An elderly lady walks into the clinic and sits on the chair opposite me. She looked very unhappy and asks that I see her quickly so that she can start walking back home. I was surprised because it was almost lunchtime and I wondered why she was in such a hurry. It was unusual that a patient will be so impatient at a medical outreach, considering that many are grateful just to talk to a specialist. So I asked her how I could help her after I introduced myself. She says she is Mwikali ,60 year old patient from Mwingi who has been troubled by her back since she was a young girl. She complained of upper back pain, which was moving to the waist and down the legs. Sometimes she feels like there are things walking on her and feels like there is heat spreading down to her feet. I then examine her and find that she has a condition called Scoliosis. Her back was twisted to one side but the curve was significant but one could not notice it until she undressed. It had been this way for a long time and never seen a doctor. I explained to her the condition she had and why she had those symptoms and gave her some medication to use. Fortunately the curve was not bad enough to need surgery and had been stable for a long period of time. If she were a teenager or a child she would have hard surgery to prevent the curve from progressing. She had pain that was nagging but didn’t prevent her from working in the farm. Mwikali is a lady we met at the surgical camp hosted by Machakos Orthopaedic Clinic in partnership with a local dispensary. The camp was held at the AIC Kyome dispensary on 3rd October 2015.
We saw many patients who needed to seek orthopaedic care who would otherwise find it hard to see and orthopaedic surgeon. There were more than 100 patients who came to the clinic. The predominant conditions were back pain and knee arthritis. There were some who came because of foot and ankle pain, unhealed fractures. About four in every 10 people will have an attack of low back pain in their lives. Those statistics may look very scary. However, the good news is that 80% of time, your back or neck pain will go away on its own with time and exercise. Though Mwikali’s case was special because of the scoliosis, many patients don’t have severe bone changes that need surgery. We at Machakos Orthopaedics clinic emphasise on the non-surgical management of low back and neck pain where possible. There are special circumstances where surgery is needed. If you have additional symptoms like loss of bladder/ bowel control, numbness in your buttocks, shooting pain down both legs, numbness in both your arms and legs, you should go immediately to hospital. In these circumstances, urgent surgery may prevent permanent paralysis.
In the patient where surgery is not indicated, patients can delay the need for surgery. This is by a good exercise program. You can play an active role in your recovery. Rest may seem like a good thing for a hurting back, but keeping active helps to restore function. It is said that one day of bed rest will cost you a 3 % loss of muscle power and loss of bone density. No wonder some people say that exercise helps to build your bones. So too much rest makes you age faster.
A spine surgeon from Alaska, USA, Dr Humphreys, once said that the best way to treat back pain is to stay active. Passive treatments can relieve pain, but long term you will need to strengthen your back and make it more flexible to recover from back pain and prevent future recurrences.
Remember: those who self diagnose themselves and self treat themselves do so at their own risk. Back and neck pain arise from a variety of causes and may require a spine specialist to perform diagnostic tests to identify your problem and the best treatment. Machakos Orthopaedic clinic has a team of specialists who can help to advice you on the best treatment options for you.
* Mwikali: name changed to protect her privacy