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Slipped disc /Sciatica
Additional Information
What is slipped disc?
When you have a prolapsed disc (commonly called a slipped disc), a disc does not actually slip. What happens is that part of the inner softer part of the disc (the nucleus pulposus) bulges out (herniates) through a weakness in the outer part of the disc. A prolapsed disc is sometimes called a herniated disc. The bulging disc may press on nearby structures such as a nerve coming from the spinal cord. Some inflammation also develops around the prolapsed part of the disc.
Any disc in the spine can prolapse. However, most prolapsed discs occur in the lumbar part of the spine (lower back). The size of the prolapse can vary. As a rule, the larger the prolapse, the more severe the symptoms are likely to be.
Who gets a slipped disc?
Bouts of back pain are very common. However, less than 1 in 20 cases of acute (sudden onset) back pain are due to a prolapsed disc. (Most cases of back pain are classed as simple low back pain. This is thought to be caused by a minor problem in a muscle, ligament, or other structure in the back – for example, a strained muscle.) The most common age to develop a prolapsed disc is between 30 and 50 years. Twice as many men as women are affected.
What are the symptoms of a slipped disc?
Back pain: The pain is often moderate to severe . The pain is usually eased by lying down flat, and is often made worse if you move, cough, or sneeze.
Sciatic pain or sciatica: Sciatica is the pain that occurs because a nerve coming from the spinal cord is pressed on (trapped) by a prolapsed disc, or is irritated by the inflammation caused by the prolapsed disc. Although the problem is in the back, you feel pain along the course of the nerve in addition to back pain. Therefore, you may feel pain down a leg to the calf or foot. Sciatic pain can range from mild to severe, but it is often worse than the back pain.
Other nerve root symptoms: The irritation or pressure on the nerve next to the spine may also cause pins and needles, numbness or weakness in part of a buttock, leg or foot. The exact site and type of symptoms depend on which nerve is affected.
Cauda equina syndrome: Cauda equina syndrome is a particularly serious type of nerve root problem that can be caused by a prolapsed disc. This is a rare disorder where the nerves at the very bottom of the spinal cord are pressed on. This syndrome can cause low back pain plus: problems with bowel and bladder function (usually unable to pass urine), numbness in the saddle area (around the anus), and weakness in one or both legs. This syndrome needs urgent treatment to preserve the nerves to the bladder and bowel from becoming permanently damaged. See a doctor immediately if you develop these symptoms.
Treatment of slipped disc and sciatic pain
Relative Rest and precautions as adviced by your doctor
Maintain normal activities as allowed by your pain
Medication:
- Initial course of anti inflammatory medicines to decrease inflammation at the site of nerve compression and decrease pain unless contraindicated .
– A muscle relaxant is sometimes prescribed for a few days if the back muscles become very tense and make the pain
-Anti neuropathic Drugs for neuralgic pain in sciatica .
- Other medications as advised by the the treating physician
Minimally Invasive Pain and Spine Interventions (MIPSI )
Epidural Steroid MIPSI
* Injections like the Cervical, Thoracic and Lumbar Interlaminar Epidural Injections and Transforaminal epidural injections are interventions which direct anti-inflammatory medicine directly at the site of nerve impingement or compression in the spine
* These injections reduce the inflammation and swelling of spinal nerve roots and other tissues surrounding the spinal nerve root and reduces pain, tingling and numbness and other symptoms caused by such inflammation, irritation or swelling.
Pulsed Radiofrequency of Dorsal Root Ganglion
* Dorsal Root Ganglion (DRG) is the most pain sensitive structure in the spine and each nerve has one DRG . In chronic low back and sciatica cases , Pulsed RFA of DRG can temporarily numb the pain sensitive nerve without affecting the motor function of the nerve . It is usually used in cases with chronic ( long lasting ) low back pain and sciatica , post spine surgery persisting pain , patients in whom surgery cannot be done due to uncontrolled medical conditions.
* RFA has proven to be a safe and effective way to treat some forms of pain. It also is generally well-tolerated, with very few associated complications
Minimally Invasive Disc decompression procedures
Ozone Discectomy :
* Injection of Ozone-Oxygen mixture into the disc is a new alternative method of treating patients suffering from back and leg pain (sciatica) caused by disc prolapse.
* Procedure can be done in a contained disc
* A small needle is used to shrink the disc by injecting oxygen -ozone gas mixture .
* Large number of international studies confirms the efficacy of this treatment and superiority of this treatment over conventional disc surgery.
Endoscopic Discectomy :
* Endoscopic Disc Decompression procedure is a minimally invasive intervention where an endoscope under direct visualization is used to remove the disc material compressing the nerves in spine under local anesthesia .
* The incision is very small around 1 cm and endoscope is put through muscle planes instead of cutting tissues . Recovery is fast and outcomes are excellent .
Open Surgery:
On your doctors advice , patients may have to undergo open disectomy with or without fixation in some cases .The aim of surgery is to cut out the prolapsed part of the disc and increase the space for the nerves .
Slipped disc and sciatic pain treatment options available at our clinic:
- Epidural Injections/Transforaminal injections
- Radiofrequency Lesioning
- Ozone Discectomy (Ozonucleolysis)
- Endoscopic Discectomy
Are you suffering with sciatica ?
Consult us for all non surgical minimally invasive treatments.