Low Back pain
Low back pain is very common and results in significant patient morbidity and time off work. The good news is that in most cases patients do not need surgical procedures rather need the right medication and intensive physiotherapy. It must be noted that in patients with symptoms of sciatica (i.e low back pain with radiating shooting pain in the back of the legs) can also be treated with physiotherapy. Only if physiotherapy fails then an MRI is indicated.
With advancing age due to wear and tear patients develop what we call degenerative changes resulting in pain and sometimes swelling in joints. In addition, some patients may develop inflammation of tendons or damage to muscles holding together your joints.
The principle of physiotherapy is to strengthen your muscles thus resulting in stabilisation of joints, reduction in wear and tear inflammation and ultimately pain. (please see below for a link to exercises).
Handouts for physiotherapy exercises
Benign Paroxysmal Positional Vertigo
Vertigo is a false sense of spinning. There are several causes of vertigo but with increasing age a common cause is Benign Paroxysmal Positional Vertigo. Usually patients report vertigo after turning in their bed or by changes in position (looking up or bending) due to calcium crystals getting dislodged and moving freely in the canals in the inner ear. Fortunately, certain exercises such as the Epley manoeuvre performed by your doctor can result in >80% cure. In certain cases it can spontaneously resolve however it may recur. A modified Epley manoeuvre can be performed by the patient at home (see below for handout and video).
It is important in elderly patients with first episode of vertigo which is persistent, not related to posture or head tilt and having inability to walk in a straight line, to see their personal doctor to exclude a cerebellar stroke.
Modified Epley Manoevre handout and video for BPPV