Question and Answer: Sakit sa Balakang

Recently I got a message from a reader posted in the comment section of my article Mamang Hilot, regarding a specific medical problem, asking for advice.

I have received several medical questions in this blog in the past, and most of the time, I just gave a short answer and recommended that they see their local doctor. I was also asked on how to make gayuma or how to counter a kulam, but of course I have no idea how to answer those.

Anyway, I decided to answer this reader in a post, regarding her medical question. Hopefully this would be helpful to her, and to some other readers with similar issues.

A reader, named Ellaine wrote:

Good day po.

Nagpahilot po ako dahil parang kumikirot ‘yung right side ng balakang ko. Pinadapa n’ya ako, dinaganan ‘yung balakang ko, saka hinila ang hita ko pataas at may tumunog. After ilang days, parang makirot s’ya at hindi nawala ang sakit.

May 3 linggo rin ang lumipas at saka ako nag-pacheck up sa doctor. Wala naman makita sa ihi ko na infection. Kaya niresetahan lang ako ng gamot for 1 month, baka daw kasi may na-damage na nerve o nabigla ‘yung muscle ko dahil sa hilot.

Natapos ko na po ‘yung medication ko, pero still masakit pa rin s’ya. And the worst, parang gumagapang ‘yung kirot papunta sa hita, binti, paa at likod ko, kaya natatakot po ako. Kahapon po bumalik uli ako sa doctor at binigyan naman ako ng x-ray request. Agad naman po ako nagpa-xray para malaman, ngunit wala rin po nakita sa x-ray.

Sabi ng doctor baka dapat na daw ako magpa-MRI, baka daw may naipit na ugat sa balakang ko. Sabi ko po wala naman akong kakayahang mgpatingin ng ganun kamahal, dahil nasa mahigit 10 thousand daw po ata iyun.

Pag-babalewalain ko daw po ‘yung nararamdaman ko, posible daw akong malumpo. Totoo po ba na talagang maari akong malumpo? Natatakot po kasi ako. Ano po kaya ‘yung nararamdaman ko at ano ang dapat kong gawin. Baka po may maitutulong kayo.

Maraming salamat po..

Dear Ellaine,

Sa aking pagkakaintindi sa iyong tanong, ang problema mo ay low back pain, na hindi natatangal kahit may isang buwan na ang nakalipas. Parang lumala pa ito kamo nang ikaw ay magpahilot. Paumanhin na lang po kay Mama o Aleng Hilot.

From the symptoms you’re describing here (pasensiya na po at nag-English na ‘ko), I believe you are suffering from lumbosacral radiculopathy. Don’t mean to sound high falutin, but this just means low back pain with possible nerve impingement (ipit na ugat) or nerve involvement, as you describe the pain as “gumagapang sa hita, binti, paa, at likod.” One specific condition is sciatica, which is impingement of the sciatic nerve.

sciatica-pain-pic-pranic-healing-jpgw652

The nerve roots from the spinal cord as it comes out of the vertebra (gulugod), can be impinged by a muscle, or when there’s vertebral disc herniation, vertebral stenosis (narrowing), abscess or infection, or in rare cases, tumors. The nerves can also damaged by being stretched when certain physical injury or manipulation is done.

For all people with acute back pain though, the overall prognosis is quite good, as 70 to 90% of the time the pain will improve in 8 weeks or so. Very few will require invasive or surgical intervention.

Even though traditional thinking would say to stay in bed, the medical literature does not agree with this. Studies have showed that people who continue to be active, do better in dealing with their back pain and also have more shortened recovery time than those who did “bed rest.” Sorry, not an excuse to skip work. Though use common judgement when your work involves heavy lifting, like carrying sacks of rice or moving pianos.

Physical therapy when properly employed and specific exercises to strengthen the back and abdominal muscles can certainly help.

Medications like non-steroidal anti-inflammatory (NSAID), which I believe is what was prescribed to you is one of the mainstay of treatment. Sometimes it is combined with muscle relaxants. In severe cases of pain, narcotic analgesics can be used, but these are controlled drugs as they can be habit-forming or addicting. (Galit si Duterte sa mga adik!)

Non-medical intervention like cold or heat therapy to the area can be applied but mostly used during the acute phase of the back pain or injury. Massage, acupressure, and acupuncture (using long needles) have been employed but data on their effectivity is variable. Please don’t just stab multiple needles in your back.

Other procedures available are steroids injection to the spine and of course surgical intervention.

If you’re condition does not improve with conservative management (exercises, physical therapy and medication), then further work-up may be needed. Unfortunately, the imaging study to best visualize the structures in the back are MRI and CT scan of the vertebrae, which I agree are expensive tests. A plain x-ray will not be very helpful.

About the concern “na maari kang malumpo?” The pain na “gumagapang” does not necessarily means it is really bad. As I said most people with back pain recovers in time. However if you’re already experiencing focal weakness in your legs, like having difficulty climbing stairs or tiptoeing, then it can be serious. Kung hindi lang ‘yung sakit, at ikaw na ang gumagapang, eh seryoso na iyon.

So in the end, I would still recommend that you see your local doctor. An Orthopedic Surgeon or Physical Medicine and Rehabilitation specialist (also known as physiatrist) may be the best doctor to see regarding this problem. I’m hoping that you’ll just need physical therapy and a sprinkle of time to fully recover.

Hope this help Ellaine, and God bless.

Sige, padala mo na lang iyong bayad mo sa akin: tatlong Choc-Nut, ok na.

Pinoytransplant

 

(*sa mga susunod na kokonsulta, mas mahal na po ang bayad:  5 Choc-Nut na.)

 

 

20 thoughts on “Question and Answer: Sakit sa Balakang

  1. 3 months na po akong nagsusuffer ng thigh pain,,,paikot pong sumasakit,,mahapding na makirot na parang tinutusok,,,sobrang sakit po,,,2 months nkong under medication ng relax at acemet,,,safe po ba ituloy
    ang medicine ko hanggang isang taon,,slamat doc

    gang

    • Sa pag-describe mo na sakit sa iyong mga hita: “paikot ang sakit at mahapdi at parang tinutusok,” – I think you’re suffering from neuropathy or neuropathic pain.

      Neuropathy is a term used when nerves, especially “peripheral nerves” are involved. Most common causes are diabetes, vitamin deficiency, injuries, and other inflammatory processes.

      Relax (carisoprodol) is a muscle relaxer, it works but can be habit forming. So use only as needed. While acemet (acemetacin) is a non-steroidal anti-inflammatory drug. As of all medicine it can have side effects, but it can be use for a long period of time.

      I suggest you follow-up with your local doctor if you’re symptoms are persisting.

      Thank you. That will be 3 choc-nut please.

  2. Hi po doc just last Thursday im suffering from my left leg & thigh pain. Just yesterday i went to see my doctor and she told me i have sciatica then she prescribed me some pain reliever name cetradol & vitamin b. Just last night i take my pain reliever and after few hours i feel dizziness. I got so nervous. The pain was gone but my left feet felt so numb but i can walk na. Unlike yesterday it was hard for me to walk. Kaya lang po my concern eh is that normal na nagmamanhid yung paa ko? Thanks doc. I hope you can answer me back.

    • Numbess can still be part of the sciatica. If you’re not able to walk due to pain before, and now you’re able to, but with numbness, then I would consider that an improvement. I think the dizziness that you experience is from the pain medication which is not an unusual side effect. Thanks.

  3. Sir good pm poh ,
    Patulong poh sna anu poh nangyare sken bigla n lng aq nagcollapse knina ndi aq mkatayo ..bgo poh mangyare un nakirot na ang mga hita ko at hirap ako umakyat s hagdan ..tpos bigla n ndi aq mkalakad at mkatayo ..mga 1 week poh cguro aq ako my nararamdaman na tigh pain at legs pain,at nangyare n nga poh ung pg collapse q knina..gus2 ko poh sna magpatingin pro ndi ko p kaya maglakad ..pinainom poh aq ng tita ko ng pharex at pinapakain ng saging kc kulang dw aq s potasium kya mhina ang buto ko,tama poh b ito?..sana poh mtulungan ninyo aq doc..mraming mraming salamat poh.

    • Sa mga dinescribe mong nararamdaman mo, sa tingin ko ay parang seryoso ang sakit mo. Maaring sa spinal cord o kaya naman ay neuromuscular ang involve dito. Walang masama sa pag-inom mo ng Pharex dahil multivitamin lang naman ito, at OK lang ang saging dahil sa potassium na contents nito. Pero advise ko pa rin na magpatingin ka na agad sa duktor, dahil sa wari ko ay hindi lang simple ang problema mo. Salamat.

  4. Sir good day.
    Bale ang case nmn po sken is yun kanan paa ko po sa tuwing i strecth ko my sumasakit sa bndang baba po ng likod ko pero pg kaliwa nmn po wala nmn ako nararamdamam. Tpos prang lagi pong nangangalay yun lowerback ko po.
    Sana po matulungan ninyo ako 2weeks ko nrin po kc iniinda to e. Salamat po

  5. Hi Doc.

    Last May 31 nashockwave po aq kasi may 2 kidney stones aq sa left side so nadurog naman po… so may may iniinum po aqng mga gamot.

    Nagtataka lang po aq bkit may masakit din sa may balakang ko ramdam ko hanggang paa na parang matagal aqng nkaupo namamanhid ang akin paa (kanan lang po)..kaya po ang ginagawa ko naglalakad aq. anu po kaya ito ?

    • Shockwave lithotripsy can commonly cause soreness, discomfort and bruising in the abdomen and back. I think this is what you’re experiencing – parang binugbog. However if it worsens or persist, notify your doctor as it can also cause more serious complications, like hematoma or internal bleeding. Thank you.

  6. good day po doc.

    mag 1 month na pong hindi makalakad ang papa ko. ang iniinda nya po eh yung sakit ng likod nya at sa sikmura nya pababa hanggang sa paa. ngayon po nagmamanas ang kanyang parehong binti pababa sa paa(mag isang buwan na din).
    hirap bumangon at bumaling kapag nakahiga. hindi na sya makatulog dahil sa sakit. pina xray at ct scan na din po namin sya pero wala naman makitang sakit o problema. kailangan syang ma mri at nilalakad na namin yon. sa ngayon para maibsan ng kaunti ang sakit ay minamasahe namin minsan ang kanyang likod at tyan.

    nagumpisa syang hindi makalakad matapos po ang isang gabi na biglang pinullikat ang pareho nyang binti. noong una ang kanang binti lang ang hindi nya maigalaw hanggang sa pareho na at hindi na makalakad.araw araw nag hot compress kami sa binti hanggang paa ng tubig na pinakuluan sa tanglad. naiisip po namin na baka naipitan sya ng ugat sa likod o baywang. ano po kaya ang mapapayo nyo sa amin. maraming salamat po. 🙂

    • Medyo komplikado yata ang sakit ng tatay mo. Though it may be reassuring that the x-ray and CT scan, which I assume as CT scan of the back or the abdomen did no show any abnormality or at least did not show a big “tumor.”

      Pwedeng naipit na ugat (nerve), but that will not explain the swelling or edema (pamamanas) of his legs. Edema of the legs usually is due to abnormality in circulation. So blockages in the circulation to the abdomen, back and legs is one I would think needed to be ruled out.

      Anyway, my recommendation is still to follow-up with the doctor that is working him up, and hopefully they would be able to diagnose what ills your father and provide the proper treatment. Thank you.

      • hi doc! may sciatica din ako,matagal na mga nasa 4 na taon na po siguro,nagpacheck up na ko dati pero mga anti-inflammatory lang binigay,na x-ray din dati ang binti ko ang findings,inflammation kya na try ko din mag injectable,at may bukol sa lower back ko po,pero hindi mismo sa spine ko,sabi ng doktor nong pinakapa ko muscle daw,hindi nman masakit pag dinidiinan na hawakan,hindi ko alam kung part pa rin ng may sciatica ito,at pansin ko prang nagkaka-tight muscle na ko sa right butt ko,parang nagsasag po,sa ngayon nagpapa-acupuncture treatment ako at stone massage,at nage-exercise po ako o kaya stretching,na lessen naman po ang sakit..doc ano po dapat gawin para totally gumaling po ako..isa po akong caregiver,nagbubuhat dati at un po ang alam kong cause nito..patulong doc. salamat.

      • It sounds like you’re already been worked-up and have tried different modalities of treatment, including acupuncture and massage therapy. I think you’re already on the right track. Continue your exercises, stretching, and muscle strengthening, for those can provide long term relief of back pain, rather than medications. Salamat.

      • opo doc,sinubukan ko lahat para ma ease lang yung pain,parang hindi na umuobra ang pain reliever,pabalik-balik ang sakit..may part na po sa leg at puwet ko na tumitigas na muscle,sobrang sakit pag nahihilot..at isa pa doc pag nag i-stretching ako or minamasahe ang part na masakit dumidighay ako 😄..ano po yon?

      • I think I can explain the muscle cramps as part of back pain, pero hindi ko yata ma-explika yung dumidighay pag minamasahe. Research ko muna ‘yon. 🙂

  7. Hi doc 😔 May ilang buwan nadin po nasakit yung right side ng balakang ko pati po yung kanang binti ko, ngayon nararamdaman ko parang lumalala na kase diko na mapaliwanag yung sakit, masakit na nangangalay. nung una po nangangalay lang yung right leg ko kaya binalewala ko lang sinisipa-sipa ko lang hanggang sa tumagal nararamdaman ko na lumalala na. Hindi na ko makatayo ng matagal kase nangangalay yung binti ko at sumasakit din hanggang sa pag upo yung balakang at binti ko sabay sumasakit na parang na-ngilo 😑 Pati sa pag higa nangangalay padin kaya palagi ako nakatagilid, hanggang sa pag gising at pag bangon ko doc masakit. Hindi ko na kaya iunat yung dalawang binti ko kase sumasakit ng sobra yung likod ko dun sa gitnang part ng balakang, pati pag yuko masakit parang konektado sa buto pababa ng binti yung sakit kapag nayuko ako 😢 Doc may simtomas ako ng skoliosis dahil po ba dun yon kaya sumasakit yung balakang at binti ko, nag pa check-up na po kame sa doctor nag pakuha na po ko ng ihi at dugo at wala nman nakita niresitahan lang ako ng gamot tapos nag pa x-ray ako, hindi nman ganun kalala yung skoliosis ko pero napansin ko na hindi na pantay yung balakang ko doc mejo mataas yung right side. Patulong naman doc 😞 Salamat po

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