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.
- 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
- 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
- Pain Killers – Over the counter pain meds
- Anti-Inflammatory drugs – NSAIDs and Steroids
- Needle guided Cortisone Injection
- Muscle Relaxants
The professionals you may have to consult includes:
- A Physiotherapist
- A Neurologist
- An Orthopaedician
- A Neuro Surgeon
- Microdiscectomy – Part of the disc is removed.
- 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.
- 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.
- Lumbar Stabilization – A flexible and strong titanium device is inserted between vertebras that relieve pain and provide support along with preserving movement.
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?
- Work habits?
- Change in your weight generally or localized?
Dr. Anurag Saxena, Senior Consultant Neurosurgery, Spine Surgery, Narayana Superspeciality Hospital, Gurugram.