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Show f Your Doctor Says ... The following is one of a series of articles written by members of the Utah State Medical A ssociation and published in cooperation with your heal newspaper. These articles are scheduled lo appear every other week throughout the year m an effort to better acquaint you with problems of health, and designed to improve the well-being well-being of the people of Utah. THAT ACHING BACK Ever since doctors began to practice medicine intelligently that symptom usually referred to as low back pain has been somewhat of a curse to the human race. By this statement we mean that a great many people suffer from low backache. back-ache. A great many things are done for it and total satisfaction following treatment treat-ment is more often the exception than the rule. For many years backache was every doctor's problem, but in later years courageous specialists have developed de-veloped their own ideas as to cause and cure. The gynecologist, for instance, frequently blamed the "fallen uterus" in women and advised a sizable surgical procedure. The genito-urinary specialist in treating men patients looked for infection in the prostate gland and worked from that angle. But since the advent of X-ray, the orthopedist or bone specialist has really gone to work on the problem and at the present time it would seem that low back pain is largely his responsibility. ; About twenty years ago a very fashionable complaint in the bone department de-partment was the sacre-iliac slip. The sacro-iliac joints are broad, almost immoveable im-moveable unions between the edges of the sacrum or lower spine and the two inner borders of the wings of the pelvis. At one time a great many low backaches back-aches were said to be caused by a looseness loose-ness of one or both of these joints. X-ray X-ray men made lots of film and truss experts did big business in what is known as the Mayo belt. According to all reports, the latter was a rather uncomfortable un-comfortable appliance. Indeed, many a patient who wore one has decided that the cure in this case was almost as bad as the disease. At any rate, the sacroiliac sacro-iliac slip one day went out of fashion like the Charleston. Belts were probably put up into the attic with Grandma's corsets and folks with bad backs had a new disease known as the herniated disc. Various names are being applied to this condition. Some doctors like to refer to it as a herniated nucleus pul-posa. pul-posa. Others just call it a "disc" and let it go at that. The spinal disc is a fibrous spongy cushion that lies between the bodies of any two adjacent vertebrae and serves to smooth out the jolts of life. There are 23 such cushions, but the one which causes the most trouble lies between the lumbar and sacral spines in the lower part of the back. When the walls of this particular disc become weak and bulge back against the spinal cord the results are local pain and aching, numbness numb-ness in the legs, and sometimes paralysis. In severe cases the best treatment is surgical removal of the "bulge" with possible fusing of the vertabrae involved. Milder cases recover with rest in bed followed by avoidance of back strain. Disc trouble is by no means the only cause of low back pain. For instance, about 6 per cent of the whole human race is born with a deformity of the lower back which might be designated as an architectural botch. Some lumbosacral lumbo-sacral spines are "lop-sided", some curve forward too abruptly, and some have joint3 that come together wrong and may eventually be dislocated if too much strain is put on them. If a young man should by chance discover that he is the unfortunate possessor of this type of back he would do well to choose his occupation accordingly and avoid disability later. In conclusion the following generalizations general-izations mav be offered: 1. Most low back pain is of bony origin. 2. The sacro-iliac slip was probably a diagnostic error in many cases and is not presently taken very seriously. 3. The present day diagnosis of herniated disc in the lower back is a very plausible explanation of low back pain. Surgery for this condition, however, is by no means 100 per cent successful and should " " be resorted to in only the most severe cases. 4. The lumbo-sacral region of the human spine is obviously a weak spot in the skeletal structure and often the site of a congenital deformity. |