Dr. Sanjivni Khanna

The spine lends structural stability and balance to our body helping us stand upright, while allowing flexibility in various movements. Moreover, it forms a protective canal in which the spinal cord, the most important part of the neural network, flows down from the brain to the rest of our body. The spinal column is an interconnected structure of bony (vertebrae) and cartilage tissues (intervertebral discs) and it is prone to age related wear and tear. Read through to learn more about a herniated disc, its manifestations and treatment options, with special reference to a minimally invasive surgical technique called endoscopic discectomy.

What is a herniated disc?

First, let’s understand an intervertebral disc. It is essentially a disc shaped, rubber like tough and flexible structure made of outer layers of fibrous cartilage with a softer gel like tissue in the centre. A disc lies between two adjoining vertebral bones of the spine and acts as a shock absorber. This disc undergoes wear and tear changes (degeneration) after a certain age. When the degenerated disc is subjected to any external strain or injury, the substance from the central part of the disc comes out through the tears in the outer fibrous layers. This condition is called a herniated disc. It is also referred to as prolapsed or slipped disc. A disc prolapse can occur in any part of the vertebral column; but, mostly observed in the lumbar (lower back) or in cervical (neck) region.

What happens when an intervertebral disc herniates?

When the inner disc material protrudes through the disc surface, it may pinch or irritate the nerve roots it comes in contact with. It also elicits a severe inflammatory chemical response in that area. If this happens in the lumbar spine, it induces symptoms such as:

Pain in the back, pain running down the leg, weakness of the muscles in the leg supplied by the affected nerve root, numbness or tingling sensation in the respective part of the leg. Loss of bladder and bowel control if a large disc prolapse compresses multiple nerve roots.

If you feel recurring radiating pain in any of the body parts, it would be a good call to see a spine specialist.

What causes disc herniation?

Disc herniation happens as a result of degeneration that is mostly related to the genetic composition of the person. Smoking is another well established factor that causes disc degeneration. Other factors also play a role in the process of wear and tear of the discs. Though the exact reason is hard to pick, disc herniation may be precipitated by strain on the spine during physical work, certain kind of frequent body movements or spinal injury due to any accident. Sometimes adopting improper body posture for physically demanding jobs of time may result in this condition.

What are the treatment options for herniated disc condition?

Most cases of disc herniation can be treated medically with rest, pain relievers, anti-inflammatory medication and physiotherapy. But, if the symptoms persist or the pain is severe or if it is affecting the nerve function causing numbness and weakness, it needs surgical intervention.

Minimally invasive (endoscopic) spine surgery

Spine surgery is generally adopted as the last resort to treat painful disc prolapse that do not respond to medication for a longer period (usually 3 months). Rarely, a severe nerve compression causing weakness of muscles or severe sciatica may need surgical treatment straight away. Conventional open surgery involves cutting the muscles and removing some portion of bone in the spine, which has its own complications and disadvantages. But, the advent of high definition image guided systems and surgical tools, now-a-days spine surgery for herniated discs can be done with minimal invasion.

Endoscopic discectomy for herniated disc is a minimally invasive spine surgery carried out through a small on the back. It involves removal of herniated disc material that protrudes and compresses the adjacent nerve roots, through specially designed spine endoscopes that help in clear visualization of the structures. Instead of cutting the muscles in an open surgery, endoscopic surgery involves dilation of the muscles causing much less damage and procedure related pain. It can also be performed under local anesthesia as a day care procedure in suitable patients.

Don't 4 - 4. Don't drink alcohol
Alcohol may greatly impact your baby's development. Women who drink alcohol while pregnant could deliver a baby with fetal alcohol syndrome (fas). Symptoms of fas include low birth weight, learning disabilities, behavior problems, and lagging patterns in terms of growth and development milestones

Do you often feel lethargic and tired? Has your partner been complaining about your not so great performance in bed? Are you not enjoying your sex life life off late? If yes, then you need to think about your behavior as the resons for such a behavior could be many. Well with some basic tips you can certainly add zing to your life.

Here are some sex positions that you can try to make yourself relaxed and lithe, enabling your body to function properly.

1. Squat pose: This yoga position works by improving your pelvic joints and targets your inner thigh muscles, abdominals, and your pelvic floor. The pose is also found to be beneficial in stimulating your spleen and sex glands (gonad). For this, you need to stand with your feet wide apart and your toes facing outward. Join your palms together in front of your heart, and slowly bring them down in the direction of the mat, stopping just before you touch the floor. Position your biceps behind your knees so that they are spread out while helping your spine to maintain its stretched position.
2. Chair pose: In this pose, your pelvic region is targeted and helps you to establish a better control over your sexual organs. It works by lifting your pelvic floor as you go about lowering your tailbone. Begin by bringing your feet together before assuming a sitting position. Keep your tailbone stretched when you lift your pelvic floor to stretch the spine.

You can also try some foods to rev up your sex life:

1. Almonds: Almonds have always been associated as stimulants. They are rich in nutrients and other minerals that help in boosting your sexual health and also aid in the process of reproduction.
2. Strawberries: They not only look delicious, but are rich in folic acid, one that keeps away birth defects in women.
3. Figs: Though this fruit may look funny, they serve as excellent aphrodisiacs and boost fertility. Filled with both soluble and insoluble fiber, they are equally beneficial for the heart.
4. Citrus: Apart from its excellent taste, this fruit is rich in with vitamin C, antioxidants and folic acid, which help in the reproductive health of men.
5. Spinach: This green vegetable is filled with plenty of advantages, but it is also beneficial for the bedroom. It reduces exhaustion and fatigue and provides the much needed energy.

Sexuality for both males and females is a complicated and often much misunderstood phenomena.

For males, research seems to indicate that premature ejaculation (PE) as well as erectile dysfunction (ED) are major causes of worry. Here is a common question that is frequently asked:

Are PE and ED serious conditions?

Interpreting these 'symptoms' is best done judiciously. ED is often a situational and perhaps a 'matching' issue. To put simply, this means that the male partner is anxious-about himself or about the desirability, correctness, environment or the reasons behind the anticipated event. Does this make the condition serious? That is best assessed by BOTH partners! PE is similar in the context described previously.

However, sometimes especially ED can be due to medications being consumed or due to some physical aberration like diabetes or hypertension. There are several medical and surgical conditions which might lead to ED and these always need to be adequately investigated and ruled out or treated. So in the approach to ED, keeping both 'situational' and medical/surgical factors in mind is always prudent, both for the sufferer as well as the physician.