Take care of your back in summer and winter: doctors gave advice to readers of “MK”

– It’s not that the back hurts more often in winter or summer. Just different symptoms, says Dr. Afonin. – In winter, people often experience overload pain, muscle pain, myositis on the background of hypothermia. In summer, herniated intervertebral discs really begin to worsen more often, which often require surgery. The way of life, activities is changing, and simply redistribution is underway.

A question that is often asked is: how to prepare your back for the summer? Doctors explain: this process must be continuous.

– First, be on the lookout for air conditioners. Our body is preparing to react to the heat by sweating, and somewhere a cold stream of air is blowing on some part. The body as a whole is tuned to the heat, and the vessels and muscles cannot adapt to the cold air flow. What’s happening? Myositis (what is called “blown out”). Secondly, be careful with physical activity. A lot of patients appeal to me for advice “I need physical education”: “You know, I have such physical education in my country house: I spud 15 hectares of potatoes and 20 hectares of something else.” It must be understood that physical activity is always targeted. When we spud potatoes, water them, this physical work brings a harvest, but harms the back. When we did a light warm-up, stretching, it does not bring a harvest, but it benefits the back, – Dr. Afonin instructs.

In addition, you need to take care of yourself – and do nothing through the pain. And you need to prepare for the summer all year round. If you know that you will have to work hard in the garden in the summer, then you need to maintain some kind of background physical activity constantly throughout the year.

“I’ll add some practical advice,” says Dr. Afonin. – First, split the load. If we spud potatoes, we must go and cut some leaves. If we watered, we need to go paint. Secondly, our body and the musculoskeletal system are very fond of symmetry. If, for example, we have watering work, we cannot carry a bucket all the time with one hand – our arm, shoulder, and neck will ache. We need a symmetrical load: on one side a half and on the other side a half. It is less harmful to the back.

You can wear a corset during physical activity.

The doctor also added that athletes are a separate caste of patients: they usually come in the spring, when they begin to prepare for the summer and train more intensively.

Since back problems are a very common phenomenon, there are plenty of folk remedies: for example, warming ointments or dog hair belts. Doctors are very skeptical about them.

“A belt of dog hair, camel hair, and all the rest is a very stripped-down weak version of a corset. It alleviates the condition, but there is no significant effect, – says Dr. Afonin.

In any case, self-medication is a bad idea. If your back hurts, you need to see a doctor. Experienced physicians have worked out the diagnostic scheme for years.

– Roughly speaking, if the patient went on his own, then some of the diseases are already cut off. Then the list is narrowed down in the process of listening to the patient’s complaints. Each condition is characterized by a specific complaint. For example, for pain in the back, in the spine, it is completely indifferent whether a person goes up or down the stairs. Here, for problems in the hip joints and in the knee joints, there, accordingly, a difference appears: a person goes up – there is no pain, a person goes down – pain appears. Or vice versa (with regard to the knee joints). Only after that we prescribe instrumental methods of examination to confirm the diagnosis, – explains Dr. Afonin.

His colleague, a neurosurgeon Andrey Mezin, added that in modern realities, contact with a doctor can be arranged online, this is quite acceptable. A remote consultation is enough to at least decide on the list of necessary studies.

– I have had many cases when people come and say: here, we have done one study, the second study, look here. And these studies were not needed, they were not shown in his case, and it’s good if it’s, say, magnetic resonance imaging (it is harmless), but computed tomography carries the risk of radiation exposure. So the first thing is contact with the doctor.

It happens that back problems can only be solved by surgery (operation). In this case, explains Dr. Mezin, in no case should you be embarrassed to ask the surgeon clarifying questions. The patient must know everything and fully trust the doctor.

– I provide my patients with full information about the disease, present different treatment options. I say that we can go this way (for example, an operation), and in this case we will have such and such further actions, there will be so much rehabilitation, there will be so many consequences. We can go a different way, we can observe, we can not do the operation for the time being, we can be treated conservatively. That is, to provide different ways to solve the problem and listen to the person and understand together with him what will be better in this situation. Because people are different. Some want to quickly solve the problem, some want, on the contrary, not to do the operation in any case, and you need to listen to the person, find a joint solution, – the doctor explains.

Doctors clarify: there are absolute indications for surgery, which means that if it is not done, there will be some serious consequences. There are relative indications for surgery, which improves the quality of life, but not all patients need it urgently. It is also necessary to discuss in advance what kind of result the patient expects from the operation, what improvements he expects in his life. In addition, it will never be superfluous to ask the opinion of another doctor. Dr. Mezin shared a case from his practice:

“A few years ago a patient came to me, he needed an operation for a spinal hernia, I told him that he needed an operation, this man disappeared and returned a month later. And he says: “You know, I visited six of the most leading neurosurgeons in Moscow. Two of you have given me the same advice. Two people suggested a slightly different operation. And two people advised the third kind of operation. Listen, neurosurgeons, do you know what to do?” I say: “No, we don’t, because each operation solves a certain type of problem.” In particular, this applies to implants in the spine, sometimes something extra is done to avoid possible problems in the future. Here it is necessary to do it or not – in each case it is necessary to discuss. Therefore, there is no single solution to the problem.

Dr. Afonin added that he would not recommend more than three different opinions – this is no longer pluralism, this is a confusion in the patient’s head.