City-Based Sports Medicine Expert Announces Breakthrough in Back and Neck Pain Management.

Hyderabad, 28th August 2024: Background: Millions of people globally experience moderate to severe episodes of back or neck pain at some point in their lives. Prof. Maj. Dr. S. Bakhtiar Choudhary, a renowned sports medicine expert, proudly announces a monumental breakthrough in understanding and managing the causes of back and neck pain. These conditions, if left untreated, can significantly diminish the quality of life, affecting daily activities, productivity, and overall well-being. In India, approximately 79% of women aged 20 to 50 suffer from chronic pain, Lower back pain affects around 80% of women, compared to 59% of men. Around 25-70% of both genders experience neck pain.

The majority (70-80%) of back and neck pain cases stem from mechanical causes, while more serious issues (small percentage), such as birth defects, scoliosis, cancers, tumors, and trauma, require surgical intervention. Patients often seek help from a range of professionals, including RMPs, alternative medicine practitioners, paramedics, orthopedic doctors, neurologists, and neurosurgeons. With the widespread availability of MRI scans today, particularly in urban areas, many patients are opting for surgical solutions. Limited data suggests that an estimated 300,000 to 350,000 surgeries are performed each year. Common procedures include discectomy, laminectomy, fusion surgery, and disc replacement, primarily conducted in urban spine centers.

Dr. Choudhary, with 40 years of experience treating patients from diverse backgrounds, including schoolchildren, housewives, armed forces personnel, and various occupations, has saved over 10,000 people from undergoing unnecessary surgeries. He now believes that many surgeries can be prevented through early intervention and preventive strategies. His latest study, titled “Association of Vitamin D Deficiency with Frozen Shoulder Syndrome and Repetitive Strain Injury on Spine,” is under publication and promises to offer new insights into preventing these debilitating conditions.

Why Back and Neck pain?

1.  Human body mechanics have changed during Evolution leaving some vulnerable areas (Shoulder joints and Spine) for Disease.
2.  Lifestyle factors like internal Environment (diet & absorption) and external environment (Sunlight exposure & absorption of Vit D) cause severe Vitamin D deficiency (VDD) and other micronutrients globally.
3.  This Vitamin D Deficiency Leads to Frozen Shoulder Syndrome due to subclinical Osteomalacia and other biomechanical disturbances
4. Human activities with Frozen Shoulder Syndrome (FSS) are responsible for RSI (repetitive Starin Injury) on the vertebral column (spine) leading to straightening of the spine, bulging of discs, disc prolapses, severe pain and disability, and sometimes surgery remains a choice. Many occupations face these problems and sometimes can recur even after surgery.
5.  Children and youth are at high risk of developing these issues in their future lives if not prevented.

Story of the Study

Vit D Deficiency causes Frozen Shoulder Syndrome

My observations include incorrect nutrition, inadequate nutrition, and a non-staple diet on a long-term basis, causing micro-nutrient deficiencies leading to sub-clinical joint disease, commonly in shoulder and neck joints. We further studied the relationship between frozen shoulder and micro-nutrients and proved the development of frozen shoulder disease as early as 4 years to 90 years of age, in both genders.

Information in social media from non-authentic creates confusion and people deviate from their geographical, genetic, and staple food and nutrition. We get around 20% of Vitamin D (D2) from our diet. But need 80% of Vit D (D3) from direct exposure to sunlight (exposure to ultraviolet B rays). Urban pollution, UV sensitivity, use of sunscreen, dark skin, clothing, and staying indoors prevent direct contact with the sun for the majority of the time. People do not know these facts and remain under the false assumption that they are adequately exposed to sunlight.

Our study revealed that once a person is severely deficient, the person is likely to be deficient for the rest of their life. The crucial reason is the VDR (Vit D receptor sites that absorb Vitamin D in many tissues) get damaged and their recovery is unknown. Just like the hotel reception leads you to your room, dining hall, bar, etc, these VDRs also lead the Vit D to a genetic level, all tissues, organs, and right up to the DNA transcription level. In addition, Intestinal diseases, chronic alcoholism, Thyroid disorders, and Diabetes can cause FSS.

Frozen Shoulder Syndrome responsible for RSI on the Spine

Repetitive strain injury means a repetitive activity leading to pressure on the disc, between vertebrae, thus leading to sciatica, disc disease, prolapse, and operations, and sometimes these disabilities become permanent.

We evolved from four-legged animals to two-legged ones in 3 million years and are still evolving. The current human body has undergone many evolutionary changes. Our shoulder joints have become weak and lower body joints have become stronger. The human body relies on perfect bio-mechanics, maintaining the center of gravity. A healthy person has the perfect range of motion in their joints especially in the shoulders with free movement sideways (abduction). Any activity that interferes with the center of gravity of the human spine can develop into acute or chronic back or neck pain. Any reason restricting this movement puts tremendous pressure on the SPINE during day-to-day activities of the upper limbs. In our study, 89% of people had moderate to severe frozen shoulders, and all of them suffered severe back and neck pain, leading to advice for surgery.

Back and neck pain have no direct cure! They lead to a reduction or loss of ability to work and hence loss of income, excessive costs due to investigations, medicines, and often surgery, and make life stressful and often depressing for people.

Guidelines for People

1.  Eat your Staple Food on time
2.  Get Exposed to Sunlight any time
3.  Manage your intestinal Problems
4.  Stop or reduce alcohol
5.  Keep checking your blood levels of vitamins
6.  Have supplements under supervision (No supplements)
7.  Respect your stiff joints (shoulders)
8.  Try hard to manage your neck and back pain conservatively
9.  In some special conditions, surgery may be necessary (Don’t neglect)

This a Novel Study on a Large Population

1.  There is no published research work relating to the connection between Vit D Deficiency – Frozen Shoulder Syndrome and its impact on the spine as a result of RSI.
2.  Medical professionals treat these as different entities; ex. Frozen Shoulder Syndrome is treated by physiotherapists and Orthopaedic surgeons. Vit D Deficiencies are treated by RMP to Super specialists. Disc diseases are treated by Surgeons and Physicians.
3.  I have been noting the data from these patients who approached me past 25 years, mostly with moderate to severe pain in their neck or back radiating to their limbs with various diagnostic names, and many of them were advised for surgery.
4.  Over 10000 data persons were analyzed, 5269 were selected for retrospective study and the study is under publication now in “The Journal of Clinical Orthopaedics and Trauma” under the title of “Association of Vitamin D Deficiency with Frozen Shoulder Syndrome and Repetitive Strain Injury on Spine”
5.  The protocol of management is unique; Nutrition management, Body biomechanics correction, Modification activities, Ergonomics both at the workplace and home, temporary pain management, Micronutrient correction by supplements, and selective conditioning for involved muscle groups.
6.  I have been attending these people during all my consultation places at my current place “Hyderabad Spine Clinic”. My friends and specialist doctors from Occupational Health, Orthopedics, and General surgeons have supported my work.
7.  I was awarded the prestigious National “OHSF-IAOH Mumbai Oration Award on 21 Jan 2022” for a study related to the current subject with the title “Sub Clinical Frozen Shoulder Syndrome is a Predisposing Factor for Shoulder joint injuries; Exploratory Study of all age groups”. Endorsed by the Indian Association of Occupational Health.

Experience Sharing Ms. Santhi Vasireddy LLM, Interior Designer, Around 9:30 AM on August 8, 2008, I was plucking flowers from the second floor of my house when I suddenly slipped from the parapet wall and fell. Fortunately, a shrub below softened my fall and saved me from direct impact on the ground. For a moment, I thought I was dead. I was rushed to a nearby hospital in Secunderabad, terrified and unsure of my fate, with my family equally shaken.

Expert doctors examined and took an MRI and conveyed the cold news that I had broken one vertebra into many pieces and two others were cracked leaving 80% of the disc prolapsed compressing the nerves. The only option was to perform urgent surgery immediately to prevent lower body paralysis.

Then we remembered our beloved family friend and doctor and called to get his opinion before the invasive procedure. Maj Dr S Bakhtiar Choudary then was in Apollo hospitals Jubilee Hills used to provide special training to my son for professional tennis and fitness. Luckily, he was in town and he rushed to the hospital emergency where I was lying down. He examined me and said ‘What do you want? Surgery or to give one strong attempt to recover conservatively? I was in pain but our family had tremendous faith in his sincere hands and got ready to have a second option. He said it would take three weeks of 100 % bedrest, (later he told me it was not three weeks but three months for fractures to heel and another three months to become functionally fit).

I am a reasonably disciplined person and followed all his instructions 100% of course with support from my family. I have gradually recovered and started walking in 4 months and that’s the first part of the story. He visited my house many times and assured guided supervision.

The most important part of his treatment was the second phase, which I learned later. My shoulders were frozen and getting frequent pain in my lower back. Dr Choudary assured me this is because of my Frozen Shoulder Syndrome (FSS due to Vit D deficiency) causing repetitive strain on my back in the fracture area. Dr Bakhtiar’s formula was very simple, He gave me a modification of activities because of FSS, staple diet, Micronutrient correction, supplements, and selective exercises in a step later fashion. He took my MRIs again in 2009, 2012, and 2023 and I am still following his advice periodically. He cured my problem in two phases. 1. Healing of spine fractures, 2. Prevention of strain on my backbone.

Now, 16 years later, I’m leading an active life, doing aerobics and Zumba. My family and I remain deeply grateful to Dr. Choudary for his exceptional care. Even today, my husband, Dr. Uma Maheswar Rao Director of R&D Laurus Labs, and my son, Krishna Chaitanya, Architect with his firm still consult him for our family’s health.