Evidence based physiotherapy treatment for PIVD: an alternative to painful surgery!

Introduction

“Why to go for painful spinal surgery with number of side effects when there is a safer and proved alternative available?”, asks Dr Aneeta Verma, a physiotherapist and nutritionist with 11 years of experience in helping people with medical conditions to regain their normal life via adopting healthy life style and physical therapy. “One of PIVD patient came to me with problem of back pain which reappeared again even after spinal surgery. A proper and customized physiotherapy treatment was structured for the same person who regain the confidence and better life with almost no back pain.” Let’s explore what is PIVD and dig the details of the mentioned alternative approach for the same.

What is PIVD

PIVD refers to “prolapsed intervertebral disc”. It is the protrusion of inner soft gel like portion of spinal disc and is also called as “slipped disc”. Spinal disc are the circular structures present between successive vertebrae of the spine. These discs have semi fluid mass of cartilage and collagen fibers in the center which is surrounded by rings of the fibers collectively called as annulus fibrosus. The spinal nerves come out through the spinal disc to obtain the messages from different body parts. The discs also makes back to bend and flex while serving as shock absorber. PIVD occurs when the disc is stretched enough to return to its normal shape or there is prominent bulging of inner soft fibers or there is complete spillage of the inner soft jelly or there is sequestration. There is inflammation around the bulged disc and pressing of the any of the spinal nerves.

Causes of PIVD

PIVD can occur due to incorrect posture, obesity, manual labor, weakened trunk, long sitting hours and/or ageing.

Symptom and diagnosis of PIVD    

Symptoms of PIVD include severe lower back pain, pain in legs, feet and buttocks due to pressed spinal nerve, muscular spasm, and loss of control over bowel movement. Pressing of last few spinal nerves causes Cauda equina syndrome which includes numbness in area around the anus, weak leg muscles, lower back pain and loss of control over the bowel and bladder.

Diagnosis is based on the symptoms and include SLR, bowstring tests and femoral stretch test.

Need of surgery?

In most of the cases, the painful treatment of spinal surgery is recommended which becomes mandatory for Cauda equina syndrome. Some of the risk factors associated with spinal surgery include damage of nerve root, infection, bleeding, nerve damage, formation of blood clots and even reappearance of pain in time, as it occurs in many cases.

Physiotherapy: An alternative approach

Having said about risk factors of spinal surgery, it becomes necessary to talk about the alternative approach. Though, surgery seems to give a quick relief from back pain as compared to the physiotherapy, it is not beneficial in long term owing to its too many side effects and no assurance of permanent pain relief. The physiotherapy aims at pain relief, muscle strengthening and relaxation, relief from inflammation and prevention of any further complications. The structured exercise regime includes nerve mobility exercises, press ups in prone condition, simple spinal movements in different poses (prone, supine, half lying, standing etc) and isometric exercises. A regular routine of exercise under supervision of experienced physiotherapist gives visible results. The person is then motivated to do some aerobic exercises, walk etc. to increase the strength of the muscles further. A routine of exercises keep the person away from any pain and nullify the need of any spinal surgery at all.

Eva physiotherapy and wellness clinic aims to achieve sum of the physical and mental health of the person who are demoralized due to recommended need of risky spinal surgery.

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