurgical treatments before choosing surgery.

One can try the below conservative treatments before proceeding to the surgery.

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You may need to consider surgical intervention for your back problem that is caused by a tumour or infection.

Removal of Spinal Tumours

Spinal tumours are growths found on the bones and ligaments at the spine, the spinal cord or on the nerve roots. The tumours can be benign (noncancerous) or  malignant (cancerous). During the surgery, the surgeon will remove the tumour or any bone that has damaged.

If some parts of the spine is affected by the disease and needs to be removed, the surgeon can use metal implants, bone grafts or bone cement to make your spine stable.

There are certain types of tumours which you can ignore. However, it is important to speak to a doctor to ascertain that the risks involved is minimum. Get advice from a surgeon who is an expert in treating spinal tumours.

Debridement of the Spine

This surgery is usually recommended for patient who has infection or injury to the spine. Debridement of the spine involves removing parts of the bone or other soft tissues that are infected.

The surgeon will remove the infected and damaged dead bone. The area is then cleaned with sterile solution that contains antibiotics. If the spine is severely affected and requires to remove a lot of the bones or entire vertebrae, he or she may use the spinal fusion (arthrodesis) method to stabilise the spine.
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What is upper and middle back pain?

You may experience upper and middle back pain anywhere from the bast of your neck to the bottom of your ribs cage.

Our ribs are attach to a long, flat bone in the centre of the chest also known as sternum and attach to and wrap around our back. If a nerve in this area is pinched, irritated or injured, you may feel pain in other places where the nerve runs, such as your arms and legs.

Ribs

The upper and middle back also known as thoracic spine has:

  • 12 vertebrae.
  • Discs.
  • Muscles and ligaments that hold the spine together.

Upper and middle back pain is less common compare to low back pain or neck pain, because the bones in this area do not bend as much as the bones in the lower back or neck. Upper and middle back work with the ribs to keep the spine stable and protect the vital organs, such heart and lungs.

What causes upper and middle back pain?

Upper and middle back pain can be caused by various factors include:

  • Soft tissue injury such as overuse, muscle strain, injury to the muscles, ligaments and discs that support your spine.
  • Incorrect posture.
  • Constant pressure on the spinal nerves such as herniated disc.
  • Fracture one of the vertebrae.
  • Wear and tear of the cartilage that cushions the small facet joints in the spine. Commonly known as osteoarthritis.
  • Myofascial pain that affects the connective tissue of a muscle.

What are the symptoms of upper and middle back pain?

Common symptoms you may experiencing for upper and middle back pain include:

  • Weakness in your arms or legs.
  • Numbness or tingling sensation in your arms or legs.
  • Dull, sharp, burning pain.
  • Muscle stiffness and tightness.

How is upper and middle back pain diagnosed?

Your doctor will perform a physical examination to your spine. X-rays and MRI may be ordered for you to find out whether there is any broken bone or slipped disc that is causing your pain.

How is upper and middle back pain treated?

Treatments to upper and middle back pain include:

When to call a doctor for your upper and middle back pain?

  • Numbness to your legs or arms.
  • Weakness to your legs or arms.
  • Pain that gets worse.
  • Pain affecting your sleep.
  • Unable to walk or stand because of the pain or weakness.

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As children and teenagers are more flexible, in this age group back pain is not common as compare to adults. Only about 1 to 4 young competitive atheletes and 1 on 6 young recreational atheletes will have occasional back pain. Back pain in children that happens immediately after an injury or an atheletic event should be checked by a doctor.

Overuse injury can cause back pain in children. As overuse back injury happens gradually, children or parents may not be able to remember what injury that triggers the back pain or when the back problem started. Carrying heavy backpack may increase a child’s chances of a back injury or problem.

Back pain that is very severe and limits a child’s daily activities or back pain that lasts for 2 weeks or longer, needs to be checked by a doctor.

Back conditions that affect children and teenagers

  • Pain that is made worse by specific movements, such as swimming, gymnastics, or contact sports, may be caused by spondylolysis or spondylolisthesis. Young athletes with low back pain have a higher risk of spondylolysis. These back injuries are usually caused by activity and overuse.
  • Scheuermann’s disease can cause pain to the back. However, it is not severe enough to affect the daily activities of your child. It is the second most common cause of back pain in children and teenagers. Scheuermann’s disease may cause your child to have a rounded spine.
  • If your child who is awakened by back pain during the night may have an infection, arthritis, or tumour of the spine.
  • Back pain that happens with changes in balance or coordination may be a cause in the brain or spinal cord.

Back pain symptoms may be caused by other problems that the children is having. If you suspect that your child is having a spine problem, bring them to see a doctor to check their spine.

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