Tuesday, January 9, 2024

Surgery or physiotherapy for vein compression?

 Surgery or physiotherapy for vein compression?


Asmita Dulal from Kathmandu was suffering from back pain for a long time. She was ignoring it, thinking it was normal pain.


One day suddenly the pain started to be unbearable. How long did the back pain become, it became impossible to get up and sit down. She rushed to Veer Hospital. The doctor advised him to do an MRI of the back. From the MRI, it was found that the vein in his back was torn. The doctor said - you should have surgery immediately.



At the mention of surgery (operation), she hiccupped. She was afraid that the surgery would cause other problems.


In the meantime, someone told him, 'You should not do surgery when the vein is torn. It can also be cured by physiotherapy. She went to a natural hospital for therapy. She underwent a few weeks of therapy. During the therapy, the pain decreased.


But with the passage of time, his problem became there. Finally, she reached a state of mind where she had to undergo surgery.


Similarly, the naive officer of Nuwakot was suffering from lower back and one leg pain from time to time. As the pain worsened, he went to Green City Hospital for treatment. His back vein was slightly compressed. The doctor gave him pain relievers and advised him to exercise daily.


Bhola took the medicine given by the doctor but did not exercise. A few weeks after the medication ran out, his problem started to worsen again. When the pain started increasing, he went to the doctor again. The doctor advised him to do physiotherapy. As per the doctor's advice, he underwent physiotherapy and also changed his lifestyle and his problem gradually got better.


Orthopedic and neurologist Dr. Unhealthy lifestyle, obesity, spending too much time on mobile phones and people who don't exercise are becoming common problems. Saroj Kumar Suwal says. "This problem can occur in any part of the body from the head to the feet, of which the spinal cord is the most common," he says.


'The spinal cord is compressed for a long time, the blood circulation is not good and the blood starts to stop in one place due to the pressure. Due to which the vein is blocked. The veins become swollen and start to hurt a lot," he says.



Dr. Saroj Kumar Suwal

People who do heavy work or lift heavy objects can also have problems with pinched veins. Apart from that, if there is a serious type of bone loss problem, if there is a broken limb, if there is a problem with bone movement and aging, it can cause the problem of vein rupture. In addition, due to lifestyle, this problem can also occur when working in one place for a long time. Suwal explains.


Neurosurgeon Dr. Dr. Dr. Rupesh Raut says.


How is the vein torn?


There are many bones in the spine in the human body. Between each bone is a circular disc. The disk is a particularly thick liquid. Due to an accident or if there is a problem with moving the bone, the disc comes out from between the two bones and tears the nerve. Dr. which we call in common parlance, the veins are torn. Suwal explains.


This problem is more common in the age group of 20 to 40 years. Mainly back and neck veins are more common," he says.


Treatment varies according to the patient's condition


In the problem of pinched vein, the treatment method is different depending on the condition of the patient. Treatment is usually through medication and physiotherapy. But if the patient's condition is serious, Dr. should be treated through surgery. Suwal explains.


It has three stages. In the first and second stages, rest, medicine and physiotherapy are the only cures. The third stage is the situation where the problem has become a bit chronic. In this condition, it is difficult for the patient to move.' He says, 'If there is a long-term problem with the nerves, surgery is required. It will be cured after surgery. It is known from MRI that the vein has been torn.


Even after reaching the third stage, the veins may not function permanently during helchectomy. He said that there could be a possibility of not moving the legs forever, paralysis.


This is what a neurosurgeon says


Neurosurgeon Dr. According to Rupesh Raut, the problem of back pain has become common these days. According to the world data, the most common reason for OPD visits is due to cold, followed by back pain. "Many patients think that a vein has ruptured when they have back pain," he says, "There are various reasons for back pain. In which the joints of the spine are affected, the bones are broken and back pain can also occur. Among the patients who come to the hospital with back pain, only 5 percent have the problem of pinched veins.


The bones of our spine are like blocks, stacked one on top of the other. Between the two blocks is a bone-like element made of thick fluid called a 'disc'. Raut says that when this brittle bone gets old or there is a major injury in the spine, it starts to come out of its place and tear the nearby nerves. He says, "In the part of our body where the nerve goes, the leg pain, tingling, and not moving properly appear in the same direction," he says.



Dr. Rupeshjung Raut

In such a case, you should consult a doctor about how to treat it. Medicine, exercise, therapy and surgery etc 


It is treated in different ways. Dr. Raut says, '90 percent of varicose vein problems are caused by medication, lifestyle changes and therapy. The remaining 10 percent should be operated only for those with serious problems.


It cannot be said with a guarantee that any treatment will cure the patient 100%. Raut says. "After surgery, the patient does not recover 100 percent," he said, "even during surgery, various complications can occur." If the vein is torn due to the disc, it needs to be removed, which is very close to the vein. Removing the disc in this way can sometimes lead to vein injuries, blood clots at the surgery site, etc.


Four percent of those who have undergone surgery may have this problem again within 10 years. Emergency surgery may also be necessary.


One of the emergency conditions of vein rupture is 'Cauda Equina Syndrome (CES)'. Cauda equina syndrome is a rare but serious condition in which nerve roots along the spinal cord are compressed and damaged. Raut says. In this case, the patient should be operated as soon as possible within 24 to 48 hours. It is better to do the surgery within eight hours for better results,” he says.


He said that if this problem occurs, symptoms such as lower back pain, pain in one or both legs, swelling in the lower part of the waist, and difficulty in stopping urination will appear.


Physiotherapist talk


Physiotherapy is an effective treatment method for pinched nerves. In physiotherapy, ultrasonic therapy, TENS, IFT are used. Physiotherapist Sapna Koju says that these therapies play an important role in reducing pain.


She says, 'Exercises during physiotherapy are particularly effective in cases of torn veins. It helps to strengthen the muscles and restore the disc to its original condition.



Physiotherapist Sapna Koju

The treatment of the herniated disc also depends on how many places the vein has been torn and how much part of the vein has been torn. If the disc is only half protruded or the nerve is only half pinched, it can be cured by physiotherapy. Which falls under the first and second phase, says Koju.


She says, 'If the disc has completely protruded, it must be surgically inserted or removed. Which is the third and fourth stage. In other words, if less than 60 percent of the disc has come out, it can be treated with physiotherapy, and for more than that, surgery is the only option.


During the first and second phase of physiotherapy treatment, the patient is given an injection to reduce the pain. Similarly, patients are treated by machines. Koju explains that the physiotherapist uses a pain control machine for that.


The patient can also be treated by creating negative pressure in the place where the vein is torn through certain exercises. By applying more pressure elsewhere during the treatment, the indirect pressure falls on the problem area,'' she says, 'as a result, the liquid comes out and helps to bring in the one in the middle.'


Ways to avoid varicose veins


Do not lift heavy weights, do not work sitting in one place for long periods of time, keep your spine straight while sitting, do not use high pillows, do not strain your neck, go to the gym and lift less weight, do not bend over for long periods of time and do regular exercise. And neurologist Dr. Suwal explains.

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