HEALTH:
Pain can be of any type mild, moderate or severe according to that treatment can be done either by using conventional therapy or conservative therapy.
Pain management can be defined as the vital part of medicine, whose approach is to give patients ease and release of chronic pain by the help of interdisciplinary approaches including physiotherapy, medicine, psychology and other therapies.
Sometimes this may include classical techniques like meditation, hypnosis, acupuncture and light therapy.
Therapy that aims at relief of pain, increasing mobility of the spine, and strengthening the paraspinal musculature includes the following measures:
Bed Rest
The position of greatest comfort is sought. As a general rule, slight flexion of the hips and the knees is best.
A firm mattress or a board under the mattress help to reduce lumber lordosis and relieves painful tension on articular ligaments.
Heat
Painful muscle spasm is reduced effectively by moderate warmth. Hot wet packs are laid along the spine and covered with wrap and an electric heating, pad.
Short-wave diathermy should be avoided, since it may cause necrosis of bony trabeculae, which are already deficient in many of the patients.
Massage
Massage is best done following application of heat. It supposedly improves tone, circulation, and elasticity of muscles and effectively preserves integrity of the skin.
Flooding the bed with a powder containing lanolin will reduce friction and prevent bedsores.
Salicylates
Sodium salicylate (approximately 1 gram) is administered three times a day.
Because it produces gastric irritation, the tablets should be enteric-coated and combined with an alkali.
Salicylates are specific for relief of pain in osteoarthritis.
Persistence of symptoms should cause one to suspect other pathology.
Immobilization
A corset, a brace, or a plaster cast provides rest to the spine in the ambulatory case.
Supports are reserved only for the stage of acute pain.
Their prolonged use is pernicious in causing muscle atrophy, which in turn invites further degeneration of the spine.
Traction
Head halter traction is useful in cervical arthritis. Pelvic traction is applied in cases of lumbar arthritis. Both types of traction may be combined.
Exercises
As soon as the acutely painful stage has subsided, general exercise is prescribed to strengthen the paraspinal, the abdominal, and the gluteal muscles.
These must be carefully graduated and never performed to the point of fatigue.
Oral Corticosteroids
These medicines are rarely indicated for associated rheumatoid disease.
When the source of an acute episodes can be traced to an acute arthritis of a specific pair of an apophyseal joints (e.g., lumbosacral), local infiltration of a mixture of short-acting and long-acting corticosteroids can be quite effective.
Sex Hormones
Occasional cases can be identified as developing during the menopause.
At intervals, a repository type of androgen-estrogen mixture may be administered.
Mineral Baths
The benefits derived from a sojourn at a mineral spa include rest, heat, and the laxative effects of drinking mineral waters.
