Management of Backache and Neck Pain
Eight out of 10 people will suffer from back or neck pain at some point in their life. Acute pain is abrupt, intense pain that subsides after a period of days or weeks. However, some people continue to suffer from pain that continues despite nonsurgical or surgical treatment methods. This long-term pain is called chronic pain.
The following advice will benefit a majority of people with acute back or neck pain. If any of the following guidelines causes an increase of neck or back pain, spreading of pain to the arms or legs, or increase in weakness in the arms or legs, do not continue the activity and seek the advice of a doctor or physical therapist. For additional advice about chronic pain, see Pain Management.
What can I do about acute back or neck pain?
The key to recovering from acute back or neck pain is restricting your activity and taking over the counter medications, because most back pain is related to muscle strain. In most cases, acute back pain will go away on its own over a period of days. Here are some tips that will help you recover:
1. Take it easy
If you think you’ve hurt your back, ease up on the pressure you’re putting on your back. Many people actually have little choice in the matter—their back pain will force them to drop to their knees or “freeze” in a bent-over position. Others will be able to function somewhat normally, but with uncomfortable pain. Contrary to popular belief, studies on acute back pain actually show that a few days of restricting your activity, and taking the appropriate over-the-counter medication, is all that many people really need to allow the strained muscles to relax and unbind. However, it is important to talk with your health care provider before taking any medication, especially if you are taking other medications or have a chronic medical condition.
2. Ice, then heat
Remember this rule: “Ice first for 48 hours, then heat.” Ice and heat can alleviate local pain that comes from muscle and ligament strain. Ice slows swelling and inflammation and acts as a local anesthetic, but after 48 hours, it loses its effect. Using heat afterwards increases blood flow to the deep tissues and relaxes muscle spasms.
3. Over-the-counter medications
Inflammation is the body’s protective response to irritation or injury and is characterized by redness, warmth, swelling and pain. To aid in healing and relieve pain, use of over-the-counter medications such as ibuprofen, naproxen sodium, aspirin or ketoprofen are often recommended. These medications are called non-steroidal anti-inflammatory drugs (NSAIDs), and they can effectively reduce inflammation and relieve pain. Prolonged use of NSAIDs can lead to gastrointestinal problems, so it is wise to check with your health care provider before using NSAIDs or any medication. Over-the-counter NSAIDs are intended for short-term use, so never use one for more than a week unless it is recommended by your health care professional.
In some cases, acetaminophen may be recommended. While not an anti-inflammatory drug, acetaminophen can be effective in relieving pain without the risk of gastrointestinal problems that have been associated with prolonged use of NSAIDs. However, acetaminophen can also cause side effects, so it is best to follow these basic rules before taking any medication: always read the directions on the label; watch for the side effects listed; and consult your health care provider before your begin self-treatment.
If you have a willing companion, gentle massage may provide some relief by stretching tight muscles and ligaments.
5. Don’t stop moving
Studies maintain that limited movement of muscles and joints is more effective for treating simple back pain than passive methods such as rest and drugs. Restricting your activity is important, but as the pain eases, you should move your muscles and joints past the point of the initial restriction. Simple exercises can help this process, but it is important to consult your health care provider or a back specialist for the exercise program that is right for you.
6. Adjust your daily routine
When you are in pain, you need to make adjustments to the way you approach daily activities. The key to recovering from acute back and neck pain is maintaining the normal curvature of the spine. Supporting the hollow of your back and practicing good posture will help decrease your recovery time.
Management of Knee & Shoulder problems
The treatment of soft-tissue shoulder pain includes the use of anti-inflammatory medication and/or paracetamol. Pain may also be treated with a local application of moist heat or ice.
A local corticosteroid injection is often helpful for inflammation of the shoulder. For shoulder pain, movement exercises and physiotherapy may help. For cases in which tendons or ligaments are involved, surgical procedures may be necessary.
Emergency Management of Fracture and Dislocation
Follow DRSABCD action plan.
Control any bleeding and cover any wounds.
Check for fractures – open, closed or complicated.
Ask patient to remain as still as possible.
use broad bandages (where possible) to prevent movement at joints above and below the fracture.
support the limb, carefully passing bandages under the natural hollows of the body.
place a padded splint along the injured limb.
place padding between the splint and the natural contours of the body and secure firmly.
for leg fracture, immobilise foot and ankle.
check that bandages are not too tight (or too loose) every 15 minutes.
Watch for signs of circulation loss to hands and feet.
Sutures Removal & Dressings
Sutures are tiny threads, wire, or other material used to sew body tissue and skin together. They may be placed deep in the tissue and/or superficially to close a wound. A variety of suture techniques are used to close a wound, and deciding on a specific technique depends on the location of the wound, thickness of the skin, degree of tensions, and desired cosmetic effect.
There are three types of sutures techniques: intermittent, blanket, and continuous. The most commonly seen suture is the intermittent suture.
Plaster & Spica Application
An orthopedic cast, body cast, plaster cast, or surgical cast, is a shell, frequently made from plaster or fiberglass, encasing a limb (or, in some cases, large portions of the body) to stabilize and hold anatomical structures, most often a broken bone (or bones), in place until healing is confirmed. It is similar in function to a splint.
Plaster bandages consist of a cotton bandage that has been combined with plaster of paris, which hardens after it has been made wet. Plaster of Paris is calcined gypsum (roasted gypsum), ground to a fine powder by milling. When water is added, the more soluble form of calcium sulfate returns to the relatively insoluble form, and heat is produced.
2 (CaSO4·½ H2O) + 3 H2O → 2 (CaSO4.2H2O) + Heat
The setting of unmodified plaster starts about 10 minutes after mixing and is complete in about 45 minutes; however, the cast is not fully dry for 72 hours.
Nowadays bandages of synthetic materials are often used, often knitted fiberglass bandages impregnated with polyurethane, sometimes bandages of thermoplastic. These are lighter and dry much faster than plaster bandages. However, plaster can be more easily moulded to make a snug and therefore more comfortable fit. In addition, plaster is much smoother and does not snag clothing or abrade the skin.