5 Things You Should Know About Back Pain | Body Stuff with Dr. Jen Gunter | TED

Back pain is one of the biggest reasons we seek medical care,

Prevodilac: Una Kavazović Lektor: Milenka Okuka

Bol u leđima je jedan od najvećih razloga zašto tražimo lekarsku pomoć,

and low back pain is listed as a leading cause of disability worldwide.

a lumbago je naveden kao vodeći razlog invaliditeta širom sveta.

But there's a lot of misinformation out there,

Međutim, postoji dosta dezinformacija,

and along with it, a lot of bad treatments.

i pored njih, dosta loših tretmana.

(Music)

(Muzika)

[Body Stuff with Dr. Jen Gunter]

[„Body Stuff” sa dr Džen Ganter]

So today, I want to bring up five things you should know about back pain.

Danas želim da pomenem pet stvari koje bi trebalo da znate o bolu u leđima.

One:

Prvo:

Back pain isn't just limited to the spine.

bol u leđima nije samo ograničen na kičmu.

Our back is made of bones called vertebrae

Naša leđa čine kosti zvane pršljenovi

that run from your neck to your tailbone.

koji se pružaju od vrata do trtične kosti.

These vertebrae form the spinal column, which houses the spinal cord.

Ovi pršljenovi formiraju kičmu, u kojoj se nalazi kičmena moždina.

Each vertebrae is also connected to the others by ligaments.

Svi pršljenovi su takođe povezani međusobno putem ligamenata.

Between each vertebrae are discs

Između svakog pršljena su diskovi

which provide cushion and help absorb and distribute pressure.

koji funkcionišu kao jastuci koji upijaju i raspoređuju pritisak.

Within this structure of connections

Unutar ove povezane strukture

are also joints, muscles, tendons and nerves.

su takođe zglobovi, mišići, tetive i nervi.

But our back isn't held up by just the spine.

Ali naša leđa nisu poduprta samo kičmom.

In fact, a lot of that work is done by our core,

Zapravo, dosta tog posla obavlja naše jezgro,

which includes our abdominal muscles,

koje obuhvata naše abdominalne mišiće,

low back muscles, hips and glutes and pelvic floor.

mišiće donjeg dela leđa, kukove, glutealne mišiće i karlični pod.

The muscles in our core take pressure off the rest of the spine.

Mišići u našem jezgru skidaju pritisak sa ostatka kičme.

Every day, we put all kinds of pressure on our backs

Svaki dan, mi stavljamo razne vrste pritiska na naša leđa

when we walk, stand, carry our groceries, lift boxes,

kada hodamo, stojimo, nosimo namirnice, dižemo kutije,

and even when we sit.

pa čak i kada sedimo.

So it’s not only spinal pressure

Tako da nije samo spinalni pritisak

but torn muscles or slipped discs that could be contributing to back pain.

već i istegnuti mišići ili prolaps diska to što može doprineti bolu u leđima.

But pain itself is even more complex.

Međutim, sami bol je još složeniji.

Often, it's how pain signals are processed in the nerves,

Često, način na koji se signali bola obrađuju u nervima

or in the brain

ili u mozgu

that perpetuates the pain.

je ono što produžava bol.

Other factors, like stress and anxiety, can amplify pain.

Drugi faktori, kao stres ili anksioznost, mogu da pojačaju bol.

This complexity is why treating back pain can be so frustrating,

Ova složenost čini lečenje bola u leđima prilično frustrirajućim,

and why it's enticing to seek out all sorts of medically suspect care.

i razlog je što je primamljivo tražiti sve vrste sumnjive medicinske nege.

Which leads me to two:

Što me dovodi do broja dva:

Chiropractic treatment is not backed by science.

kiropraktički tretman nije podržan naukom.

Going to chiropractors for spinal manipulation is very popular,

Odlazak kod kiropraktičara za kičmenu manipulaciju je jako popularan,

especially in the United States.

posebno u SAD-u.

But a study that looked at 45 systematic reviews

Međutim, studija koja je istražila 45 sistematskih pregleda

found no evidence supporting chiropractic treatment

nije pronašla dokaze koji potvrđuju da je kiropraktički tretman

as effective for any medical condition.

efikasan za bilo koje medicinsko stanje.

I'm not denying that people who visit chiropractors

Ne osporavam da se ljudi koji posećuju kiropraktičare

sometimes feel better after a session,

ponekad osećaju bolje nakon tretmana,

but studies suggest that the comfort and relief from being touched

ali studije pokazuju da su komfor i olakšanje usled dodira

is most likely a placebo effect.

najverovatnije placebo efekat.

This is also a reminder

Ovo je takođe podsetnik

that chiropractic treatment can sometimes be dangerous.

da kiropraktički tretman može ponekad biti i opasan.

There are people who have suffered vascular strokes after neck adjustments.

Postoje ljudi koji su iskusili moždani udar nakon pomeranja vrata.

Three:

Treće:

Imaging techniques like MRI or X-ray

snimanja poput magnetne ili rendgena

don't always help with diagnosing back pain.

ne pomažu uvek pri dijagnostikovanju bola u leđima.

For instance, you can be in a lot of pain

Na primer, možete biti u jakim bolovima

and get an MRI showing a pristine spine with nothing out of the ordinary.

i dobiti magnetni prikaz zdrave kičme bez ičega sumnjivog.

Or you could have no pain whatsoever,

Ili možete da uopšte ne osećate bol,

and an MRI could turn up abnormalities, like a bulging disc.

a da dobijete magnetni prikaz abnormalnosti, poput ispupčenja diska.

What’s more, sometimes, when you do have pain,

Štaviše, ponekad kada osećate bol,

and abnormality on MRI may have nothing to do with it.

abnormalnost na magnetnom prikazu možda uopšte nije uzrok toga.

Additionally, an MRI doesn't always capture what's happening with your muscles

Dodatno, magnetna rezonanca ne uhvati uvek šta se dešava sa vašim mišićima

or tell us how pain is being processed in the brain.

ili ne pokaže kako bol biva obrađen u mozgu.

There are instances when imaging helps to rule out a serious problem,

Postoje slučajevi gde snimanje pomaže da se eliminiše ozbiljan problem,

especially after trauma or an accident,

naročito nakon povrede ili nezgode,

or if there are red flags,

ili ako postoje sumnjivi znaci,

meaning warning signs for cancer or troubling neurological symptoms.

odnosno znaci upozorenja za rak ili zabrinjavajući neurološki simptomi.

But for the majority of people with back pain,

Ali za većinu ljudi sa bolom u leđima,

imaging has actually been associated with worse patient outcomes

snimanje se vezuje za gore ishode za pacijente

and unnecessary surgeries.

i nepotrebne operacije.

Speaking of surgeries, four:

Kad već govorimo o operacijama, četvrto:

Back surgeries can sometimes do more harm than good.

operacije leđa mogu ponekad načiniti više štete nego koristi.

Researchers analyzed studies on two types of spine surgery,

Istraživači su analizirali studije o dva tipa operacije kičme,

lumbar spine fusion and lumbar spine decompression.

fuziji lumbalne kičme i lumbalnoj dekompresiji kičme.

They found that neither of these surgeries

Našli su da nijedna od ovih operacija

was more effective than nonsurgical treatment,

nije delotvornija od neoperativnog lečenja,

which I'll get into in a bit.

o čemu ćemo pričati uskoro.

Finally, five:

Konačno, broj pet:

Physical therapy is a really good option for back pain.

fizikalna terapija je jako dobra opcija za bol u leđima.

A well-designed physical therapy program

Dobro skrojen program fizikalne terapije

can often be very effective at treating acute and chronic back pain.

može često biti jako delotvoran za lečenje akutnog i hroničnog bola u leđima.

But it does take work.

Međutim, treba uložiti napor.

Good physical therapy involves not just assessments,

Dobra fizikalna terapija uključuje ne samo procene,

but also a structured home exercise program,

već i strukturiran program vežbanja kod kuće

which you need to do regularly.

koji morate da radite redovno.

There are also multidisciplinary clinics that can offer multimodal therapy,

Postoje i multidisciplinarne klinike koje nude multimodalnu terapiju,

like medications, physical therapy, and, sometimes, injections.

poput lekova, fizikalne terapije i, ponekad, injekcija.

What I'm saying is there isn't always an easy fix for back pain.

Ono što želim da kažem je da nema uvek lakog rešenja za bol u leđima.

The solutions take time

Rešenjima je potrebno vremena

and sometimes need a multipronged approach.

i ponekad je potreban višeslojni pristup.

For now, you can show your back some love by staying active

Trenutno, možete pokazati vašim leđima malo ljubavi tako što ćete biti aktivni

and doing exercises that strengthen your muscles,

i raditi vežbe koje ojačavaju vaše mišiće,

including your core.

uključujući i vaše jezgro.