Dr. Atul Prakash
Orthopedician and Traumatology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I am a 20-year-old female. I have been experiencing constant backaches since I was 10-12 years old. My back and spine would often go super stiff, so I tend to crack it by twisting my body back and forth, easing the pain. Usually, a cold temperature would trigger a painful stiff, making it almost numb or sitting for so long. When we went for a tour last year, we walked the whole day. Until the night, I could not manage even to move my body, nor can I bend down or sit. It may be some muscle cramps, or I am also concerned it has to do with maybe lung problems. My lower back over the years back, I get to a small but not so serious accident where I hit my arms on the ground, causing it to hurt more than the upper back where I have a slight bend in the spine near my nape area. Hoping to hear an opinion and possible treatments I could get. I am currently on Lamotrigine.
Hello,
Welcome to icliniq.com.
I must say the X-rays are not very clear (attachment removed to protect patient identity), and I will leave to assume that the angle mentioned is true. The pain in the back of a young person with only 8 degrees of the curve is unlikely, and we must explore other possible causes. It could be Scheuermann's disease, inflammatory conditions like inflammatory spondyloarthritis, etc., that need to be checked for. You need to first send me a better digital film and not a camera picture of the X-ray. Please get done complete blood count, ESR (erythrocyte sedimentation rate), CRP (C-reactive protein), and urine routine. Have you tried physio, manual therapy, antiinflammatory tablets, deep breathing, and core strengthening exercises? Also, what your local doctors said, and what are the clinical examination findings?
Patient's Query
Hi doctor,
I apologize for the quality of the x-ray as I can only use my camera and the TV screen to capture the x-ray film as clear as I could. Since I am living alone at a condominium. I normally would not attempt core strengthening or perhaps strenuous exercises as I have a history of asthma and now recurring at present at certain times. I have not tried any therapy or taken any anti-inflammatory drugs for the existing condition that I had. The local doctor said as I could remember, mentioned about muscle pain and that a portion of my back if seen bending is not equal. Like there is this side may be stiffer than the other. Other than that, I have already mentioned the clinical findings about the Cobbs angle. For the blood test, I am not so sure if I could get it as soon as possible since there is still the pandemic. Going to the hospital may seem not a choice for me at the moment as I also do not have anyone to accompany me.
Hello,
Welcome back to icliniq.com.
Start taking pain killers. I do not want to start anti-inflammatory tablets as it may aggravate asthma unless you can confirm that Diclofenac or Piroxicam have been tried and do not aggravate asthma. So our initial choices are Paracetamol 500 mg four times a day, Tramadol 50 mg twice a day, hot pack or ice whichever works for you, and you can also alternate them. Apply pain-relieving gel. Do a gentle range of motion exercises. Do your local clinics not provide home collection services for blood? And I am also not sure my prescription here will work in your set up. I am keen that you do gentle stretches and once this is comfortable, then start with bridges and planks.
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Orthopedician and Traumatology
Orthopedician and Traumatology
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