I am discussing about thousands and lakhs
of patients moving around in the society with chronic low backache and who are changing their doctors every few weeks.
I take it for granted that we are discussing patients who are very healthy with normal weight, normal blood count, normal ESR and no other complaints. For a long time, chronic low backache has been taken as a combination of psychosomatic manifestation with only 5% of organic element.
Lately, even the social element in the maintenance of backache has been brought out. The role of 2 days complete rest or a lumbo sacral belt for 2-3 days is only for a severe acute exacerbation. The latest management is the "spinal manipulation" of the back. The question is "Who will do this spinal manipulation?" The modern physiotherapists are not really trained for that.
Now we have chiropractors or chiropodists in Mumbai, who have qualified from medical colleges in America and are specialised in this art. It is now high time that many of us should start referring such patients for this procedure. Promotion of back exercises, encouraging swimming, reduction of weight, still remain, the best recommendations. Finally, do not forget to teach the patients of chronic backache - "Good days - Bad days". Remember that passage of time is the best healer.
I am very much against giving NSAID group of drugs, wearing of lumbo sacral belt for a long time, or attending the physio-therapy clinics for unlimited period.
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