Categories: Spine Surgery

Herniated Disc: Diagnosis and Treatment

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 let’s 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
  1. Reflex Testing
  2. Straight Leg Raise: In lying leg is raised and an increased pain confirms the diagnosis
  3. 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:

  1. Pain Killers – Over the counter pain meds
  2. Anti-Inflammatory drugs – NSAIDs and Steroids
  3. Needle guided Cortisone Injection
  4. Muscle Relaxants
  5. Opioids

The professionals you may have to consult includes:

  1. A Physiotherapist
  2. A Neurologist
  3. An Orthopaedician
  4. A Neuro Surgeon
  • Surgical Management:
  1. Microdiscectomy – Part of the disc is removed.
  2. Fusion – 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.
  3. Disc Replacement – 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.
  4. Lumbar Stabilization – 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.

  1. Exercise: back strengthening exercises Simple isometric exercises for abdominals and back have no contraindications.
  2. 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.
  3. 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.
  4. 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.

Narayana Health

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