Sciatica

A prolapsed disc is a condition which can present in various forms such as bulging, protrusion, extrusion and sequestered. These terms are used interchangeably depending upon the severity to indicate intervertebral disc has leaked out into the spinal canal leading to compression on the nerves. The prolapsed disc can occur at any level but is more common at cervical and lumbar level.

Causes

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Most common cause of prolapsed disc is a natural aging process. However, it is more commonly seen in patients with a history of lifting heavy weight, chronic tobacco chewing, chronic smoking, and obesity. With aging the water content in the disc begins to decrease, loses its natural flexibility becomes dehydrated and hence not able to sustain the pressure exerted on it. The dehydrated disc gets prolapsed leading to compression on the nerves. 

Common Symptoms

It is a condition in which patient presents with pain in low back/neck along with radiation to the lower/upper limb. The pain is because of compression of a nerve in the low back/neck, which lead to radiating pain along the particular nerve. The pain is also associated with other symptoms such as tingling and numbness, cramps and muscle weakness.
If the compression is severe patient may get bend on one side to relieve pressure on the nerves. In severe long standing, cases may lead to weakness in legs/arms. It may also lead to weakness of bladder and bowel leading to difficulty in passing urine and stools.

Treatment

The treatment of prolapsed disc varies according to the severity of the condition.
Conservative: Patients presenting with mild, on and off pain with the history of short duration can be considered for conservative management. These include analgesics and anti-inflammatory medication and physiotherapy exercises to develop good trunk stabilisation along with good aerobic fitness.
Surgical: Patients with severe pain in the back along with lower limb radiculopathy are candidates for surgery. The primary determining factors for surgery are pain leading to restricted lifestyle and failure of conservative management. Surgery helps to gets rid of the pain but in long term patients, life style modifications are necessary so as to prevent the recurrence of a disease. Surgery for prolapsed disc does not lead to paralysis. The surgical treatment delayed for long period affects the outcome of surgery.
The surgical treatment includes removal of pressure on the nerve which is done by either laminectomy or foraminotomy. The surgeries are done via endoscopic methods. All the patients are allowed to walk on the same day of surgery after 6 hours. The patient is discharged next day after the surgery. Hence the surgery for sciatica is a day care surgery in which the patient is mobilised and discharged in one day of surgery.
How to prevent sciatica:

We at Shanta spine institute believes in prevention is better than cure, so we keep our main emphasis on prevention of the disease more than the treatment. The main cause of prolapsed disc is lifting heavy weights, chronic tobacco chewing and chronic smoking and aging process and unhealthy lifestyle. So we aim to prevent the disease by certain lifestyle modifications which had to be followed regularly. This includes daily 1 hour of exercise, healthy diet which includes lots of fruits and salads, 4-5 litres of water daily and to maintain weight which is normal according to your height and age. The exercise program like swimming, yoga, walking jogging etc helps to develop core strength and allows us to maintain strength and flexibility of the spine. Apart from exercises, it is very important to take tobacco in any form. Lifestyle modifications such as quitting tobacco chewing, smoking cigarette and alcohol is also very important.

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