With your interest in this segment of disc prolapse, I assume that you are through with what herniated disc is, what causes it and how it represents itself in a person. Now letтАЩs look diligently into its Diagnosis and Treatment Options.
Diagnosis:
- Verbal Questions: The doctor will ask for symptoms and location
- Physical Examination of the site for redness or inflammation
- Reflex Testing
- Straight Leg Raise: In lying leg is raised and an increased pain confirms the diagnosis
- Another series of physical test for the same
- Blood Test to confirm inflammation
- X-Ray to rule out other causes of backache. It shows wear and tear and its metabolites the osteophytes.
- MRI/CT scan shows properly the level of disc herniation
- A Myelogram with a dye in the spinal column for color contrast scans
- Electromyogram is helpful to determine the muscle involved
- Nerve conduction velocity test determines the nerves involved
Treatment:
- Physiotherapy based on the type of disc protrusion. Flexor/Extensor regimen as required.
- Electrotherapeutic modalities like TENS are highly pain-relieving in the case of radiating pain.
- Postural Modification
- Contrast Bath: Alternating Heat and Ice
- Collar or belt for support
- Acupuncture and Chiropractic Treatments
Medication Management:
- Pain Killers тАУ Over the counter pain meds
- Anti-Inflammatory drugs тАУ NSAIDs and Steroids
- Needle guided Cortisone Injection
- Muscle Relaxants
- Opioids
The professionals you may have to consult includes:
- A Physiotherapist
- A Neurologist
- An Orthopaedician
- A Neuro Surgeon
- Surgical Management:
- Microdiscectomy тАУ Part of the disc is removed.
- Fusion тАУ The Degenerated vertebrae are fused together with a bone graft. It is an ancient form of surgery that stops the disease from progressing but limits the spinal movement. Therefore this surgery is no more recommended.
- Disc Replacement тАУ As other replacements, one or many degenerated discs are removed and replaced by artificial discs that are almost the same in function as the natural disc.
- Lumbar Stabilization тАУ A flexible and strong titanium device is inserted between vertebras that relieve pain and provide support along with preserving movement.
Prevention:
Prevention is very necessary for the people carrying out active to very active lifestyles, especially sportspeople and heavyweight carriers. There is a correct way to perform a specific heavy activity, which we will discuss here.
- Exercise: back strengthening exercises Simple isometric exercises for abdominals and back have no contraindications.
- Postural Advice: while sitting for long hours keep your back straight. Take breaks every 2 hours, take a stroll and continue. Keep heavy loads close to your body. While lifting from the ground, sit close to weight rather than bending from the back. While performing a machine pull-down make sure to keep your back stable and straight, so in the rest of the dumbbells or bodyweight training exercises.
- Weight Control: It is really good to keep in shape. Make sure you eat your dinner early and do not consume excessive water right after your meal.
- Quit Smoking: Say no to all other tobacco products too.
What you can do?
Find yourself a specialist. You may be asked any of the following questions:
- When did symptoms start?
- Mechanism of Injury?
- The extent of pain from a scale of 1 to 10?
- Anything aggravating or improve your symptoms?
- Medications or supplements do you take?
- Do you smoke?
- Does the pain radiate into your arms or legs?
- Do you sense weakness or numbness in your arms or legs?
- Does your leg pain aggravate from coughing or sneezing?
- Does it hurt while sleeping or resting too?
- Lifestyle?
- Work habits?
- Change in your weight generally or localized?
Dr. Anurag Saxena, Senior Consultant Neurosurgery, Spine Surgery, Narayana Superspeciality Hospital, Gurugram.