What causes Lower back pain & Solutions.

Case Study of International Patient:

 “My name is Onome Asgara, I am from Nigeria. I was admitted at Wockhardt Hospital South Mumbai for a minimal invasive spine surgery under Dr Mazda Turel, a renowned neurosurgeon at the hospital.  In Nigeria I was experiencing excruciating pain especially when I would drive and sit down.

 As months passed my condition worsened and I decided to take medical treatment. I was given the reference of Wockhardt hospital by my boss.I was advised an MRI, it revealed a disc prolapse in my lower back which was compressing my nerve aggravating all my symptoms.

 Dr. Turel explained in great detail about my medical predicament and advised the minimal invasive spine surgery. This novel medical technique is a great boon to patients who need treatment in such type of cases. The remarkable event that took place after the surgery was that in less than a week I could walk pain free, unassisted and I could sit and move around freely. This really improved my overall quality of life. I really appreciate the personalised treatment that I received by all the staff at the hospital right from admission and even after my surgery. Thank you, Dr Mazda Turel and Wockhardt Hospital for your medical intervention and quality of medical care.”

More than 80% Indians experience the crippling back and leg pain. .Of these individuals 25% will have osteoarthritis while 35% will have mild spinal stenosis and 19% will have significant symptomatic stenosis (narrowing) of spinal canal.

The condition mainly presents as part of the aging process, but the arthritis like condition also may appear in younger individuals. Back pain takes a toll not only on the patient, but also on his or her family and friends. Many patients find that along with their back health, their relationships slowly deteriorate as well.

Why does it occur?

A prolapsed (herniated) disc occurs when the outer fibres of the intervertebral disc are injured, and the soft material known as the nucleus pulposus, ruptures out of its enclosed space.

The prolapsed disc or ruptured disc material can enter the spinal canal, squashing the spinal cord, but more frequently the spinal nerves.

Herniated discs rarely occur in children, and are most common in young and middle-aged adults. A herniation may develop suddenly, or gradually over weeks or months.

Some patients have spinal stenosis due to slipped intervertebral disc. This commonly called as sciatica. Sciatica often associated with leg numbness or paresthesias and weakness in legs.

What are the causes ?

Intervertebral discs can Prolapse suddenly because of excessive pressure.

Example included:

·         Falling from a significant height and landing on your buttocks. This can transmit significant force across the spine. If the force is strong enough, either a vertebra (bone) can fracture, or an intervertebral disc can rupture.

·         Bending forwards places substantial stress on the intervertebral discs. If you bend and attempt to lift an object which is too heavy, this force may cause a disc to rupture.

If left untreated what are the complications?

Intervertebral discs can also rupture as a result of weakening outer fibres of the disk. This is usually due to repetitive minor injuries which build up over time.

This damage may occur with aging, hereditary factors, work- or recreation-related activities. Often there is no obvious reason why such a process should have occurred. Then at some point you may lift something, twist or bend in a manner which puts enough pressure on the disc to cause it to rupture through its weakened outer fibres.

What are the symptoms of Prolapse Disc?

Ø  The symptoms of a herniated or prolapsed disc may not include back or neck pain in some individuals, although such pain is common.

Ø  In severe cases, loss of control of bladder and/or bowels, numbness in the genital area, and impotence (in men)

Ø  Numbness, pins and needles, or tingling in one or both arms or legs

Ø  Pain behind the shoulder blade(s) or in the buttock(s)

Ø  Pain running down one or both arms or legs

Ø  The location of these symptoms depends upon which nerve(s) has been affected. In other words, the precise location of the

Ø  symptoms helps determine your diagnosis.

Ø  Weaknessinvolving one or both arms or legs

How do you diagnose?

Diagnosing a prolapsed disc begins with your specialist taking a complete history of the problem. This is often completed by a relevant physical examination.

A definite diagnosis is made by radiological investigations. CT scans will usually reveal significant disc prolapses, however these are often not the most reliable tests.

An MRI scan is the most accurate test, however small prolapses may be missed, particularly as most of these investigations are performed while you are lying flat – this places less pressure on the disc and may show less bulging than when you are sitting.

Other investigations that your neurosurgeon or spinal surgeon may organise include a CT myelogram (where dye is injected into the spinal canal and a CT performed), and a nerve sheath injection with local anaesthetic (this may confirm exactly which nerve is generating your symptoms.

What is the Treatment involve?

At least 80 or 90% of disc prolapses settle by themselves and their symptoms almost disappear. Typically this process takes 6-8 weeks, but may take longer.

Unless there is evidence of significant spinal cord or nerve root compression or impaired function, acute disc prolapses are almost always treated conservatively in the first instance.

 If the symptoms do not settle with reasonable conservative treatment, intervention may be recommended. This may include a nerve sheath injection with local anaesthetic (steroids have not been shown to provide additional benefit), or surgery. Surgery has been shown to speed recovery following disc prolapse.

Please visit our spinal surgery department at Wockhardt Hospital for further treatment and evaluation if you are facing any symptom of disc prolapse.