Frequently Asked Questions

Questions and Answers about Spine Problems

   

Click on the links below to take you to the particular question.

   
  • Please go through these questions in order to assess your problem

    >  Do you have Low Back Pain? Does it go down / radiate to your legs - up to knee or ankle?

    >  Do you have Neck Pain? Does it go down / radiate to your arm/ forearm / hand / fingers?

    >  Do you feel Tingling, Numbness, Heaviness, Pulling, and Burning, Bursting sensation in your arms or legs?

    >  How long can you walk nonstop (2min, 5 min, 10 min, or more)? Do you often have to sit and take rest when you walk? Do you feel leg heaviness when you      walk? Do you look for chairs to sit down when you are shopping around / moving around?

    >  Due to this pain what all things you are not able to do in normal life. How much is this pain affecting you functionally

    >  Do you feel your body is stiff in the morning when you get up in the morning?

    >  Do you get Night Cramps in the calf muscles in legs in night which awakens you up?

    >  Are you suffering from constipation / acidity or some urinary problem

    >  Do you have sound sleep?

    >  Do you have fever, recent weight gain / loss, decreased appetite?

    >  Do you have giddiness / vertigo?

    >  Do you have difficulty in walking / loss of balance, climbing stairs, changing positions in bed?

    >  Does the pain increase when you cough, sneeze / bend forwards?

    >  Do you smoke / consume alcohol

    >  Does your job involve long hours of continuous sitting / traveling on bad roads / computer work?

    >  Do you have Diabetes, Hypertension (High BP), Thyroid, Asthma, Heart problem?

    >  What all surgeries did you have till now?

    >  Do you often feel anxiety? Do you feel depressed?

  • Q n A

    Q.WHAT IS A SLIPPED DISC?

    It is also called as Herniated Disc .Our Spine is made up of a number of small bone blocks called VERTEBRAE stacked one on top of another. A disc is a soft, gel-like structure present between two adjacent vertebrae. Normally, these discs act like SHOCK-ABSORBERS and also allow some movement between the two adjacent vertebrae, giving the spine its flexibility. When this disc slips beyond its normal confines, it can compress the spinal cord or its nerve roots leading to problems.


    Q.WHY DOES THE DISC SLIP OUT?

    Over the years, the disc develops small tears, which may unite together over a period of time and with some small injury (Lifting a heavy weight / bucket, Long travel on a bad road, bending forwards, jerk) the disc may slip out of its normal place and press the nerve. Sometimes as a part of the normal aging process, the spine may develop some extra bone growth, leading to pressure on the adjacent spinal cord or its nerve roots leading to pain.


    Q.WHAT ARE THE GRADES/STAGES OF SLIPPED DISC?

    STAGE 1 Disc: Degeneration –Disc stops Working – becomes Non functional – pt feels Difficulty in bending forwards and long sitting. Small jerk lead to severe pain
    STAGE 2 Disc: Protrusion Nucleus comes out of disc but still attached to it.
    STAGE 3 Disc: Extrusion Nucleus Comes out but attached by a thin base to the main disc
    STAGE 4 Disc: Sequestration – Disc bursts and its small fragments start pressing the nerves Lead to severe pain. Requires Surgery


    Q.WHY IS THE PAIN NOTICED IN THE LEG, WHEN THE DISC HAS ACTUALLY SLIPPED OUT IN THE SPINE?

    The nerve which supplies the buttock, thighs, leg, calf and foot starts from the spine. So, if there is some pressure at the starting point, there will be pain in the region where the nerve travels and supplies.


    Q.IS THERE ANY NONSURGICAL TREATMENT FOR SCIATICA?

    90 % of such cases get better by bed rest and medicines.

    During the acute period of sciatica, complete bed rest is helpful. This Includes 23 hours/day of bed rest. During this RESTING PERIOD you are allowed to get up from the bed to use the washroom only with the L S belt. Among all the positions; sleeping, sitting, standing and walking, the load on the spine is least in the sleeping position.


    Q.HOW SHOULD YOU SLEEP?

    You should sleep on your side, either right or left, whichever is comfortable, with a pillow in between your legs.

    Q.WHAT KIND OF BED SHOULD YOU SLEEP ON?

    A FIRM mattress is ideal!!! No need to sleep on hard beds, nor you need “spine-friendly” expensive mattresses sold out in the market.

    Painkillers will be prescribed to allow a smoother and easier return to normal function. In addition,, you may also be prescribed muscle relaxants so as to relax and soothe your back muscles. This is so because whenever you have neck or back pain, your muscles tend to go into spasm (contraction) and hence, lead to pain. It is essential to break this spasm with a muscle relaxant so as to give effective pain relief.

    After pain relief, you will have to do physiotherapy as spinal exercises.

    You would need to have some activity restrictions to help your spine get back into shape and stay that way!! You would not be allowed to bend forwards; sit on the floor; lift weights; travel (particularly not on 2 and 3 wheelers). These restrictions would be generally enforced for a minimum period of about one month.


    Q.WHEN IS SURGERY ESSENTIAL?

    Surgery would be indicated when >  There is no pain relief despite symptomatic treatment as mentioned above

    >  when there is significant leg weakness

    >  repeated attacks of sciatica so as to get a permanent solution to the problem

    >  there is difficulty in passing urine or stools/motions.


    Q.WHAT IS THE NATURE OF SURGERY?

    Minimally Invasive Discectomy is the usual surgery for sciatica. This is a surgery performed through a very small incision (2 cm).


    IS IT A MAJOR SURGERY? WHAT ARE THE RISKS INVOLVED?

    Everything in life carries some small risk associated with it. The option for surgery would be offered only if the benefits of surgery are more than the risks. Rather than asking as to what are the risks of going in for surgery, it would be more logical to ask as to what are the risks and benefits of getting the surgery done as compared to not getting the surgery done?

    Spine surgery has had a lot of advances in the past decade or two; there are better imaging facilities like MRI, better surgical instruments to further increase the safety level of surgery, better training and information in an overall sense making spine surgery no longer the taboo that it once was! So, if you have a problem that genuinely requires surgery, there is no point in tying yourself down to the bed for days or months on end.


    Q.CAN WE NOT REPLACE THE DISC BACK INTO ITS PLACE; IN OTHER WORDS, WON'T IT BE HARMFUL TO REMOVE THE DISC?

    The disc that has slipped out can no longer carry out its normal function; rather, it is causing harm to the body rather than doing anything good! So, trying to replace the disc back into its position is not a viable option.


    Q.WILL I BE ABLE TO RETURN BACK TO WORK AFTER THE SURGERY?

    Though you would be up and about, walking about within the first 2 days following the surgery, you would be allowed only limited mobilization within the house in the first one month following surgery. Thereafter, if you are having a sedentary light job, then you may be allowed to resume work, provided you do not have to travel for a prolonged time on some bumpy road(s).

    If you were having some job that required some moderate labor, you would be allowed to resume work about 3 months after surgery.




  • When to show to spine specialist?

    >  You have back pain for more than 3 months.

    >  You have pain radiating in the Leg (Sciatica) for more than 6 weeks.

    >  If you have numbness or weakness in one or both legs for more than 3 weeks.

    >  Pain & Numbness/Weakness has not improved with rest/physiotherapy for 3 weeks.

    >  Pain awakens you from sleep.

    >  You are finding it difficult to pass Urine or Stool.