Although the diagnosis of lumbar disc herniation or commonly known as the slipped disc can seem serious and scare many people, the truth is that most of them can resume a normal life without surgery in a few weeks. An accurate diagnosis and proper slipped disc treatment in Delhi help in this quick recovery.
What is a herniated (slipped) disc?
It is a displacement of a portion of the intervertebral disc from its normal location. The fibrous annulus weakens or breaks allowing a part of the pulpy nucleus to be introduced through it, bulging and thus compressing the nerve root.
As it happens?
The peripheral part of the intervertebral disc is called a fibrous annulus and consists of a series of overlapping circular blades (onion skin type). Inside there is a gelatinous and elastic tissue that works as a deformable buffer between two rigid vertebrae.
Over the years, the fibrous annulus is damaged by the weakening or even rupture of some of these peripheral fibres. The pressure that the pulposus nucleus exerts on that same fibrous annulus with movements, sometimes aggravated with physical efforts, can lead to the pulposus nucleus being “squeezed” through that already incompetent annulus to contain it, thus coming into conflict with the nerve that is nearby.
In some cases of discs subjected to pressure that are not able to support part of the nucleus pulposus, it can even break the fibrous annulus and come out of it, being in direct contact with the nerve root (extruded hernia).
Why does it cause pain?
Because the hernia compresses and/or chemically irritates the nearby nerve.
Each nerve innervates a part of the body in a very precise way, so that reaching a certain nerve root causes symptom in a specific area. So, for example, a tight nerve below the 5th lumbar vertebra will cause pain on the outside of the leg and foot.
Is it possible to have a herniated disc without pain?
Yes. Not all hernias compress the nerve. It is estimated that 30 to 60% of all adults have protrusions or small herniated discs that do not cause any pain, a number that increases with age.
Does sciatica involve herniated disc and surgery?
No. There are other entities besides the herniated disc that can cause sciatica and whose treatment is different. Even in sciatica caused by herniated disc rest and slipped disc treatment in Delhi are enough for more than 75% of patients to recover completely.
At what age do herniated discs appear?
Most often between 30 and 50 years old.
What symptoms can a herniated disc cause?
The most common is pain that is typically more intense in the leg than in the back. It is this pain radiated over a lower limb that is called sciatica. Pain in the lower limb is located in the territory of the sciatic nerve, since one of the roots that constitutes it is compressed.
In addition to the pain, it can cause a sensation of numbness in the skin territory whose innervation depends on the compressed nerve and loss of strength in the muscles that the same nerve controls (for example, a hernia between the 4th and 5th vertebrae can cause numbness of the inside of the foot and foot. fallen due to loss of strength to lift it)
When are additional tests necessary?
In most cases of pain radiated to the lower limb, the clinical examination allows the diagnosis, and medical treatment is immediately started. When rapid improvement does not occur, an examination should be carried out to identify the cause of the clinical condition.
A different situation occurs when the pain is associated with a significant deficit in muscle strength, a condition in which appropriate examinations must be carried out immediately.
Options for Slipped Disc Treatment in Delhi
Except for the rare forms of herniated disc that cause disturbances of urinary and intestinal control, the initial treatment should always be medical, and may include, in addition to rest, analgesics, anti-inflammatories, muscle relaxants or even infiltrations.
When with this treatment you are unable to resume your normal lifestyle in 4 to 6 weeks, surgery may be an option, with a success rate of over 90% in pain relief. There are already some minimally invasive surgery solutions that, in properly selected cases, can allow treatment with a hospital stay of a few hours.
What does the slipped disc treatment in Delhi consist of?
Usually, treatment begins with a short rest period associated with medication considered appropriate by your doctor.
Bed rest should be short and complemented by some stretching and postural changes. It is important to resume some activity as quickly as possible in order to start an education and physical training program.
The analgesics are medicines to relieve pain, some commonly used. Anti-inflammatory analgesics in addition to pain reduce inflammation that may be associated with a herniated disc. They should not, due to their side effects, be used without medical supervision.
Take only the prescribed medication and do not increase the doses to achieve a faster improvement (usually you can only increase the undesirable effects of the drug)
Physical medicine treatments (ultrasound, electrical stimulation, heat, cold massage) can also be useful at this stage. Vertebral traction can be useful in some patients, as well as specific manipulation techniques.
Nerve infiltrations consist of an injection of anaesthetic and anti-inflammatory into the nerve to reduce inflammation and relieve pain. They are useful in some cases of particularly severe pain and resistant to medical treatment and should be performed in a hospital environment with radiological control and by a doctor trained in this type of technique. They must be included in a broader treatment and rehabilitation program.
As soon as it is possible to resume day-to-day activities without pain, a physical exercise program (at home and at the gym) that simultaneously protects your spine and gives you life with a minimum of limitations becomes essential.
What does the surgery consist of?
When conservative slipped disc treatment in Delhi fails, surgery may be an option. Since the cause of the pain is mechanical compression and the chemical irritation of the nervous tissue by the herniated disc tissue, the purpose of the surgery is to remove this aggressive tissue from the proximity of the attacked nerve. Lumbar microdiscectomy remains the most used technique for surgical treatment of lumbar disc herniation, although in some selected cases we also use other techniques. Lumbar microsurgery uses a smaller skin incision than traditional surgery, which means that more muscles are left intact and, as a result, healing is faster. About lumbar microdiscectomy there are many years of experience with successive improvements.
It is this procedure, with the aid of the surgical microscope and under general anaesthesia, that neurosurgeon in Delhi use routinely. The surgery begins with a small incision in the skin (18 to 40 mm, depending on whether a classic or minimally invasive microsurgical technique is used), with the muscles then spreading apart, in order to reach the spine. After the placement of the surgical microscope and often without the need for any bone removal, the nerve root is then exposed and the herniated disc removed under direct view, in order to leave the nervous tissue decompressed. The amount of disk remaining will still maintain some damping effect. It is a quick surgery (45 to 90 minutes) with very little blood loss.
In very selected cases, we can opt for percutaneous discectomy, a technique that does not require hospitalization and in which, through an appropriate needle placed in the centre of the disc, a part of that disc is aspirated. However, it does not allow a direct view of the decompression carried out, being our opinion that it is a technique that may be useful in a limited number of cases.
What precautions should I take before surgery?
It is essential to discuss your medical history with your neurosurgeon in Delhi and, in particular, the medications you are taking (even common medications such as aspirin must be stopped a few days before surgery).
Organize your life for a period when you will have some physical restriction namely
- Put everything you need the week after the surgery in a suitable place.
- Organize your trips because you won’t be able to drive for two weeks
- Get someone to help you with some household chores
- Separate wide, easy-to-wear clothing
- Buy shoes that you can put on without bending
What happens after the surgery?
Immediately after the surgery, you stay in a recovery room (1 to 2 hours) until you can return to your room.
Pain is not common after surgery, except for some discomfort at the incision site.
Bed rest is only necessary for a few hours and even during this period, personal hygiene must be done in the bathroom.
During hospitalization (24 to 48 hours), you should walk a little every 30 minutes.
A few days after the surgery you can start to leave the house for small repeated walks throughout the day and progressively prolonged.
Sexual activity can be resumed 1 to 2 weeks after surgery.
Car driving can usually be resumed 2 weeks after surgery.
In the month following the surgery, you will remain limited to some attitudes such as being in the same position for a long time, bending over or picking up weights.
Depending on the physical effort that your profession requires, the return to work occurs 3 to 8 weeks after surgery.
What result can I expect from the surgery?
If the main symptom is pain in the leg and there is a perfect correlation between the data from the clinical examination and the results of the complementary tests (CT and / or NMR) you can expect a good result from the surgery. The success rate is over 95% in the short term and remains above 80% in the long term.
The complications of this surgery (haemorrhage, infections, damage to the nervous tissue) are very rare and should be discussed with your doctor.
And in the long run?
Pain recurrence can occur both in patients undergoing conservative treatment and in operated patients (5 to 10% in this case).
However, surgery is only the first step in your recovery, depending on the following steps. Recovery will be all the faster and will prevent new crises if you are able to make changes in your daily life.
Weight control (to avoid overloading the spine), correct postures during professional and leisure activities (to reduce forces on the spine) and a regular walking and exercise program (to strengthen the muscles and muscles) are essential. thus, protecting the column). Participation in classes at a Column School is a useful method to achieve these goals.