SLIP DISC / SCIATICA / HERNIATED DISC
What is Slip Disc?
When the disc or cushion slips into the spinal canal causing compression of nerve/ nerves it is called SLIP DISC OR HERNIATED DISC or SPINAL STENOSIS. Compression of the nerve/ nerves results in BACK PAIN or Buttock pain or LEG PAIN.
What is Sciatica?
Compression of the nerve/ nerves in the spinal canal due to spinal stenosis or slip disc resulting in low back pain and buttock pain traveling down the leg causing numbness and difficulty in walking are called Sciatica.
What is the cause of Slip Disc/ Disc Herniation/ Bulged Disc?
Slip disc is the result of daily wear and tear. It is an ongoing process of aging of the disc. This wear and tear process is called Degeneration and is related to daily activities over a period of time aggravated by poor posture and weak core muscles.
What are the Symptoms of Herniated disc OR Slip Disc/ Bulge Disc?
Herniated disc may cause various symptoms including a dull or sharp pain in the back, muscle spasm, locked back, stiffness in back, morning stiffness, radiating leg pain, numbness in the calf, pain in the back traveling down to legs with numbness and weakness, tingling, or referred pain to leg commonly referred to as sciatica. Although rare but Herniated disc or slip disc may cause loss of bowel or bladder control with weakness in lower limbs called cauda equina syndrome (CES) which rarely may cause paralysis of one or both lower limbs.
How do we diagnose Slip disc/ Herniated disc/ Bulge Disc?
Your spine specialist may examine you clinically and may ask for investigations like X- rays and MRI scans to diagnose the presence of slip disc in presence of symptoms. MRI can show various grades of Slip disc and may also suggest if surgery is really needed in view of ongoing compression of nerves in the spinal canal.
Commonly asked questions about Slip Disc/ Sciatica/ Herniation
Do all patients with Slip Disc require surgery?
No – Most of the patients with Slip disc/ Disc herniation get better with non-surgical methods
What are the non-surgical options in slip disc/ herniated disc/ sciatica?
Normally the type of non-surgical treatment is decided based on the duration and severity of symptoms in consultation with your spine surgeon/spine specialist. The options available for slip disc treatment are
- Medications — NSAIDS/ Muscle relaxants / Pregabalin /TCAS/nonopioid analgesics
- Hot fomentation
- Cold sponging
- Physical therapy
- SWD
- However before one resorts to any options, one should have the opinion of a spine specialist.
What is the Best Surgery for a Herniated Disc?
Surgery for slip disc is safe and simple. It involves freeing of the nerve from compression caused by the slipped disc or herniated disc or bulged disc and this surgery is called discectomv or removal of part of the damaged intervertebral disc. Minimal Invasive Spine Surgery is the gold standard for discectomy in patients with slip disc / herniated disc. Slip disc surgery performed with small incisions and with an endoscope and microscope is the best way to perform disc surgery. This results in less pain, negligible blood loss & minimal to no bed rest after surgery. This is also called Micro-endoscopic discectomy
Is physiotherapy useful in slip disc ?
Yes – Physiotherapy has a major role in herniated disc recovery. It teaches how to condition your body to prevent further injury and help in the recovery of the painful episode. Physiotherapy shall be taken in the supervision and guidance of a spine specialist.
When is surgery for a Slip disc required?
Most patients with slip disc respond well to non-surgical treatments (such as medication),
- Indications for spinal surgery in slip disc/ herniated disc are:
- No response / partial response to non-surgical treatments
- Progressive radiculopathy, – pain, numbness, and tingling in the arms or legs.
- Loss of power/sensation in arms or legs.
- Loss of bowel or bladder control.
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