Low back pain

Low back pain does not have a clear cause, but it is caused by a large number of problems that affect the muscles and spine and affect approximately 40% of people. This percentage increases in developing countries and decreases in developed countries.
In most cases, the cause is a muscle or structural problem such as weight gain, muscle fatigue, muscle strain, smoking and pregnancy, and 90% of cases are similar to recovery without the need for a doctor in less than 6 weeks
– As for the causes of pain in the low back, make it known
1 – bone infections, osteoporosis, vertebral disc prolaps, muscle strain, muscle spasm, weight gain, smoking, pregnancy, and spinal fractures
2 – bone tumors, whether primary or secondary tumors
3- osteomyalites
4- Arthritis, reactive arthrites, psoriatic arthrites and inflamatory bowel deseas
5- Narrow vertebral csnal
6- Pain may occur in the low back due to urinary or reproductive system problems in females and males
* To diagnose the reason for the back pain, there are many things that must be taken into consideration if there are red signs such as weight loss, sweating, heat, or a history of cancerous tumors.
These things are known by taking a medical history from the patient
If there are no serious signs taken into account, the doctor will resort to some tests, such as the normal XRay of the spine or CT, or MRI to diagnose fractures of the spine, muscle strain, herniation disc between the vertebrae or canal narrowness
And some tests to exclude reactive and psoriatic bone arthrites and bone infections such as CBC, CRP and ESR.  And ASOT
And some tests to detect rheumatic diseases, such as ACCP and ANA
* treatment
– In a large percentage that exceeds 70% of patients, symptoms of pain gradually disappear without the need for treatment or consulting a doctor.
A large segment of patients is treated systematically without knowing the cause of low back pain
First, exercise and are useful for strengthening the muscles of onyx and back in general and contribute to relieving back pain in the short term and maintaining the aspects of daily life
– Physiotherapy may be beneficial for many cases in which it is not possible to interfere with medication or surgery, and it may be more beneficial if physiotherapy and rehabilitation are carried out in addition to drug therapy.
Drug therapy may not be 100% cure, but it maintains the best possible daily activities for the patient and most often the response is great for some medications such as NSAID, but it is advised that the start with paracetamol is because it has fewer side effects to the stomach, liver, and kidneys.
And muscle relaxants and some anti-depression drugs, and this is a good way to treat this type of treatment
– Celeprex 200 tab
Tablet every 12 hours after eating
– multirelax 5 tab
Tablet immediately before bed
– pregabalin or gabapentin 100
Morning and evening tablet after eating
If the NSAID is not effective in relieving pain, we resort to a stronger type of painkillers, but with the risk of side effects such as stomach ulcers and problems with kidney failure and hepatic impairment such as morphine.
Spotting quotezone injections may provide short-term improvement, but there are no strong indications for long-term benefit.
As for surgical treatment
It is the golden solution for some diseases, such as herniation disc between the vertebrae, if the pain radiates to the lower limb (sciatica), spine fractures, some cancerous tumors, narrow spine and some deformations of the spine.
* As for herbal remedies, manipulation of the vertebrae, acupuncture, and some herbal remedies, it has not been proven effective in the long run, but it may be effective if it is added to another type of treatment, such as physical therapy, medication, or sports.
There are types of stents for the back that contribute greatly to relieving back pain and practicing daily activities and reduce the need for pharmacological or surgical intervention, but they must be used with sports exercises or physical therapy. These are some of the types that provide a high response to relieve pain in the lower back
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الم اسفل الظهر


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الام اسفل الظهر ليس لها سبب واضح ولكنها تنتج عن عدد كبير من المشاكل التي تصيب العضلات والعمود الفقري وتصيب تقريبا نحو ٤٠ ٪من البشر تزداد هذه النسبه في البلاد الناميه وتقل في البلاد المتقدمه
ويكون في غالبية الاحيان السبب هو مشكله عضلية او هيكليه مثل زيادة الوزن والاجهاد العضلي والشد العضلي والتدخين والحمل وتتماثل ٩٠ ٪ من الحالات للشفاء دون الحاجه للطبيب في اقل من ٦ اسابيع
-اما عن اسباب الام اسفل الظهر فاشهرها
١ – التهابات العظام وهشاشة العظام وغضاريف العمود الفقري والشد العضلي او الاجهاد العضلي او زيادة الوزن والتدخين والحمل وكسور  العمود الفقري
٢ – اورام العظام سواء كانت اورام اوليه او ثانويه
٣- عدوي العظام الصديدية
٤- التهابات المفاصل والعظام التفاعليه والتهابات الصدفيه والتهابات الامعاء
٥ – ضيق العمود الفقري
٦- قد تحدث الام اسفل الظهر بسبب مشاكل الجهاز البولي او التناسلي لدي الإناث والذكور
* ولتشخيص السبب في الم اسف الظهر فهناك امور كثير يجب اخذها في الاعتبار اذا كانت هناك اشارات حمراء مثل فقدان الوزن او التعرق او السخونه او تاريخ مرضي للاصابه باورام سرطانيه
ويتم معرفة هذه الاشياء عن طريق اخذ تاريخ مرضي من المريض
اذا لم تكن هناك دلائل خطوره مأخوذة في الاعتبار يلجأ الطبيب الي بعض الفحوصات مثل الاشعه العاديه XRay للعمود الفقري او الاشعه المقطعيهCT او الرنين المغناطيسي MRI لتشخيص كسور العمود الفقري او الشد العضلي او انفتاق الغضروف بين الفقرات او ضيق العمود الفقري
وبعض التحاليل لاستبعاد التهابات العظام التفاعليه والصدفيه وعدوي العظام مثل CBC و CRP و ESR. و ASOT
وبعض الفخوصات للكشف عن الامراض الروماتيزميه مثل ACCP و ANA
* العلاج
– في نسبة كبيره تتخطي ال ٧٠٪ من المرضي تختفي اعراض الالم تدريجيا دون الحاجه للعلاج او استشارة الطبيب
– يتم علاج شريحة كبيره من المرضي بشكل نموزجي دون معرفة سبب الم اسفل الظهر
-اولا التمارين الرياضيه والعاب القوه مفيده لتقوية عضلات الجزع والظهر عموما وتساهم في تخفيف الام الظهر علي المدي القصير والمحافظه علي مظاهر الحياة اليوميه
– العلاج الطببعي قد يكون مفيدا لكثير من الحالات التي لا يمكن التدخل فيها دوائيا او جراحيا ويكون اكثر استفاده اذا تم العلاج الطبيعي والتأهيل مضافا الي العلاج الدوائي .
-العلاج الدوائي قد لا يكون علاج شافي بنسبة ١٠٠٪ ولكنه يحافظ علي افضل قدر ممكن من الانشطه اليوميه للمريض و في اغلب الاحيان تكون الاستجابه رائعه لبعض الادويه مثل NSAID ولكن ينصح ان تكون البدايه بالباراسيتامول لانه اقل اثارا جانبيه للمعده والكبد والكلي
والادويه الباسطه للعضلات وبعض ادوية المضاده للاكتأب وهذه روشته لهذا النوع من العلاج
—   Celeprex 200 tab
قرص كل ١٢ ساعه بعد الاكل
— multirelax 5 tab
قرص قبل النوم مباشرة
— pregabalin or gabapentin 100
قرص صباحا ومساء بعد الاكل
اذا كان ال NSAID غير فعال في تسكين الالم نلجأ الي نوع اقوي من المسكنات ولكن مع مواجهة خطر الاثار الجانبيه مثل قرح المعده و ومشاكل  الفشل الكلوي واعتلال الكبد مثل  المورفين .
قد يوفر الحقن بالكوتيزون في العمود الفقري تحسنا علي المدي القصير لكن لا توجد مؤشرات قويه لفائدته علي المدي البعيد
* اما بالنسبة للعلاج الجراحي
هو الحل الذهبي لبعض الامراض مثل انفتاق الغضروف بين الفقرات اذا كان الالم يشع للطرف السفلي ( عرق النسا ) وكسور العمود الفقري وبعض الاورام السرطانيه وضيق العمود الفقري وبعض تشوهات العمود الفقري
* اما العلاج بالاعشاب او التلاعب بالفقرات او الوخز بالابر وبعض طرق العلاج بالاعشاب فلم يثبت فاعليتها علي المدي البعيد لكنها قد تكون مؤثرة اذا تم اضافتها لنوع اخر من العلاج مثل العلاج الطبيعي او الدوائي او الرياضه .
وهناك انواع من الدعامات للظهر تساهم بقدر كبير في تخفيف الام الظهر وممارسة الانشطه اليوميه وتقلل من الحاجه الي التدخل الدوائي او الجراحي ولكن يجب استخدامها مع التمارين الرياضيه او العلاج الطبيعي وهذه بعض الانواع التي تؤتي استجابه عاليه لتخفيف الم اسفل الظهر
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knee pain


The knee joint consists of four bones

It is fixed and facilitated its movement by a group of ligaments such as the anterior and posterior cruciate ligament and the inner and outer ligament of the knee

Knee pain can cause a wide range of problems, the most important of which are the following

1_ Tear in one of the knee ligaments

2_ rupture or cutting of the meniscus of the knee

3_ cramp muscles of the thigh or calf caused by lack of movement or constant fatigue of the calf muscles

4_ Fracture of one of the leg bones involved in the formation of the knee joint

5_ different group of bone diseases such as

Arthritis

_ Inflammation of the ligaments, cartilage or joint cysts, by knee separation

Rheumatoid infections

_Osteoporosis

Bone tumors

Inflammatory vertebrae sclerosis

Bacterial or purulent infections of the knee joint

Gout

General nerve inflamations

Hamstring infections

Bone deformities, such as some internal and external curvature of the leg

Low temperatures

dislocation one of the bones that make up the knee joint

_ There is a pain caused by lack of movement due to being overweight, aging or having a chronic disease such as strokes and diabetes.

To relieve knee pain, there is a set of instructions that must be followed. The most important of the following and talk here about chronic pain cases that do not require surgical intervention. Bone tumors

Otherwise, this treatment is very effective

1_ Weight Loss

2_ the use of some anti-inflammatory such as ibuprofen

3_ Use of nerve infections medicine for those suffering from chronic nerve infections or for some diabetics

4_There are many joint infections that cause joint roughness that show a high response to platelet rich plasma injection

5_ septic arthritis needs strong treatments with antibiotics after taking a sample and making a farm for pus

6_ Physiotherapy under the care of a specialist for those with chronic knee pain

7_ Some cases of knee roughness respond to a flawed response to the injection of hyaluronic acid, such as hyalubrix, synviscone, or crespin gel, but some of these drugs are difficult to provide to many patients because of the high prices

8_ In very many cases a very high response appears to use some knee paints such as sulfax and knee joint supports are used with these paints

This last treatment is considered the least in the side effects of the patient because it does not need surgical intervention or injection or any oral medications as it is effective for many cases

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WWW.DOCTORS5.COM

This is the first thing that we write on our new website, Doctors 5, which will be a website written in English and Arabic. We hope that we can be an informational destination for doctors and the public. Short articles will be written in various fields, and most of the world events will be commented on in five areas: health, sports, art, and social media trends and politics. This is the reason why the site has named doctors5. I conclude with a saying by Oliver Wendell Holmes. Wisdom is a summary of the past and beauty is the promise of the future.


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