Back Pain Patients
Back pain can occur at any age. Most of them are found in working age, the elders and those with risk behaviors, such as sitting for work for long hours, lifting heavy objects, accidents from playing sports, activities or traveling. It is mainly caused by the spine moving over the nerve, spinal disc herniation or fibrosis and stone formed pressing the nerve, resulting in back pain, cracking down the legs along the nerve line. Depending on the severity of the nerve compression, the treatments are varied, such as taking pain relief medications, injection of anti-inflammatory medications into the spine, physical therapy, and rehabilitation by specialized physiotherapists. In the case of chronic symptoms, the physician would recommend surgical treatment to ensure better treatment outcomes.
To assess the pain, we use the international standard of pain assessment which is the Visual Analogue Scale (VAS) and Numerical Rating Scale (NRS), where level 0 means no pain and level 10 means the most pain.
The treatment results that patients received from the Orthopedic Unit & Spine Academy at Bangkok Hospital Phuket
Average Pain Level After Treatment for Low Back Pain
In 2019, patients with low back pain in the Orthopedic Unit & Spine Academy at Bangkok Hospital Phuket were undergoing the treatment by taking pain relief medications, receiving physical therapy and rehabilitation by specialized physiotherapists within 6 weeks. If the symptoms did not improve, the physician would recommend the injections into the spine to reduce the inflammation.
Patient Rate with Better Quality of Life After Receiving the Injection to Reduce Inflammation
Quality of life means the ability to carry out various activities as normal. To assess the quality of life, we use the Oswestry Disability Index [3] that consists of the assessment of pain, self-care, movement, walking, standing, sitting, sleeping, lifting, sexual intercourse and socializing.
In 2019, all 127 patients with low back pain at the Orthopedic Unit & Spine Academy, Bangkok Hospital Phuket underwent injection into the spinal cavity to reduce inflammation. the quality of life in patients was measured by the Oswestry Disability Index Assessment Form mentioned above. According to the international standards, the assessment was performed within 2 weeks, 6 weeks, 3 months, 6 months before and after the treatment. We measure and report the results by comparing the treatment before and after 6 months of treatment. In the first 6 months of 2019, all of 79 patients had improved (the treatment goals require that patients’ symptoms had improved by at least 25 percent and the result was an average of 37.5 percent).
Patients with Spinal Injuries:
Patient Rate with Better Quality of Life after Spine Surgery
Quality of life means the ability to carry out various activities as normal and is assessed by the EuroQOL Thermometer Assessment Form [4] that consists of the assessment of movement, self-care, regular activities, discomfort, anxiety and the health condition at that time.
In 2019, prior to the spinal surgery all patients in the Orthopedic Unit & Spine Academy, Bangkok Hospital Phuket will be evaluated the quality of life by the EuroQOL Thermometer Assessment Form to allow the physician to monitor the patient’s symptoms as well as to consider the treatment plan. Within 6 months after the surgery, the result came out that all patients had a better quality of life. The quality of life score increased by 25 percent compared to the result before the treatment.
Patient Rate Without Spinal Cord Injury After Spine Surgery
In 2019, no patients were injured the spinal cord after the spine surgery which is an outstanding statistics when compared to the rate of patients without spinal cord injuries of the North American Spine Society.
Sources:
[1] Royal College of Physicians.The assessment of pain in older people.CONCISE GUIDANCE TO GOOD PRACTICE A series of evidence-based guidelines for clinical management.October 2007. https://www.britishpainsociety.org/static/uploads/resources/files/book_pain_older_people.pdf
[2] Ellard DR, Underwood M, Achana F, et al.Facet joint injections for people with persistent non-specific low back pain (Facet Injection Study): a feasibility study for a randomised controlled trial.Southampton (UK): NIHR Journals Library; 2017 May.https://www.ncbi.nlm.nih.gov/books/NBK436377/
[3] https://en.wikipedia.org/wiki/Oswestry_Disability_Index, National Council for NCOR Osteopathic research.Oswestry Disability Index.2006.https://www.ncor.org.uk/wp-content/uploads/2012/12/Oswestry-Disability-questionnairev2.pdf
[4] Mandy van Reenen, Bas Janssen.EQ-5D-5L User Guide Basic information on how to use the EQ-5D-5L instrument.April 2015:Version 2.1.https://euroqol.org/wp-content/uploads/2016/09/EQ-5D-5L_UserGuide_2015.pdf
[5] Sadiqi, Said. Spine Trauma Outcome Measures for Patients and Clinicians. UMC Repository (North American Spine Society). 2018. https://dspace.library.uu.nl/handle/1874/369695
