Backache

Updated 17 September 2014

Unbearable neck or back pain

What should you do about the pain? And if you need an op, what are the available procedures?

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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.

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 (e.g. Panado), an anti-inflammatory such as ibuprofen (e.g. Brufen) or diclofenac (e.g. 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%.

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% 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 hasn't been correctly managed.
  • Visit your doctor.
  • There’s a 50% 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

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%

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%

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%


Implant of vertebral spacers


Spine implant


Spinal fusion

- (Health24.com)

 

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Backache expert

Susan qualified as a Physiotherapist in 1990, and completed her master’s degree in Physiotherapy in 2013 at the University of Pretoria. She has a special interest in human biomechanics, as well as the interaction between domestic and work-related ergonomics. Read more here.

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