Lumbar Disc Prolapse (Herniated Disc) Treatment in Delhi, India

• Leg pain: It is typically worse than lower back pain. If the pain radiates along the path of the large sciatic nerve in the back of the leg, it is referred to as sciatica or radiculopathy.
• Nerve pain: Usually described as nerve pain in the leg, with the pain being described as searing, sharp, electric, radiating, or piercing.
• Variable location of symptoms: Depending on variables such as where the disc herniates and the degree of herniation, symptoms may be experienced in the low back, buttock, front or back of the thigh, the calf, foot and/or toes, and typically affects just one side of the body.
• Neurological symptoms: Numbness, a pins-and-needles feeling, weakness, and/or tingling may be experienced in the leg, foot, and/or toes.
• Foot drop: Difficulty lifting the foot when walking or standing on the ball of the foot.
• Lower back pain: Described as dull or throbbing and may be accompanied by stiffness.
• Pain that worsens with movement: Pain may follow prolonged standing or sitting, or after walking even a short distance. A laugh, sneeze, or other sudden action may also intensify the pain.
• Pain that worsens from hunching forward: Includes positions such as slouching, hunching forward or bending forward at the waist.
• Cauda Equina Syndrome: It is a loss of bladder or bowel control, lower back pain, numbness in the perineal region, and/or weakness in both legs. This can lead to pressure and swelling of the nerves at the end of the spinal column.
  

Lumbar disc prolapse is caused by the following factors:

• Age: The most common risk factor is being between the ages of 35 and 50.
• Gender: Men have roughly twice the risk compared with women.
• Obesity
• Smoking

• Neurological Check: The patient may be asked to walk normally and on tiptoes to check for a condition called foot drop, in which the muscles used to flex the ankles and toes are weakened. Muscle strength and reflexes in other areas are also likely to be checked.
• Leg Raise Test: One familiar stretch to test for a herniated disc is the straight leg raise or LaSegue test. For this test, the patient lies down flat on the back, and the doctor gently raises the affected leg until the pain is felt. If pain occurs when the leg is raised at a 30- to a 60-degree angle, it is considered a sign of lumbar disc herniation. If raising the unaffected leg hurts the affected, it also indicates that a nerve root is impinged or irritated.
• Gait Monitoring: The doctor will observe whether the patient appears to be walking slowly due to pain, or with an abnormal gait.
• Lumbar Spine Area Exam: If there is inflammation in the lumbar spine, the skin may appear abnormal or sensitive to touch.
• X-Rays: These are mainly used to rule out problems such as a broken bone, bone abnormalities, infection, tumour, or alignment of the spine.

Surgery may be recommended if the patient experiences:

• Severe pain and is having difficulty maintaining a reasonable level of daily functions, such as standing or walking.
• Progressive neurological symptoms, such as worsening leg weakness. and/or numbness.
• Loss of bowel and bladder functions.
• Pain even after taking medication, physical therapy, and/or undergoing other nonsurgical treatments.

Max Institute of Musculoskeletal Sciences offers a spectrum of treatment options for a lumbar herniated disc. These are as follows:

Initial Pain Control

Controlling the intense pain is the most urgent need when herniated disc symptoms first appear. Our initial pain control options for emergency cases include: 

• Ice application
• Heat therapy
• Pain medications
• Muscle relaxants
• Admitting the patient for bed rest

Surgery

Surgery for a lumbar herniated disc has a high rate of success. One extensive medical study reported good or excellent results for 84-90% of those having a microdiscectomy.

• Microdiscectomy: A minimally invasive procedure that is commonly recommended for lumbar herniated discs. Small incisions are used in a microdiscectomy. The procedure takes the pressure off the nerve root and provides a better healing environment for the disc. Usually, only the small portion of the disc that is pushing against the nerve root needs to be removed, and the majority of the disc remains intact. Most patients can return to their regular routines in one week.
• Kyphoplasty (Cement surgery): It is a minimally invasive procedure that is used to treat the fractures of the spine. In kyphoplasty, first, a balloon is inserted and is then inflated in order to expand the compressed vertebra, before filling the space with some bone cement. The procedure is repeated for each affected vertebra. The cement-strengthened vertebra now allows the patient to stand straight, reduces the pain, and prevents further fractures.

Therapy

• Physical Therapy: It involves targeted stretching and exercises for rehabilitation. It helps the patient safely perform ordinary activities, such as lifting and walking.
• Medicational Therapy: Epidural injections of steroid medications can offer pain relief in some cases.
• Massage Therapy: It can ease back pain by increasing blood circulation, relaxing muscles and releasing the body's natural pain relievers, called endorphins.

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