 Hi, I am Dr. Pathyanesh This is the continuation of the Facebook live broadcast that we have done last month So this time let's be more interactive so that I can answer your queries And to an extent make you feel a little bit more comfortable when you go and visit your spine care specialist So until the questions start popping up let me talk about certain few conditions which patients have come and explained to me in the past few weeks So I had a 30 year old gentleman who had lifted water can and started having a severe catch on his back And after that he was not able to stand up straight And with that he has went and lied down for 2 days Still his pain was severe So he came up and met me after 2 days of lifting the water can So he was walking in a bend in the sense he was not able to walk straight So typically with the history and after checking him it was more likely to be a acute in the sense a recent disc bulge The moment I say a disc bulge many of them think that a great thing has happened It's not going to heal in any way and he is going to be having this trouble throughout his life And he was very upset that he won't be able to go back to his normal life So let me tell you this, disc bulges are pretty pretty common Do not worry just because someone says you are having a disc bulge or a prolapse disc Or maamsa, solipa, velagra, vanpe, something like that if they say don't get worried This is just as common as a headache Your pain might be more when you are having a recent onset disc bulge But that will subside with as simple as rest, few medicines and some physiotherapy So that you will get back to your normal life for how many hour days the pain will slowly go off So get back to sitting and walking as tolerable Move about within your house to start with Have some hot pads, a few medicines as prescribed by the doctor And you will be seeing the difference within a day or two after taking those medicines Regarding exercises, there is one set of exercises which you can do when you are having severe back pain But that specific set is known by very few therapists or doctors per se So on a blank note I will say that don't do any exercises when you are having severe back pain Until your back pain settles off Be on medicines, some hot water fermentations for your back and very minimal rest I repeatedly say that I respect pain Pain is a protective mechanism The body kind of communicates with you through pain So when you are troubling your organs of the disc coming out more or pressing your nerves It talks to you through pain So as simple as that If you have pain on any particular position or doing any work Don't do that Definitely there will be some positions in which you are more comfortable Pain is more relieved or reduced So just follow those until you become more and more normal Keep a note on how your sensation is there on the foot Is there any change in you visiting the restroom For example, you are too frequently visiting the restroom You go past urine comeback And then also you feel like still more you want to avoid urine Or you feel that before you enter the restroom you are passing few drops of urine Or you are not able to strain You are not able to push the urine out when you try that the back pain increases All these are few things which are very important And these has to be communicated to the doctor With this pandemic a new or rapid progression happened over video consultations So when you are speaking with doctor over video or live chat or WhatsApp or over call Please tell them regarding these so that we will be able to get an account of how much or how bad you are Then check how you are feeling the chillness of the floor on both your feet If there is any difference between the sensation Please let us know and contact the doctor immediately This gentleman luckily he did not have any variations in sensation or any bowel or blood In the sense preferences in control of urine or motion He had just the back pain There was no numbness or weakness, no fever, nothing else So he did pretty well within two days of medicines And some physios Within a weeks time he is back to his normalcy So someone has had a similar kind of a trouble Now they say that Okay I got rid of this pain With some medicines, with some hot water fermentation and very minimal rest What should I do next? So once your pain reduces off there are certain exercises that will pretty much help you in building your Lumbar muscles, lumbar in the sense the back muscles As a follow-up after the facebook feed so that you can Let me simply explain that Just lie down on your back on the bed or any firm surfaces Lift your leg one by one up without bending your knee And hold it at 45 degrees and count for 10 Similarly repeat for the other leg This particular exercise will build up the muscles on your stomach area and the back area Similarly try to lie down on your stomach and lift your legs one by one up And hold it for 5 counts Repeat these two exercises to start with 5 times Next, stand erect And then try to balance your weight in each leg for 5 seconds Do minimal stair climbing and frequent intervals When you are having severe pain that to a proven or you have a previous history of disc bulge Don't do any exercise that involves forward bending Bending on the front or lying down on the bed and crouching That will increase the incidence of this popping out Next few exercises which will build your back muscles are stretches Which you will be better to correlate with the pictures that follows after the feed So we have a few comments from our viewers One is pain due to constant sitting So this all of us are facing for the past few months So most of us have or you would have already bought some office chair or revolving chair or something like that If you have bought so and if you are comfortable with that continue that And in the easier way to stretch when you are sitting on a revolving chair is Keep your foot planted on the floor that is firm on the floor And rotate the chair to the right and left That gives stretches on your back Something like this Stretch to the maximum of either side Next try to bend down and touch the floor and hold that for 1 or 2 seconds All this you can do when you are on a voice call with your clients or when you are working on a system Next lift your legs straight up one by one when you are sitting And hold it for few seconds parallel to the ground Repeat it with either legs And when you are doing so try to stretch your foot so that you will feel the pressure on the back of the legs This will improve the blood circulation in your legs And also stretch your muscles Thereby you yourself will feel that half that effect you will feel That exercise is both good for your legs and for your back Next try to stand up in the same place And then sit without supporting the arms of the chair Do it for say 3 to 5 times This will again build up your back, your gluteal muscles and your leg muscles These are simple stretches exercises which you can do on a frequent interval when you are sitting on a chair For people who are using sofas or bed when you are working There is no exercise you are basically harming yourself Shift to a firm chair like a wooden chair of your dining table Or some chair which kind of supports you on the back Or reading table chair In those chairs the stretches and getting up from the chair you can do pretty well Instead of sitting and twisting stand up and twist These few exercises will keep your back happy So this few exercises will help you to prevent pain when you are sitting for a long time and working Next when these stretches are all helping out At the end of your session on every day you can have some hot water or fermentations Or lie down flat on a firm surface so that your back pain will go off So we have one more comment saying that his mother is having knee pain for past 4 years And more pain only on sitting on the floor or when they suddenly get up from the seated posture So I don't know the exact age of your mother So supposedly she is more than 40 and she doesn't have pain while walking on a flat surface This has nothing to do with the spine, this has more to do with the knee joint And it is an early stage of arthritis occurring in the knee just below the small mobile bone it should see in the front So with some knee exercises this pain will go off, nothing to worry about that And she has to avoid sitting on the floor for the next few weeks so that the swelling comes down and her knee pain goes off Contact physiotherapist nearby and tell them to teach her some knee strengthening exercises With that she will feel much better, she can take plain parstomol tablets So we have one more person saying that they have a back pain for three months Consulted a doctor and MRI was done at dismal at two levels, pain reduced with medication Same whatever we have discussed earlier, just because an MRI shows you are having a dismal you don't have to worry You take randomly 10 people from general public even though they don't have pain Generally whoever is walking on the road take 10 of them and do an MRI of lumbar spine and see out of that Minimum 5 will be having some disc bulge here and there It means that disc bulges are pretty common even for normal induced An MRI will pick up empty number of disc bulges whether you are young, old or even though you are active or athletic or whatever it is You might have some disc bulges and these disc bulges unless they don't trouble you you don't have to worry about that How you can prevent further progression or worsening of your disc bulges Simple exercises for your back, reduce weight if you are on the obese side Do some walking, do some exercise for your back, be active, those disc bulges won't trouble you anymore Whether will you get a severe back pain in the future That depends on how active you are, if you are active there is definitely very minimal chance of you getting a back pain in the future Another person has asked whether back pain is common for old age In old age as a person grows old there is wear and tear in his body throughout right from the hair to the foot Just how hair becomes white similarly because of wear and tear all the joints in the body will show some amount of pain here and there So back pain can occur in people who are on the elderly side And not all back pains are only related to age, there are certain other back pains As long as someone is getting pain occasionally only when they are bending down and doing some work Or when they are travelling for long distance or suddenly they try to do something and they had a catch Those back pains can be treated for a few days with medicines and rest If that is not subsiding meet a specialist Otherwise occasional very dull aching minor back pains on the back are pretty common for people on the elderly side For them all this wear and tear pains cannot be brought back to normalcy On a plain words they cannot be made young again but they can be made active in their lifestyle Just with some way production and some walking and some exercises That will bring a very huge change in their back pain or knee pain or whatever pain they have Then we have another person stated that few people come in the age of 30s and say that they are having severe back pain And then back pain is troubling them much and more pain only on working in the system In the age of 30s if you are developing back pain and that too is lasting for few months Get checked once The MRI shows you are having minor disc bulge or degenerative disc something like that and no major compressions All you will be requiring is only some strengthening exercise for your back With the advent of rapid growth of Google to receive the MRI report they start googling what is this what is that So one of that word which kind of threatens the person is degenerative disc disease Degeneration is nothing but again wear and tear The disc is supposed to have water inside it so that it acts like a cushion If the water goes out it becomes dried up and becomes firm that will cause back pain for few A person recently asked why can't be inside fluid inside it it doesn't work like that The disc is a closed system when you try to introduce something from outside there is high chance that it will fail first thing It won't work Second thing you will have high chance of infection So that's why all this though it has been dried in the past and they have all been dropped out now So the best way is to drink adequate amount of water keep your back your spine mobile The more mobile the more exercises the more water you take disc will get its fluid consistency back again And it will become most of them come back within a week or two states and say that they are doing exercises regularly But the back pain is not going till the back pain is there the exercises the medicines for years So just because you do something for the next two days two weeks or so don't expect a major CC improvement by the end of around six to nine months So that's how much time your back needs to get back to its normalcy Because you have been keeping your back immobile or less mobile or you have been abusing your back for so many years Just because you change your lifestyle for two weeks it can't forgive you and come back to its normalcy again You have to prove to your back that you are working hard to make your spine normal So that will take around six months to nine months and by the end of it you will definitely feel much much much better And all those degenerative disc disease or disc bulges won't be bothering you after that again So this is one metropillar incident that one of the person has asked about We had a young lost his foot where he lost his grip and he fell down and landed on his buttock It's almost a height of around say 30 feet So with the force that he landed up there he developed a fracture on the spine He developed three other fractures on his hip level the huge bone And with within few minutes he was luckily he fell in front of the hospital so he was immediately brought to Being assessed when we were checking him his BP and everything dropped and he lost consciousness That is mainly because the other three fractures on his hip they started bleeding a lot And he almost went in for a cardiac arrest in the sense his heart stopped working So we started him on blood he was revived he was observed for two days and they were in the same place They didn't move away much and regarding the spine it was a pretty bad fracture If he has to stand up walk or do anything or even sit on the bed and eat his spine had to be stabilized So he was operated we have fixed the spine post the surgery he was happy to turn in the bed He was happy to sit on the bed with some support And by the end of the month we made him walk and by the end of six weeks all his fractures on the hip have healed And he was happy to return back to his hometown and come back for a short break So this is a 35 year old gentleman who is a sole breadwinner So he is this is an example to state that if someone has a fracture on the back or any problem on the spine Whatever be the age it doesn't mean it is the end of their life or it doesn't mean that it is going to greatly change the way they are going to move around or do the work Based on the type of problem that they have with few modifications at the maximum surgery they can go back to their normalcy Whether they are into high contact sports or whether they are into lifting weights on a daily basis Whether they are into manual labor or whatever it is based on the type of problem that they have They can go back to their same life, same work or a few modifications in both With that they can be having a same happy life again So we have shared a few points stating how you can prevent abusing your back One common aspect is when you are sitting and doing any work for more than half an hour Try to do some amount of change in your position at the least Either get up and sit or change the position That is the least possible that you can do The next step more is just to twist your sides Get up and sit back again or walk a few steps and get some water and come back and sit The next step is to take a few minutes break Walk outside your home or outside your office to the lawn Or walk a few steps if you are staying on few floors of your office Go up a plate of stairs, one floor up, one floor down Do something like that so that your body becomes active again These are few things which you can do without sweating much You don't have to put too much energy on to it The other way is to how a commercial came walk and talk When you are in an office you are getting a personal call and if you are going to attend that don't sit and attend Get up, talk over the phone, walk or go to the staircase area Climb up stairs and down stairs and we will talk After you meet again try to climb steps or go down the steps Again from then on you are not able to stand straight or walk more comfortably Pain increases on coughing and the pain comes along the leg with numbness of the toes So I hope you are in the active age group in the sense young between 20 to 40 And this pain what you have stated like lifting the water can and the pain coming to the legs Most likely you are having a minor disc bulge and the numbness in your toes Again it implies that the disc is compressing one of the nerves So don't get frightened with this You have to be checked once personally to assess how much of numbness or weakness or the disc bulge is causing you trouble And you will definitely require an MRI Based on the findings that we see on you And MRI you will be initially treated with some medicines And additionally you might be given some physiotherapy heat modalities If you are showing improvement in the next few weeks You will be maintained with medicines only and medicines will be tapered off and we will teach you some exercises Only if these medicines or the physio are not going to work in the next few weeks Or if the numbness increases or any of the trouble you get Only then you might be subjected for a minor surgery Just because MRI shows a huge disc or just because you had a numbness right now It doesn't warrant that you will immediately require a surgery You will be managed with medicines or these are all pretty normal ones or frequent ones Visit once a spine specialist We will check you once, we will assess and compare how you are, what we have found out and what MRI is showing We will discuss with you the options of medicines or injections or whatever it is And we will try with peace and if at all if they fail or if you are not improving Then you might have to undergo a minor surgery And post surgery you can gradually go back to your normal life, fail again At the earliest In the sense if you get, if at all if you get operated Same day you will be made to walk And the next day you can go home and slowly start working Or sitting on a firm surface Because they develop some irritation on it That's why that area inside the body tries to protect that area by causing some swelling over there And the pain tells you the area which you are constantly used to First thing, make hot water or hot pack application for the tailbone area Third thing, again try to climb a few steps Try to go for a walking so that they will build up the muscles on your buttock region So that whenever you are sitting, the muscles will prevent the bone from touching the surface where you are sitting If the pain is too severe, you can buy something called as arches pillow C-O-C-C-Y-X, caucic pillow which is readily available at most of the time It basically has a gap where the tailbone is going to press when you are going to sit Means the pressure will be relieved from the tailbone area So that it will have some time for the swelling to come down And slowly the pain will go off Once the pain goes off, do some squats Squats in the sense like sit on the floor and get up, climb steps Lift your legs one by one up when you are standing, alternatively Either legs to be lifted and held for few minutes, all this will build up your gluteal muscles That is the buttock muscles So that you won't develop this problem again If this problem persists or if this problem is troubling you too much Meet a specialist where we might have to check you again Do an x-ray at the minimum and do some basic blood investigation to check whether you are having any associated infection over there If everything else is ruled out, there is something called as tailbone manipulation which will be done That will give you much more pain relief So don't worry, this is again pretty common ones as a tailbone pain With a few modifications, how you sit and work, this will also go off And most of them are worried with MRI showing again disc balls and disc prolapses or dysentery disc disease Those are all just few words, medical terms that they use But those are all pretty common Don't worry regarding that Any doubts regarding the MRI or other blood reports or whatever it is Be free to talk with a doctor who has advised all these Will state so many things which might threaten you the max The easier way to find out that is whatever field you are in Take a small discussion or a topic or whatever you want to know in your particular field And type in Google and see how various people have said so many things in a different way And you will laugh out how things are being misinterpreted by so many people Or false information are given on the websites Then you will know whether you have to do a Google search and all these medical terms or whatever it is All the bad pains, almost 90% of them can be treated with medicines The rest 10% may or may not require a surgery It depends on what trouble you are having with And all this 90% falls on all this muscle weakness, muscular pain on the back Or degenerative disc disease pain or disc bulge pain All those fall into this So if you have any more, I hope I didn't go too much away from the topic We have discussed a few things about MRI, bad pain, disc bulges, tailbone pain and on knee pain also So if you have any more doubts or if you want to discuss further more You are very welcome to post few more comments or queries or whatever you have I will be happy to address your doubts And thank you for watching, we will catch up again on some other day