Spine-Related Problems
Hi,
I am Dr. Neelabh, Orthopedist. Aaj mai aap ko spine ki problems ke bare mein bataunga. Hum slip disc ya disc prolapse bolte hain. Ismein curvature aage ki tarafa hota hai. Jab ye chhati ki taraf aata hai to ye curvature piche aa jata hai jo niche kama ke hisse mein aa kar vapas piche ki taraf aana shuru ho jata hai. Bone ke bich disc hota hai. Ye sari hadiyan ek ke upar ek hoti hain aur piche se bhi ye covered hota hai. Canal se sari nerves cross karti hain. Ek bayein taraf aur dayein taraf nerves nikalti hain jo sare sharir ko supply karti hain. Hamare sare sharir ka control brain ke niche ki nerves mein hota hai. Ye ek main circuit hai jiske through control hota hai. Inko balance karne mein doo chizen kaam aati hain. Abdominal and chest muscles aage se isse support dete hain. Piche se back muscles support karte hain. Back muscles ka strong hona bohot jaruri hota hai kyuki hum khade hoke chalte hain. Humara sharir sidha hota hai. Islia in muscles ka strong hona bohot jaruri hota hai.
Agar hum exercise nahi kar rhen hain ya fir peat aage nikala hua hai, achanak bhari saman utha lia ya fir aage jhuk ke kam kar rhen hain ya fir chot lag gyi ho, toh is se spine pe pressure aata hai and aage ki taraf ye bend hota hai. Bend hone ki vajaha se disc piche ki taraf pop out kar jata hai. Iska space narrow hota hai. Piche aane ki vajaha se disc compress ho jata hai. Is se us particular area mein pain and swelling aana shuru ho jata hai. Agar hume light aur fan on karna hai to hum switch board se switch on karte hain. Isi tarah humare sharir ke sare switches yahan par hain. Isi tarah jab pairon me dard iski vajaha se aan shuru hota hai to ise sciatica kehte hain. Sciatica koi alag bimari nahi hai. Jab slip disc ya disc prolapse hota hai toh uski vajaha se jo pairon mein dard jata hai use sciatica kehte hain. Is se bachne ke lia kya karna chaiye?
Aap ko regular exercise, walk karana hai. stomach ko aage na aane den, weight control rakhen, back muscles ko strong banayein. Ye problem mainly 45 ke baad hoti hai. Disc mein water kafi jayada hota hai jo age ke sath-sath dehydrate ho jata hai. Dheere-dheere ye hard ho jata hai and iski elasticity khatam ho jati hai. Islia hum suggest karte hain ki 45 ki age ke baad aage jhuk ke kam mat kriye aur weight mat uthaiye. Agar ye sab precaution lene ke baad bhi disc prolapse ho gaya hai to kya karna chaiye? Ismein deciding factor hota hai ki disc apni jagah se kaha nikali hai aur kitna nikala hai?
Agar vo center se nikalta hai to halka sa pressure deta hai. Ismein piche ek strong ligament hoti hai aur agar ye ligament ke andar rehta hai toh usse buldge kehte hain ke disc buldge kar rha hai piche ki taraf. Ye buldges exercises, medicines se thik ho jate hain. Lekin agar ye agle stage me aa gaya hai jahan par disc bahar aa gaya toh usse hum exterior disc kehte hain. Agar ismein nerve press ho jati hai toh kafi severe pain hota hai. Bohot jaldi sonapan aata hai aur kamjori aani shuru ho jati hai. Agar disc buldge kar ke neuro phenomena mein chala jata hai to sirf operation hi ek ilaj bachta hai. Lekin agar ye central canal mein aa jata hai toh iske symptoms hote hain back pain, legs pain and hand pain hota hai. Hum medicines, physiotherapy and exercises batate hain swelling ko kam karne ke lia. Almost 70% patients us se thik ho jate hain. 30% patients ka group hota hai jinko koi aram nahi aata hai. Iske lia hum kamar me injections lagate hain. Ye local injection dia jata hai taki iska effect sare sharir par na aaye. 20% patients ko is se aram aa jata hai. Jiska matlab hai ki 100 mein se 90% patients in sab chizon se thik ho jaate hain. Jo baaki ke 10% patients bachte hain jinhone sare treatments le lia hain but aram nhi aa rha hai fir hum operation ke baare me sochna shuru karte hain. Jaise jaise age hoti hai, vaise ligament dissolve hone shuru ho jaate hain and arthritis develop hone lagta hai. Patient jab 1km chalta hai toh uske pairon mein jhan jhanahat hone lagati hai, bharipan aata hai, dard hota hai aur dard itna hota hai ki aap ko 2 minutes ke lia baitha deta hai.
Dheere dheere distance coverage aap ka kam ho jata hai. Agar lumbar canal stenosis ya fir cervical canal stenosis hai toh iska ilaj kewal operation hota hai. Ismein medicines and exercises ka koi role nahi hota hai. Hume nerve ka pressure release karna padta hai. Agar ye problem niche ke area mein hai to patient ko pairon me sunapan aa jata hai, weakness aa jati hai. Isse cauda equina syndrome (CES) kehte hain. Ye ek emergency hota hai jismein humein patient ka immediately operation karna padta hai. Hume kaise pata chalta hai ki problem kitni badh gyi hai? Humare kuch routine investigation hote hain jaise x-ray, MRI aur ye tests hume guide karte hain ki patient ko humen kaise treat karna hai. Slip disc ke operation kayi tarah ke hote hain. Agar buldge hai toh conservative ya fir injections se thik ho jata hai. Agar disc right or left side aa gaya hai toh hum durbin se operation kar dete hain endoscopically. Is operation se hum disc bahar nikal dete hain. Kuch ghante baad mariz chalna firna shuru kar deta hai.
Operation karane se patient ko dubara problem nahi hoti hai and spine stable ho jata hai. Mai aap ko yhi suggest krunga ki weight apna control me rakhen, regular walk karen and back ki exerccise regular karen. 45 cross karne ke baad weight lift karana and aage jhukna band kar den. Gym jaane par belt pehnen back ko support karne ke lia aur tabhi weight lift karen. Humare paas 14-15 saal ke bache bhi aate hain slip disc ki problem leke jis se unka lifestyle zindagi bhar ke lia change ho jata hai. Islia aap apna khaas khayal rakhen.
Thank You.