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.)

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Post Script: Sa lahat po ng may katanungan pa, pakibasa na lang po ang aking article: “Sakit sa Balakang: Final Answer”