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Updated 12 February 2013

Neck or back pain

Do have neck or back pain but no pain in your arms or legs? Is it a new pain you’ve had for less than four weeks? It could be a muscle that’s in spasm or torn or a herniated disc.

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What should you do about the pain? And if you need an op, what are the available procedures? We've put together a guide to help you determine what could work for you.
BY BETINA LOUW AND THE HEALTH24 TEAM for YOU Pulse magazine

You have neck or back pain but no pain in your arms or legs.

Is it a new pain you’ve had for less than four weeks?

It could be a muscle that’s in spasm or torn or a herniated disc.
Try the following:

  • Rest in bed but for no longer than three days as longer bed rest could aggravate the pain.
  • Use painkillers such as paracetamol (eg Panado), an anti-inflammatory such as ibuprofen (eg Brufen) or diclofenac (eg Voltaren). These can bring great relief. Your doctor can also inject a painkiller and muscle relaxant should the pain be unbearable.
  • Do back stretches.
  • Sleep with a pillow between your legs and sit, walk and bend in the correct way.
  • See a physiotherapist.
  • A chiropractor can also help.

The possibility that you may need an operation is extremely slim.

Is it a new pain you’ve had for more than four weeks?

  • It could be a herniated disc pressing against your spinal cord.
  • Visit your doctor, who will refer you to a specialist.
  • The chance you’ll need an operation is less than 10 per cent.

Is it a pain that had gone away but has now recurred?

  • This is usually indicative of permanent damage caused by a herniated disc or a stress fracture that isn’t healing.
  • See your doctor.

  • There’s a 50 per cent chance you’ll need an operation.

Do you have back or neck pain all the time?

  • Chronic neck or back pain is the result of acute neck or back pain that has not been correctly managed.
  • Visit your doctor.
  • There’s a 50 per cent chance you’ll need an operation.

If you need an operation it will probably be one of the newer, less invasive procedures. This includes implanting silicon or titanium struts to space vertebrae or implanting a new titanium disc to replace the cartilaginous one. It could also be that you require a spinal fusion.

 

PROCEDURES FROM SIMPLEST TO MOST COMPLEX PATIENT'S AVERAGE AGE DURATION RECOVERY TIME SUCCESS RATE TOTAL COST
Implant of VERTEBRAL SPACERS (interspinous prosthesis)

A silicon or titanium strut is implanted at the back of the spine to support a herniated disc.

30-55 years 1 hour 6 weeks 70% R55 000
REPLACEMENT OF A HERNIATED CARTILAGINOUS DISC with a titanium one

The damaged disc is removed and a metal one inserted. The surgery is done through the stomach or neck, which makes any follow-up surgery extremely risky.

20-60 years About 2 hours 4-6 weeks 80% R80 000
SPINAL FUSION The vertebrae are permanently connected above and below a damaged disc by means of screws and a bone transplant. 30-65 years 3-4 hours 6-12 weeks 70% R80 000 - R100 000


Implant of vertebral spacers


Spine implant


Spinal fusion

(This is an edited version of a story that originally appeared in YOU Pulse / Huisgenoot-POLS magazine, Autumn 2008. Buy the latest copy, on newsstands now, for more fascinating stories from the world of health and wellness.)

 
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