 Hi, I am Noor Dr. Dhyanand. I was fine consultant at Manipal Hospital and today I am going to talk about a common, commonest problem that occurs for many during this lockdown period called the vacate. Many of us have been introduced to new work or extra work or we have to change our work style during our lockdown period because we work from home, because we are helping our kitten-kin at home, we are helping our family, we are helping our friends. So we are used to doing work that are not our regular ones. So we end up with back pain, body pain, neck pain, headache, too much of stress. So regarding the back pain and neck pain, let me tell you a few comments. Back pain is very common. So don't worry, just because you have got a back pain you are going to get trouble. Whenever you get a back pain, whenever you get a back pain, all you do is that you take some, you go and lie down in a bed which is comfortable for you, apply some ointments and keep some hot water pack. If the pain is too severe, you can take one croissant or calcol tablet and take rest for an hour or two. That should kind of leave you with your muscle pain. Next, if the pain is too severe, if it's radiating to your legs, if it's coming all the way to your buttock and all to your legs or if you have some weak tingling or numb sensations in your legs, do visit a nearby doctor or if you are afraid that you won't be able to step out of the hospital, sorry, you won't be able to step out of your home. Take a video consultation with any spine surgeon or orthopedic surgeon and we will help you out and how you can tackle it out. Back pains are pretty common when you all of a sudden jump into your overzealous exercise workouts. Like, all of a sudden someone and say, I challenge you for doing so many burpees or so many squats or so many minutes of plants, when you all of a sudden do all those, it's very common for you to develop a backache or a catch. Again, apply some ointments, hot water pads, rest. That's all is needed to relieve that back pain. Regarding your neck pain because of either lifting, moving, any objects. Again, if your pain is only on the back of your neck and it's limiting your neck movements, no pain to your shoulders or any numbness or tingling sensation in your fingers. Don't need to worry, it's just a muscle catch and you can very well treat it at home with ointments and hot water fermentation. When you have neck pain, don't use a pillow for lying down. Either use a small rolled towel or a very thin, soft pillow for your head. Observe your neck and back pain for a day or two. If you are getting comfortable, nothing to worry. If your pain is still persisting or increasing, do consult a doctor. Preferably an orthopedic surgeon or a spine surgeon. When do you have to get worried about your back pain or neck pain? When it's increasing or coughing or sneezing? When you find some alteration in the pattern of you using the restroom? Like you are too frequently using the restroom? When you feel that you are developing some numbness or weakness in your hand or legs? When you have associated fever? When you have lost weight? Or the pain is most with your head night when you are lying down in your bed? In these cases, you have to visit the doctor at the earliest. Next, what are all the basic steps to be taken to prevent back and neck pain? Easiest way and the one that most of us don't follow is simple stretching exercise. When you get up from the bed, all you have to do is move your head to the left and right, move your head up and down, stretch it to the maximum possible. Again, stand up from your bed, twist your body to your left and right, bend a little bit forward and bend a little bit backwards. This will stretch your muscles. Next, you do these stretches a bit repetitively, like 5 times or 10 times a day. This will keep your muscles active. When you are working on a system or a laptop, say for potentially for 6 hours or 8 hours before working home, try to sit on a chair with a good back support. Rest your back on the back support. Don't slouch, don't bend forward, don't sit on a sofa or don't sit on a bed and then work on your system. That will definitely cause a problem and the neck pain. Keep your system at a comfortable level and the monitor should be at your high level. Your hands should not have any stress when you are using the keyboard. When you are sitting on a chair, try to stretch your leg and try to hold it for 10 counts when you are working. Again, keep your water body a bit far away so that each time when you drink water, you have to go ahead, stretch and take your body. This will help indirectly in the moment of your head, neck, arms, shoulders and your back. Take a break once an hour or two. Just go around your home or go to the kitchen, fill up your bottle of water and come back or just a few minutes of walking around and then come back to sit and work. Next is how to do your extra work at home. Try to do it in a slow addition. Like if you have to clean your room or clean some space, try to split it over a few days and do it so that you don't strain yourself much. If you have to move an object, if it's easily moveable to the wheel, you can do it. If you have to lift and do it, get someone's help and then try not to lift it by bending forward. Bend your knee, bend your hips like how you sit for the squash. Sit like that and slowly lift the object up. There is a high chance for your disc to collapse if you lift too heavy way by bending forward or if you try to lift something over your head. The other myth regarding problems with the spine, not all back pains and neck pains are the same. Most of them around 80% are simple cuts, another 20% varies between disc bulge, infection or any bone that has grown because of wear and tear, which is commonly called as spondylitis. Next are conditions wherein there is some nerve getting pressed because of either the disc or some overgrowth of the muscles or the overgrowth of the ligament or the bone. So the 20% is a bit tricky to find out which pattern has caused you the neck and back pain. So don't blindly follow our video on YouTube saying that if you have a back pain or neck pain do all these exercises, you will see better. You can try once. If you are comfortable, you can try it a couple of more times. But if it is causing you any trouble, do not try it again because it might increase your back pain. And from a simple treatable problem, you might land up into a more complex problem wherein you will be requiring some intervention like an injection in your spinal cord or a surgery. It's better to get an opinion from a trained spine surgeon or an orthopedic consultant before you venture out into any sort of exercises based on your views. Or just by hearing someone say 2-2 that your back pain will do off, you might land up in more trouble. Then most of the common perception is that all spine surgeries are risky ones. Just like how back pain and neck pain are all not the same, not all spine surgeries are the same. With recent advances of medicine, there are more safer options and more options to pre-tune without any surgery. If surgery is warranted, then it means that the benefit of you going in for a surgery is much higher than the risk. It means you will feel much much better when you come out of surgery. In regards to your indication for surgery, whether it is pain, numbness or weakness, whatever it is, only if you are going to improve, a doctor is going to suggest you for a surgery. So, if at all if you have any doubts regarding the surgery, ask well before to the doctor, discuss with him and have full faith before you land up in a surgery. Most of the surgeries do not require you to be in the bed for more than a day. All when I do surgery, I like to make them move at the earliest immediately. When they retain their full consciousness and the anaesthetic effect is weaned out, say around 6 hours after the surgery, I will try to make them move so that they will feel more comfortable. They will feel more happier and the happier the patient is, the faster will be there, better will be. Most common doubts that people ask only for a surgery will be the first thing whether it is risky. The risk involved in a simple spine surgery like discotomy or micro discotomy or microscopic discotomy, endoscopic discotomy, everything else, less than one person. All the complications are less than one person. Immediately, as I have said before, as soon as the patient is comfortable, they will be made to walk. There is nothing called as bed rest after these simple discotomy procedures. We want you to walk back as much as tolerated. The more you walk, the better you are. There are no major restrictions after spine discotomy surgeries. You can walk, you can sit, you can lie down anywhere you want and climb steps. You can travel for a few minutes or nearby places or from the hospital to home in a car. Few things that are better avoided are bending powers, lifting weights and sitting on the floor for the next 6 weeks. After 6 weeks, we will teach you some spine exercises to strengthen your back so that you don't develop a similar back pain in the future. Then there is the MRA. Many people think just because a doctor asks for an MRA, they will land up on surgery. MRA gives us a clue how to treat you better with medical management, with medicines or any other modalities. Or if there is no scope for that, then only a surgery is going to be the end option. So MRA, based on that, we can judge how well will you improve and how fast can you improve with what kind of treatment that we have to give you. In an MRA, disc bulges are pretty common just because a disc bulge is there, you don't have to worry. Only if they are giving you any trouble, they have to be dealt with. So just don't go by the reports and think that you have disc bulges in so many places, you are going to be bedridden or your future is gone. Disc bulges are very very common findings in an MRA. Even for a normal people, if you do an MRA out of 10, 5 to 8 will have a disc bulge without having any back pain. So don't go by the reports, always discuss with the doctor and he will be knowing better which disc is causing you trouble or there is something else in your MRA or in your body that is causing you trouble. And all other findings can be ignored as long as they are not causing you any trouble. Next comes the physiotherapy. Physiotherapy has two components. One is wherein they will do something on you. Next is the one wherein you have to do. In physiotherapy, they will give you some heat applications, stretchers, various machines will be there. That will give you some heat applications and stimulation. That is the clear part. The next major part is you involving yourself. Like doing exercises. The more you do exercises as prescribed, the faster you will recover. Either after surgery or during the course of treatment with medicines. Unless we get the cooperation from you, we won't be able to see any result from you. Regarding rehabilitation, let us, okay, I have landed up in a surgery. What should I, what changes should I do in my life so that I won't get back to a similar kind of a problem in my neck or back. Maintain a proper posture when you are sitting and doing work, when you are standing and doing work. Do the exercises regularly as prescribed by the doctor and physiotherapist. Ideal weight is very, very important so that you won't develop any neck or back pain. Quit smoking. Smoking has a high correlation for a disc pulse to occur. Don't enter into any high core exercises unless you start with the basic stretches. Any hiking or jumping or what, high value games you want to play. Before that, you do some stretches so that your body adapts to what you are going to be with the next. Be active. A sedentary lifestyle is always prone to cause you some back pain. A common, commonest among nailmen that a person can get in their lifetimes. One is headache. The next commonest thing is backache. And commonest among the backache is muscle catch or strength which goes off with rest and medications. So don't worry if you get a back on neck pain. Try with some ointments, a better rest and hot water pack at home. If it doesn't settle, consult orthopedic surgeon or a fine surgeon who is nearest to you. And follow their advices so that you will be back to your regular activities. Be positive. Stay healthy. If any questions are there, do post me. I will be happy to reply them.