Prevention and treatment for back pain was the topic at the Sunday, May 17, meeting of the Pattaya City Expats Club. Dr Somrot Phonglamai, from the Physical and Rehabilitation Medicine Department of the Bangkok Hospital Pattaya, spoke about “Back Pain in Advanced Age.” He mentioned that a refrain we often hear as we grow older is, “Oh, my aching back!” We may hear ourselves saying more and more as we grow older. Well the good news is that there are ways to treat back pain. The even better news is that there are ways to prevent it.
Dr. Somrot Phonglamai has worked part time in the Rehabilitation Centre, Bangkok Hospital Pattaya since July 2013. He received his medical degree in 2009 from the Faculty of Medicine, Prince of Songkla University and his Diplomate from the Thai Board of Rehabilitation Medicine, Faculty of Medicine, Songklanagarind Hospital in 2013. He received his Certificate in Chinese Acupuncture from the Medical Army Department, in 2014.
After describing the various causes of back pain, Dr. Somrot emphasizes the physiotherapy and rehabilitation treatments available to relieve the pain.
In beginning his presentation, Dr. Somrot stated that the causes of back pain are many and varied. These can be complications from surgery such as weakness, numbness, infection and post-operative pain, which can produce back pain. Other causes include sciatica, which involves compression of the nerve root; lumbar stenosis, which is a narrowing of the spine canal; spondylolisthesis, otherwise known as a slipped disk, which can produce severe back pain, especially in the lower back and particularly among women; also a tumour or other malignancy; trauma or other injury, such as a from a fall; and a lumbar fracture, where a bone in the spine collapses (sometimes as a result of osteoporosis). Further, back pain can be caused by infection, obesity, muscle weakness due to aging, and sitting for too long without a break. Also, many golfers suffer from back pain. They experience tightness and loss of flexibility, which can lead to injury. Pain can limit their motion and cause weakness. The weakness means less power and when the golfer compensates for that, it can cause more injury. It is a kind of vicious cycle.
MC Richard Silverberg presents Dr. Somrot Phonglamai with the PCEC’s Certificate of Appreciation for his informative talk about prevention and treatment of back pain.
Physiotherapy and rehabilitation comes in various forms, including prescribing rest; using a brace; applying heat and cold; using ultrasound; using lumbar traction; getting exercise; using medical acupuncture; taking medication; and giving a local injection (steroid). Rest is usually called for in the acute inflammation stage, typically the first 24 to 72 hours. Lumbar support braces are used to treat muscle spasms and sciatica. Metal braces are used for fractures and slipped vertebra. Cold presses are usually used at the acute inflammatory stage, for 15 minutes 3-5 times a day, while heat is generally applied after the first few days (i.e. during the chronic stage). However, Dr. Somrot mentioned there are exceptions. Some people find that heat helps right from the outset. Ultrasound is useful for both the acute and chronic stages because it applies heat at a depth of 7 cm. Ultrasound treatments are typically done 3-5 times a week.
PCEC Member Ren Lexander interviews Dr. Somrot about his presentation to the PCEC. To see the interview, visit: https://www.youtube.com/watch?v=QluPK4EuQi8.
Lumbar traction is useful for treating sciatica, stenosis, and joint impingement and stressed muscles. This treatment is typically used once a day for 5-10 days. Stretching and yoga-type exercise can help improve flexibility and strengthen the core muscle. Also useful are aerobics, jogging, stationary bicycling, swimming and balance training (tai-chi). For back pain, the stationery bike is better than walking, Dr Somrot said. Further, steroid injections to treat back pain should be used very sparingly with the maximum being three times in a lifetime. Medication can also be used to treat back pain, but it is not the preferred option. He noted that taking too many pain killers can cause damage to the liver, kidneys and stomach. Generally, pain medication should be used only during the acute phase.
Diet is important, Dr Somrot said. Avoiding fat and sugar will help prevent back pain. Certain drugs – such as statins and simvastatin (both cholesterol-reducing medications) and even alcohol – can cause back pain. There is a lot of information on back pain available on the Internet, Dr Somrot said, but it is not always reliable. He advised people to consult sites what contain evidence-based information, such as www.PubMed.com, www. Mayoclinic.org and www. NIH.gov. For example, the Mayo Clinic website mentions the following to prevent back pain: Exercise using regular low-impact aerobic activities; Build muscle strength and flexibility – abdominal and back muscle exercises help condition these muscles so that they work together like a natural corset for your back and flexibility in your hips and upper legs aligns your pelvic bones to improve how your back feels. Maintain a healthy weight to avoid strain on your back muscles. Use proper body mechanics by standing smart, sitting smart, and lifting smart.
After the presentation, MC Richard Silverberg brought everyone up to date on upcoming events and called on Roy Albiston to conduct the Open Forum, where questions are asked and answered about Expat living in Thailand, especially Pattaya.
For more information on the PCEC’s many activities, visit their website at www.pcecclub.org.