Chronic Back Pain

ปวดหลังเรื้อรัง

ปวดหลังเรื้อรัง อาจเป็นโรคข้อรูมาติสซั่ม

Back pain with different severity degrees can be caused by a wide range of medical conditions. Acute back pain can be treated effectively if accurate diagnosis can be timely made. However, if back pain progresses to chronic and severe pain without adequate response to given treatments, it might strongly indicate arthritic disease, called ankylosing spondylitis. Ankylosing spondylitis is defined as an inflammatory disease that, over time, can cause some of the small bones in the spine (vertebrae) to fuse. This fusing makes the spine less flexible, resulting in stiffness and chronic back pain that can largely interfere with quality of life. If warning signs and symptoms of ankylosing spondylitis arise, medical attention and treatment must be sought immediately.  

Causes And Risk Factors

Definite cause of ankylosing spondylitis remains unknown, although genetic alterations seem to be involved. People who have the HLA-B27 gene are at a greatly increased risk of developing ankylosing spondylitis. However, other contributing factors are certain infections and exposure to particular substances. Men are more likely to develop ankylosing spondylitis than are women while onset generally occurs in late adolescence or early adulthood.

Get To Know Ankylosing Spondylitis

Spondyloarthritis is a group of diseases characterized by inflammation in the spine (spondylitis) and joints (arthritis). Ankylosing spondylitis is one type of spondyloarthritis, defined as a long-term inflammation of the joints of the spine. In severe cases, the body attempts to heal by forming new bones with calcium deposits which gradually fuse sections of vertebrae. This fusion can stiffen the spine, leading to less flexibility, severe back pain and inability to move. In some patients, stiffness of other joints might be present e.g. ankle, knee and hip. Other manifestations of other organs that are induced by chronic inflammation besides spine and joints often include red eyes, blurred vision, pain in the heel or arch of the foot and psoriasis –an autoimmune disease that manifests in the form of scaly red and silvery skin patches.

 Diagnosis

Diagnostic tests of ankylosing spondylitis usually involve:

  • Medical history: The doctor conducts medical reviews to identify pain location, pain intensity and duration as well as to collect patient’s medical history.

  • Physical examination: During physical examination, the doctor might ask the patient to bend in different directions for testing the range of motion in the spine. The doctor reproduces the pain by pressing on specific portions of the pelvis or by moving the legs into particular positions.

  • Blood tests: Blood tests can check for markers of inflammation and the HLA-B27 gene which is a major factor to develop the disease. Nonetheless, people who have this gene might not have ankylosing spondylitis and vice versa, patient can develop the disease without having this gene.

  • X-ray: X-ray is an imaging test to identify the location of inflammation and fusion as well as wear and tear of the spine.

  • MRI scan: An MRI uses radio waves and a strong magnetic field to provide more-detailed images of bones and soft tissues. With high degree of accuracy, MRI scans can reveal evidence of early disease and help to plan treatment as well as monitor treatment outcomes during follow-ups.

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Tension Headache

Tension Headaches – Fulton Massage Therapy

A tension headache is generally a diffuse, mild to moderate pain in the head. Signs and symptoms of a tension headache include dull head pain with sensation of tightness or pressure across forehead or on the sides and back of the head. It usually lasts for 30 minutes to several hours, though it can last up to 1 week. The average pain duration is less than 24 hours. Other related symptom in some patients is mild nausea, usually without vomiting. Bright light, body movement and loud noise do not usually worsen the symptoms.

Cluster Headache

Cluster headache is classified as a part of the trigeminal autonomic cephalalgias or (TACs). Cluster headaches are more prevalent in men than women. Pain is characterized by recurrent, severe headache on one side of the head, typically around the eye. It generally occurs in cyclical patterns or cluster periods. Main symptoms include excruciating pain that is situated in, behind or around affected eye which may radiate to other areas of face, head and neck, severe eye pain with burning sensation on the affected side and drooping eyelid on the affected side. Other autonomic symptoms are redness of affected eye, excessive tearing, stuffy or runny nose on the affected side, swelling eyelid, forehead or facial sweating on the affected side. Restlessness and tinnitus (the perception of noise or ringing in the ears) are possible symptoms during attack. Without treatment, it may last from 30 minutes to 3 hours  (average pain duration is an hour). A unique characteristic of cluster headache is that attacks occur at specific times in waves (cluster) as a cyclical rhythm with cluster bout such as cluster pain during a particular month of each year and may last for days or up to weeks. After the attack, symptoms will disappear. Following the episode, there may be no headaches until the same month of the following year.

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Novel Advancements In The Treatment Of Aortic Aneurysm

Endovascular aneurysm repair (EVAR)– and transcatheter aortic valve  replacement (TAVR)–associated acute kidney injury - Kidney International

Endovascular aneurysm repair with smaller incisions, less pain and faster recovery time.

An aortic aneurysm is a bulging or dilation in the wall of the aorta which is a major blood vessel that carries blood from heart to body, that is due to weakness or degeneration that develops in a portion of the aortic wall. Aortic aneurysms include: Endovascular aneurysm

  • Abdominal aortic aneurysm: occurs along the part of the aorta that passes through the abdomen.
  • Thoracic aortic aneurysm: occurs along the part of the aorta that passes through the chest cavity.

An aneurysm might enlarge and the wall of the aorta cannot stretch any further. At this point, an aneurysm is at risk of rupturing and causing  potentially fatal conditions.  If ruptured aortic aneurysm could not be accurately diagnosed and effectively treated in time, it can cause life-threatening internal bleeding which leads to the increased chances of sudden death. Therefore, timely and effective treatment for aortic aneurysm does not only play a major role in the reduction of mortality rates but it also significantly enhances long-term improvements of patient’s quality of life.

Surgical outcomes substantially result in a shorter recovery time with less pain and lower complications. However, not all aneurysms are suitable for endovascular repair. The location or size of the aneurysm in some patients may prevent a stent graft from being safely or reliably placed inside the aneurysm. In this case, open surgery might be advised.

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Ways to drink without hurting your health

Diabetes and Alcohol Use

When it comes to alcohol, the key is moderation. Certainly, you do not have to drink any alcohol, and if you currently do not drink, do not start drinking for the sake of your health benefits. Guidelines for moderate alcohol use are:

  • There must be 2 days in a week that you do not drink alcohol
  • In a week, you should not drink more than 7-21 standard drinks (less than 3 standard drinks a day)
  • Standard drinks are
– Wine: 140 cc
– Beer: 330 cc (1 can)
– Spirit 40 degree: 40 cc (1 shot)

Dr. Chattanong said “While moderate alcohols use may offer some health benefits, heavy drinking has no health benefits. Excessive drinking can increase your risk of serious health problems. No one should begin drinking or drink more frequently on the basis of potential health benefits. However, if you do drink alcohol and you are healthy, there is probably no need to stop as long as you drink responsibly and in moderation.”​

Is drinking wine really good for your heart?

Flavonoids are substances found in red wine. They might be key ingredients that helps prevent damages to blood vessels, prevent blood clots, and reduces inflammation of blood vessels. There are different amounts of flavonoids in different kinds of wine. However, we can gain flavonoids from eating vegetables and fruits. Therefore, there is no need to start drinking alcohol.

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Get fit for free

You don’t necessarily need expensive gym membership to keep active. Sarah Beasley gives you nine ways to shape up that will cost you (almost) nothing.

1. Use the stairs 

If you have stairs, climb a flight then go back down. Repeat, gradually building up the number that you do. When out, take the stairs instead of the lift or walk up the escalator.

2. Become a tree

Regular balance exercises are important, especially as you get older. To do a yoga ‘tree’ pose, stand up straight, lift one foot and place its sole against your other leg. To start, just touch your foot to your other ankle for a second before putting it down. As you improve, hold it for longer and move your foot higher up your leg. If you have problems balancing, hold your arms out to either side in a T-shape or hold a wall. Don’t forget to breathe! This pose can also be done by holding your hands together above your head, but if you’ve got high blood pressure, it’s best not to keep your arms above your head for too long.

3. Find free swimming for expensive gym

Some local councils still let over-60s swim for free in their pools, while others give this age group a big discount. Check at your local pool or with your council.

A pair of trainers4. Try an outdoor ‘gym’

Check to see if your local park has a ‘trim trail’: an outdoor area with pieces of exercise equipment that you can use for free. Contact your local council to ask whether there’s one near you or type ‘trim trail’ and your area into your search engine.

5. Devise a routine

Play some lively music and create your own aerobic workout. You could dance, jog on the spot, do star jumps, skip or try a combination of these. Try to do ten minutes to start with and gradually increase the duration and intensity.

6. Play throw and catch

Stand outdoors with plenty of space and a ball or stick. Throw it as far as you can, then walk or run to fetch it. Repeat, changing your arm to see how far you can throw. It’s great fun with kids or grandchildren, too.

Arm exercises with tins

7. Improvise with tins

A good way to tone and strengthen your arms and shoulders is to use tins of soup or baked beans as weights. Hold a tin in each palm, stretch out your arms to each side and move them in circles, keeping them straight. Do ten clockwise circles, then ten anti-clockwise.

8. Visit your library

Check out your local library for fitness DVDs. Okay, so there might be a small charge for this one, but at least you’ll be motivated to use it before it’s due back!

9. Offer your services

Get active by volunteering for a local organization such as a gardening project or sports club. Or try the Conservation Volunteers Green Gym – a voluntary scheme that combines exercise with public conservation projects.

If you’re not already active, get medical advice before starting a new exercise regime.

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The Cardiac Rehabilitation Program is designed for the complete care of cardiac patients and those with high risk of heart disease. 

A successful recovery from bypass surgery requires a thorough understanding of the process by the patient and their family. Recovery is directly related to the extent of damage already caused by the coronary artery disease and the natural healing ability of the heart. The cardiac rehabilitation team supports the individual and the body during the healing process and repair of the damaged tissues. The cardiac rehabilitation program is well equipped with state-of-the-art technology, and full-time cardiologists. Patient and family education is a part of cardiac rehabilitation program to help the patient understand how the heart works and what can be done to improve and maintain excellent health.

 

MINIMALLY INVASIVE SPINE SURGERY (MISS)

Minimally Invasive Spine Surgery (MISS) | Bangkok International Hospital

INVASIVE SPINE SURGERY (MISS)

Back and neck problems can affect your life in many ways and finding the underlying cause of your specific issue may not be an easy task. If back or neck pain is affecting your quality of life, it is time to seek medical attention. focuses on providing high quality services and compassionate patient care. Our facility features state of the art equipment and the latest technology. Our doctors are dedicated to providing unique and innovative treatments enabling their patients to experience an improved quality of life.

 

Rehabilitation, pain management, and anti-inflammatory medication

Spine rehabilitation program can help alleviate pain and restore function without the need for surgery. Our interdisciplinary team of rehabilitation specialists focuses on individual needs and rehabilitation goals. In addition, pain or anti-inflammatory medications can be prescribed in order to relieve the symptoms and reduce the inflammation of muscles and tendons. The doctor will decide which treatment plan most benefit the patient.

 2. Spinal Intervention

Our doctor will diagnose the problem and develop individualized plans to relieve, reduce or manage pain to help patients return to everyday activities quickly. The doctor will pinpoint the painful nerves or spinal level by using pain intervention methods. If there is a need for surgery, the surgeon will be able to know the pinpointed location to make an incision.

For patients with SI joint dysfunction syndrome, the therapy consists of physical adjustments applied to the hips SI joint, and lower back region with the goal of reducing joint fixation and muscle tension, and restoring normal range of motion. Spinal intervention treatment can help reduce the inflammation and pain.

3. MIS Spine (Minimally invasive spine surgery)

In the past, spine surgery was traditionally done as open surgery. In recent years, however, technological advances have allowed more back and neck conditions to be treated with a minimally invasive surgical techniques. The new technique avoids significant damage to the muscles surrounding the spine. Typically, this results in less pain after surgery and a faster recovery.

4.  Advanced MIS (Advanced minimally invasive surgery)

Advanced minimally invasive surgery technology includes:

IOM

Intraoperative neurological monitoring (IOM) is used to monitor the function of nerves and spinal cord by using electrophysiological methods. This is an important technology for minimally invasive surgery. It helps reducing the risk of damage to the nervous system.

O-ARM Navigator

O-ARM navigator is an imaging system designed for 3D imaging in variety of spinal procedures. The O-ARM navigator’s high quality, versatile imaging provides the information the surgeon needs to guide clinical decision making.

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Presbyopia: An Age-Related Vision Condition

Brighter Optical Company | Age-related Macular Degeneration

 

Our eyes have an automatic focusing system which adjusts the lens inside the eyes in order to see things clearly at all distances. When looking far away, up close and back again, the eyes are able to change focus at a rapid pace to keep the objects clear in our vision at close and long distance. The eye focuses light in a similar way to magnifying glass when it is used to concentrate the sun’s rays onto a piece of paper.

The distance from the magnifying lens to the piece of paper is the focal length. The bending of light mostly takes place as it enters the cornea and the aqueous fluid. This bending occurs due to the curve of the cornea as well as the change in refractive index as light moves from air into the cornea and the aqueous fluid between the cornea and the iris. Behind the aqueous fluid is the crystalline lens system which consists of a soft and pliable convex lens. The ciliary muscle is a circular ring of muscle that attaches all the way around this lens. This ciliary muscle can change the shape of the crystalline lens by stretching it at the edges. It is attached to the lens by ligament fibers that can be tight or loose. When looking at a near object, autonomic nervous system regulates the ciliary muscle to contract, allowing the lens to become more rounded at the central surface in order to focus the light rays and see a near object clearly. This causes the lens to form a more spherical shape achieving a higher level of refractive power. On the contrary, relaxation of the ciliary muscle can flatten the lens, resulting in an increased long range focus for far-away objects.

Presbyopia is a condition associated with an advancing age that results in progressively worsening ability to focus clearly on close objects. Presbyopia often affects people aged above 40 years old. Regarding aging, the two main reasons for this to happen are a reduction of the ciliary muscle functionality and a hardening of the crystalline lens. As a result, the shape of the lens fails to be properly adjusted and the high level of refractive power for seeing close objects does bot happen, leading to blurred vision. However, presbyopia mainly affects an ability to focus on nearby objects, whereas ability to see far-away objects is not usually impaired. Despite presbyopia is a natural change in the eyes as people age, it often is a significant problem that largely interferes with daily life and activities.

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Reducing Diabetes Risks For The Whole Family

Diabetes: Symptoms, treatment, and early diagnosis

The number of type 2 diabetes adult patients is striking. Even more alarming, it is now beginning to show up in children and teenagers. When it comes to type 2 diabetes, prevention is a big deal. It is never too late to start. It is good for the whole family to know about diabetes and support each other making changes to lifestyle.

These steps can help reduce everyone in the family’s risk for developing type 2 diabetes.

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2) Teenagers

  • Eat more protein, fruits, and vegetables. Eat less sugar, carbohydrate, and fat.
  • Maintain appropriate weight.
  • Encourage your kids to join a sports team.
  • Move more in and out of the house. Limit screen/TV time. Plan active outings together.

3) Working Age

  • Eat healthy food. Maintain healthy weight.
  • Limit amount of sugar and carbohydrate intake per day.
  • Exercise regularly – 5 days a week, 30 minutes a day.
  • Get an annual physical examination and diabetes screening
  • Consult a doctor when planning to get pregnant. Women who have gestational diabetes have increased risks of developing Type 2 diabetes later in life.
  • The risk for getting type 2 diabetes goes up to about 50% if close relatives have it.
  • The risk of getting type 2 diabetes increases with age.

4) Elderly

    • Limit carbohydrate and sugar intake per day.
    • Eat more high fiber fruits and vegetables. These help control blood sugar and lipid level.
    • Exercise regularly – weight training, yoga
    • Maintain healthy weight
    • Get annual physical examination and diabetes screening
    • If you have diabetes, take good care of yourself as directed by your doctor.

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