Slipped Disc Treatment

SLIPPED DISC TREATMENT

Did you know that over 95% of cases of slipped disc can be treated without surgery? Even if surgery is required, it can be performed in a minimally invasive way with neuromonitoring control and has a success rate of over 98%.

Are you experiencing any of the following issues?

• Low back pain
• Radiating pain from your back or buttocks down into your legs
• Sharp shooting or electric shock-like pain, burning pain, stabbing pain, or muscle ache in your leg
• Numbness in your legs
• Heaviness in your legs
• Weakness in your legs
• Pain, weakness, or heaviness in your legs that occurs after walking a certain distance
• Sciatica
• Loss of urinary or faecal control

If so, we have a scientifically proven and time-tested cure for you.

What Is Sciatica?

When a patient comes to us with complaints of disc prolapse, low back pain, sciatica, numbness or weakness of legs, we first do a detailed clinical assessment. We listen to the patient's complaints to find out how long they've been experiencing symptoms, how often, and how it has affected their quality of life. We use the Oswestry Disability Index to formally calculate the patient's disability. We also do a detailed neurological examination to check for muscle weakness or numbness in the legs.
The first line of treatment is usually physiotherapy, exercises, medication, and lifestyle modification. However, some patients may require surgery for disc prolapse, and delaying surgery in these cases can be harmful.

Who needs surgery for lumbar disc prolapse?

• Patients with weakness in major leg muscles such as ankle, knee, or hip muscles.
• Patients with numbness in the foot, buttock, or any part of the leg due to lumbar disc prolapse.
• Patients with severe sciatica pain despite trying 6 weeks to 3 months of conservative treatment.
• Patients who frequently (more than 3 times a year) experience low back pain or sciatica that leaves them bedridden.
• Patients with severe Oswestry Disability Index and poor quality of life despite trying conservative treatment for more than 6 months.
• Patients experiencing urinary problems like hesitancy in starting urination, slowing of the stream of urination, frequent urination, feeling of incomplete emptying, or loss of control over passing urine and stools.
• Patients experiencing numbness in the pelvic area or around the genitals.

Can spinal injection treat disc prolapse?
There are two kinds of spinal injections that can be given for disc prolapse:

• Epidural injections: In this procedure, a combination of steroid medicine and local anesthetic is given around the inflamed nerves. When a disc slips and compresses the nerves, there is usually local inflammation around the nerves. Decreasing this inflammation with steroid medication can help to relieve radiating pain. This pain relief may be temporary or permanent. Epidural injection can be tried before deciding for surgery, provided there is no neurological deficit.
• Facet injections: When a disc slips, there is strain or subluxation in the joints of the spine, known as facet joints. Giving steroid injections in these joints can relieve back pain temporarily. If the patient strengthens their core muscles during this pain-free period, they may get lasting relief from pain.

What are the different types of surgeries for a slipped disc?

• Endoscopic dissectomy: It is a minimal invasive procedure where the prolapsed disc fragment is removed using endoscope and a set of specialised instruments. A very small incision of 1 to 1.5 cm is used and this surgery preserves the spinal stability and doesnot damage the spine musculature and ligaments or joints. Anaesthesia is not required in this surgery and hence the patient is awake throughout the procedure. Pain relief is immediate. This is an OPD procedure and patient goes home walking the same day of surgery.
• Microdiscectomy: It is a minimally invasive surgery that is performed through a small incision of 1 to 1.5 inches. The surgeon uses a microscope to remove the bone or disc that is pressing on the nerve root. This surgery preserves spinal stability and does not damage the normal muscles, ligaments, or joints. Microdiscectomy is more successful in relieving leg pain than back pain. Patients can usually go home on the same day or the next day with significant pain relief. However, if the patient has weakness or numbness in the leg, it may take several weeks or months to improve and may not fully recover if surgery is done late.
• Spinal fusions such as TLIF, OLIF, PLIF, and PLF are another types of spine surgeries for prolapsed disc done in circumstances when patient has spine instability along with slipped discs.

What is a slipped (prolapsed) disc?

The spinal column is made up of vertebrae stacked on top of each other, cushioned by discs that act as shock absorbers. Each disc has a soft inner portion (nucleus pulposus) and a tough outer ring (annulus fibrosus).

A slipped disc occurs when the disc loses its normal shape and consistency. This can happen when the nucleus bulges or leaks out of its annulus, resulting in terms like herniated, ruptured, torn, bulged, or protruding disc that are often used interchangeably.

What are the symptoms of a slipped disc?

A slipped disc can happen in any part of your spine, but it is more common in the lower back. The spinal column is a complicated network of nerves and blood vessels, and a slipped disc can cause extra pressure on these structures.
The following are symptoms of a slipped disc:

• Pain and numbness, usually on one side of the body
• Pain that extends to your upper or lower limbs
• Pain that gets worse at night or with certain movements
• Pain that gets worse after sitting or standing
• Pain when walking short distances
• Unexplained muscle weakness
• Tingling, aching, or burning sensations in limbs
• Loss or change in sensations
• Difficulty controlling bowel movements or bladder function

Different people may experience different types of pain. If your pain leads to numbness or tingling that affects your ability to control your muscles, see your doctor.

How does a slipped disc occur? What are the causes and risk factors of a slipped disc?
There are two common causes of a slipped or herniated disc:

• Natural degeneration of the disc, which causes the nucleus pulposus to become less hydrated and weaken with age.
• Trauma or injury to the disc, which may occur due to lifting heavy loads using incorrect posture, external forces such as a whiplash injury, especially if accompanied by twisting or turning, and excessive strain forces associated with physical activities. Sudden forceful acute trauma is an uncommon cause of a slipped disc.
  Rarely, it might be difficult to find a particular cause of it.

The Importance of Getting a Correct Diagnosis for a Slipped Disc:
It's essential to get a proper diagnosis from a doctor when experiencing back or neck pain to determine if it's a slipped disc or something else. A correct diagnosis can rule out other causes of similar pain, like tumors, fractures, or infection. It can also help create a treatment plan that works best for you and prevents further damage to the spine or nerves.

When to Seek Medical Care for a Slipped Disc:
Consult with a doctor if the pain in the neck or back limits your daily activities or lasts for more than a few days. Seek emergency evaluation for severe symptoms like loss of bladder or bowel control, severe numbness or weakness of any extremity, and pain that prevents you from walking. Any injury that may cause significant back or neck problems, such as a fall or a direct blow to the spine, should be evaluated at the hospital's emergency department.

How Are Slipped Discs Diagnosed?
The doctor will begin with a physical examination to determine the source of pain and discomfort. They will check nerve function and muscle strength and ask about medical history and symptoms. Imaging tests can help view the bones, muscles, discs and nerves of the spine, such as X-rays and MRI scans.

Treatment of Slipped Disc

Slipped disc treatment can be conservative or surgical, depending on the severity of the pain and the extent of disc displacement. An exercise program that targets the back and surrounding muscles is often effective in alleviating pain. In addition, a physical therapist may recommend specific exercises to strengthen the back and relieve pain.

If non-prescription treatments are not effective, the doctor may prescribe stronger medication, such as muscle relaxants, analgesics, or nerve pain medications. Nerve root block may also be used.

For cases requiring spine surgery for lumbar disc prolapse, there are several practices that make the surgery safer. These include:

• Neuromonitoring - which monitors nerves and muscles during surgery, reducing the risk of nerve injury.
• Endoscopes- Endoscopic dissectomy is the latest trend for disc removal. This ensures minimal incisions and speedy recovery.
• Operating microscopes for enlarged views of the nerves and discs to prevent nerve injury.
• Dynamic X-rays - X-rays of the L-S spine in different positions to identify any spinal instability, and stabilization may be done to prevent recurrence of disc herniation.
• Full-length spinal X-rays in cases of scoliosis or kyphosis to correct spinal deformities.
• Detailed clinical and radiological assessments, including the Oswestry Disability Index, to assess disability and patient requirements before planning any surgery.
• Safe and advanced anesthesia techniques, special tables for spine surgery (Allen table), ICU, and cardiac backup for good surgical outcomes, even in older patients.

If your symptoms from a slipped disc persist for more than six weeks or if the condition is causing muscle dysfunction, your doctor may suggest surgery. In such cases, a microdiscectomy procedure may be performed, which involves the removal of the damaged or protruding part of the disc while leaving the rest intact.

Q: What is the outlook for someone with a slipped disc?
A: Most people with a slipped disc respond well to conservative treatment. Within six weeks, their pain and discomfort will gradually lessen.

Q: Is it possible to prevent a slipped disc?
A: It may not be possible to prevent a slipped disc, but there are steps you can take to lower your risk. These include using safe lifting techniques, maintaining a healthy weight, not sitting for long periods without stretching, and doing exercises to strengthen the muscles in your back, legs, and abdomen.