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Slip disc / Disc prolapse
Kapil_neuro
What is disc ?
The disc is a soft jelly-like inner portion which is surrounded by the tough annulus. It connects the two vertebrae and works as a shock absorber and also provides motion to the rigid spine.
Slip disc is not actually the slippage of disc however it is the prolapsed inner jelly-like material through the outer tough annulus. The prolapsed portion causes compression over the nerve root and causes pain, numbness, and weakness.
Symptoms
Most of the disc prolapse occurs the lower spine (lumbar) but it can at the dorsal and cervical spine also. Depending on the size and site of the disc prolapsed one can have pain, weakness. If the prolapsed is mild then it might be asymptomatic.
Pain – lumbar disc prolapsed causes pain in the back which is radiating to the legs or thigh and it increases on walking, coughing and sneezing. Cervical disc prolapse cases pain in the arm, forearm or fingers.
Numbness or tingling – depending on the level of compression one may have abnormal sensation and burning in the distribution of the nerve,.
Weakness – One can have weakness depending on the site of nerve compression.
One can have disc prolapsed without symptoms which is detected when imaging has been done for some other reason
When to see a doctor
Off and on back pain or neck pain is normal however when it is recurrent and pain is travelling to the limb then one should definitely consult the neurosurgeon.
Emergency situations
In case the pain is increasing and causing bowel and bladder symptoms(Cauda equine syndrome) and weakness of limbs one should not wait.
Causes
As the hair grows grey the same is with the disc with the advancing age the disc degenerates and because of annulus tear the soft jelly like portion comes out and compresses over the nerve root leading to symptoms.
Risk factors
Over weight
Smoking
Improper posture and lack of physical activity
Heavy weight lifting
L5- S1 disc prolpse
Left sided disc compressing the nerve
Prevention
To prevent the disc prolapsed one has to adopt healthy life style.Maintain normal weight as per norms, maintain proper posture, do regular exercise of back and quit smoking.
Treatment
Most of the time surgery can be avoided and patient can be managed conservatively on medication however when there is severe pain which is not relieved with medication. There is weakness of muscles or there is bowel and bladder involvement surgery has to be done. With the advancement of technology spine surgery is safe and very effective without increasing the deficits.
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