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Different methods to treat Disc problems
Hello friends, I am Dr Gaurav Khera. I am an orthopaedic surgeon, doing joint replacements and spine surgeries at the Access healthcare. Now today I will be talking about the lumbar degenerative disc disease. Now it sounds very big, but it is not as complicated as it sounds. It basically is what you people commonly know as a disc disease. So it is a fairly common problem that is seen in our population today. In fact about 30 or 40% of the patients who come to our OPD have lower back pains, some have other disc problems and very commonly seen after 40 years of age and this incidence gradually increases up to 60-70 years of age. The other ecological factors which are associated with this are, first of all smoking, secondly it is, mild to moderate trauma, thirdly its seen in people who lift heavy weights, fourth is obesity, especially central obesity, that is if you have a very heavy waistline.
Now what is Lumbar degenerative disc disease? Now, our spine is composed of multiple bones, which are starting from your neck and they come all the way down to your hip, divided into the cervical, dorsal, lumbar and sacral spine. And between these bones, there are these small pieces of discs, which act as cushions. When your body walks, these act as shock absorbers between your body’s bones. Now this discs, when these come out of their normal place, it gives or presses against the nerves which are passing through these areas and it causes pain. This is what happens in the disc disease. Basically, in the patient it will come as a lower back pain, and this pain will be travelling down to the hip, and it will also be coming down to the legs. Some people complain that as they walk, the pain increases.
They also complain of tingling numbness. They complain that sometimes their fingers or their toes are feeling numb. These are some of the very common symptoms which are being seen. Few people may have only lower back pain, and these are the people who do not have very significant disc disease. Now there are two main causes of the disc disease. First is an inflammatory reaction that occurs in the disc, and second is the micro motion instabilities that occur. Inflammatory reactions may occur as a result of some small traumas which may occur such as when you may injure your back. Such inflammatory reactions occur in the form of small swellings in the body. And micro motion instabilities are when the body ages, the disc which has an outer fibrous thick layer, that degenerates, and as it degenerates, the pulp which is there at the centre, of the discs, tends to degenerate. What I mean is it comes out of its normal space. And as it comes out of the normal place, it comes and tends to press on the nerves and these are the two most common causes.
All disc patients are not to be operated. When we get these patients, the first and foremost investigation that we do is a X-Ray. And if required, we go in for a MRI. Frankly MRI is the known standard to diagnose the disc disease. The findings of a MRI are always coordinated with the clinical findings. Once we have diagnosed that it is a disc problem, we have to establish that what the compression on the nerves is. If the nerve compression is a lot, and if we think that we cannot do anything other than surgery, then we take the patient for a surgery.
If not, we take the patient fro physiotherapy, lifestyle changes and few medications. These medications may carry on for few weeks to few months. And a lot of exercise has to be carried on regularly. Lifestyle changes such as weight loss, stoppage of smoking is very important. And if you can achieve this, then your problems are very easily solved. If you have any queries regarding your disc problems or back pains, then you can get in touch with me for the same.
You can reach me in my clinic, which is there in Indrapuri, by the name of Dr Khera’s Wellness Clinic or you can also contact me through Lybrate for the same. Thank You.
I am 54 year old male having MRI [LS-SPINE]. Finding Reveal Annular Tear, circumferential Disc Bulge With Small Posterocentral Protrusion at L4-L5 level, Causing No Significant Neural Compression Or Canal Stenosis" I have no pain anywhere since 5 months only difficulty in standing or on walking without pain. Become tired for few seconds, then start again walking. Ortho. Says no need to worry it will heal naturally. Spine Surgeon says need of "DISC FIX" treatment required. Getting confuse. WHAT TO DO.'
I have diagnosed with infiltrating ductal carcinoma, NOS, in right breast (in biopsy report, triple negative (ER-negative, PR-NEGATIVE, HER 2-NEGATIVE). The tumor measures 4 cm* 3 cm mammographically. After giving 3 no. Of chemo My doctor suggest me for modified radical mastectomy. Please tell me if I go for complete breast removal & subsequent chemotherapy Radiotherapy is must or optional?
Herniated disk l3-14 mm L4-11 mm L5-10 mm S1-8 mm My age 23 /M Dr. suggest for surgery but I didn't want that any chances for normal.
Cerebral ischaemia or brain ischemia is a medical condition that restricts the flow of blood to the brain, resulting in an unmet metabolic demand. This leads to limited oxygen supply in the brain, which could result in death of brain tissues, cerebral infarction or an ischemic stroke. Thus, a cardiorespiratory arrest, a stroke, and irreversible brain damage are few possible consequences of cerebral ischaemia.
People with compressed blood vessels, low blood pressure, congenital heart defects or sickle cell anaemia have a high risk of developing cerebral ischaemia, since compressed blood vessels or very low pressure can lead to restricted blood flow. Also, sickle-shaped cells have a greater tendency to clot, causing obstructed blood flow.
Patients with cerebral ischaemia experience a host of symptoms, such as weakness in the body, problems in coordination and movement, vision and speech impairment and unconsciousness.
Cerebral congestion, on the other hand, refers to excessive quantity of blood in the brain vessels, causing pressure on the cerebral substance. Cerebral congestion is of two types. It is termed as active when there is too much arterial blood flow and passive when there is undue quantity of venous blood in the veins of the brain. Both conditions cause symptoms, such as severe headache, insomnia, irritability and unconsciousness. The patient gets little sleep and is disturbed, often followed by dreams. When awake, the patient’s mental activity in the brain is very high.
Homeopathy is now a well-established school of medicine backed with years of research and practice. Gone are the days when homeopathy was considered no more than an extension of herbal home remedies. Homeopathic laboratories around the world produce large number of medicines covering almost all ailments. The benefits of homeopathic treatment are now well established due to its holistic approach and minimal side effects. Homeopathy is undoubtedly a ray of hope for patients with cerebral ischaemia and cerebral congestion, as it delivers a comprehensive treatment plan designed to target the signs and symptoms of the disease and address its non-occurrence.
The medications deal with mild to severe symptoms, including inflammation of the brain, headache, vomiting, insomnia, stroke/convulsions and seizures. The stramonium drug, for example, deals with seizures. Belladonna is an effective remedy for sharp shooting headaches, a common symptom of cerebral congestion. Ferrum is believed to be a valuable remedy for brain ischaemia. Few drugs deal with the symptoms of both ischaemia and congestion—nux is a suitable drug for the treatment of ischaemia as well as for passive cerebral congestion. Similarly, phosphorus can be used to treat brain ischaemia and congestion. Zincum metallicum is a highly recommended drug for chronic cases of ischaemia.
The treatment is comprehensive and long term and shows substantive results. Regular follow-ups and consultation with a homeopath specialist is the key to an effective treatment.
My rt. Breast surgery for breast cancer had done and presently from last 3-4 months rt. Hand and full arm are swelling.
I am male 39 I have a problem of obesity combined with disk problem. If to reduce tummy I go for walk the backache develops. If I take rest for improving disk problem then tummy gets large. Suggest solution.
I have L5-S1 disc extrusion condition from a year resulting in severe pain in the right leg. Is surgery the only solution?
I am 33 years old, I have backache from last 1 year, x ray indicate there is borderline slip disk, what kind of precaution can I take for future?
Spine surgeries are complicated and have serious repercussions if the procedure doesn’t go as planned. Probing your doctor is therefore very critical to ensure a safe operation and early post-op recovery. Questions can range from the type of treatment chosen for speedy recovery to side effects. Here is a list of questions that you need to ask your spine surgeon:
1. Why is the surgery recommended?
Typically, there could be more than one treatment option for a particular problem. Your doctor should be able to tell you very precisely as to why the surgery is recommended and how it is going to address the problem.
2. Is there any non-surgical option?
Many spine related issues can be treated with medicines and physiotherapy. Ask your doctor if such options exist.
3. Explain the surgical procedure in detail
Your doctor should explain the whole surgical procedure, explaining the minute details and help will help you to understand the implications.
4. What is the duration of the surgery?
Spine surgeries do not take more than 2 hours. It, however, depends on the procedure that is being performed.
5. How will the surgery address the pain?
It is important to know the source of the pain. Exploratory surgeries are not performed on the spine. Ask your doctor how he intends to address the pain through the surgery.
6. What are the risks involved?
Risks and side effects vary from patient to patient. For instance, a person with obesity, spondylitis and smoking has greater chances of complications associated with the operation.
7. Will the doctor perform the whole procedure or he will use practicing surgeons and intern for the job?
Many senior surgeons use interns and junior surgeons to perform a minor procedure. Get a clear understanding of the role of the doctor and his assistants. It is a good idea to know the background if the surgical team who is going to perform the procedure.
8. What is the success rate of the doctor for the procedure he is going to perform?
A successful spine surgeon should be able to give you valid data on his/her success rate and the overall success rate of surgeons all across the country.
9. How many days do you need to spend in hospital?
Your hospital stay is directly related to your insurance. It is essential to get a clear picture on the same.
11. What is the time required for recovery?
The recovery greatly varies from patient to patient. What you should ask your Doctor is the expected time required for you to join your job/school.
12. Will there be any physical limitation after the operations?
Many spine surgeries require you to refrain from strenuous jobs for a while. For instance, certain surgeries require you to stay away from driving for a while. Address all these apprehensions from your doctor.
Herniated disks or bone spurs in the vertebrae of the neck may become the reason behind severe neck pain. They sometimes take too much space and compress the nerves branching out from the spinal cord.
I am a 25 years old male, I have been suffering from bulging disk at l5-s1. I have been resting for 2 months, now my neck has started paining too and left pelvic joint is making popping sound everytime it is bend. So I got my blood acid checked. And its been 8 for last two months, I have been drinking like 6 lts water everyday. Is uric acid main reason of pain? And how can I get it down as I don't want to start the medicine so early in life and drinking water is not working. Please suggest, my career is suffering a lot.
The uterus or womb, is a muscular structure and is held in place by ligaments and pelvic muscles. If these muscles or tendons become weak, they cause prolapse and are no longer able to hold the uterus in its place.
Uterine prolapse happens when the uterus falls or slips from its ordinary position and into the vagina or birth waterway. It could be complete prolapse or even incomplete at times. A fragmented prolapse happens when the uterus is just hanging into the vagina. A complete prolapse depicts a circumstance in which the uterus falls so far down that some tissue rests outside of the vagina. Likewise, as a lady ages and with a loss of the hormone estrogen, her uterus can drop into the vaginal canal. This condition is known as a prolapsed uterus.
Risks: The risks of this condition are many and have been enumerated as follows:
- Complicated delivery during pregnancy
- Weak pelvic muscle
- Loss of tissue after menopause and loss of common estrogen
- Expanded weight in the stomach area, for example, endless cough, constipation, pelvic tumors or accumulation of liquid in the guts
- Being overweight
- Obesity causing extra strain on the muscles
- Real surgery in the pelvic zone
Symptoms: Some of the most common symptoms of prolapse involve:
- Feeling of sitting on a ball
- Abnormal vaginal bleeding
- Increase in discharge
- Problems while performing sexual intercourse
- Seeing the uterus coming out of the vagina
- A pulling or full feeling in the pelvis
- Bladder infections
Nonsurgical medications include:
- Losing weight and getting in shape to take stress off of pelvic structures
- Maintaining a distance from truly difficult work
- Doing Kegel workouts, which are pelvic floor practices that strengthen the vaginal muscles. This can be done at any time, even while sitting down at a desk.
- Taking estrogen treatment especially during menopause
- Wearing a pessary, which is a gadget embedded into the vagina that fits under the cervix and pushes up to settle the uterus and cervix
- Indulging in normal physical activity
Some specialists use the following methods to diagnose the problem:
- The specialist will examine you in standing position keeping in mind you are resting and request that you to cough or strain to build the weight in your abdomen.
- Particular conditions, for example, ureteral block because of complete prolapse, may require an intravenous pyelogram (IVP) or renal sonography. Color is infused into your vein, and an X-ray is used to view the flow of color through your urinary bladder.
- An ultrasound might be utilised to rule out any other existing pelvic issues. In this test, a wand is used on your stomach area or embedded into your vagina to create images of the internal organ with sound waves.
Breast cancer(स्तन कैंसर) is on the rise in india. Surveys show that every 4 out of 5 Indian women who have breast cancer, suffer from an advanced stage of the disease by the time they reach the doctor. Urban women are at two times more risk of being diagnosed with breast cancer than rural women. Being overweight, eating unhealthy food, and consuming excessive alcohol or tobacco are some of causes that can make you susceptible to this disease.
How you can avoid breast cancer?
- Every woman should do a self-breast examination every month after the periods. You should check for any abnormal lump, change in skin texture or any abnormal discharge from the nipples. Any abnormality above aspects should be promptly investigated by a doctor's appointment, and an ultrasound or Mammography, as required.
- Apart from self-examining your breasts every month for a lump, going for a mammography (an X-Ray of the breast) is vital for early detection of the problem.
- Consult a gynaecologist before going for the test as its frequency depends on your age and risk factor. About 80-90% of tumours can be traced through this screening.
Breast cancer may run in family. If there is no family history of breast cancer, you start doing mammogram at 40 yrs of age but if there is a family history you start even earlier as advised by your gynaecologist.
जिगर शरीर में सबसे बड़ा ग्रंथियों वाला अंग है और शरीर को विषाक्त पदार्थों और हानिकारक पदार्थों से मुक्त रखने के लिए विभिन्न महत्वपूर्ण कार्य करता है। पेट के दाहिने ऊपरी चतुर्भुज मंर स्थित है, पसलियों के ठीक नीचे। लिवर पित्त के उत्पादन के लिए जिम्मेदार है, जो एक पदार्थ है जो आपको वसा, विटामिन, और अन्य पोषक तत्वों को पचाने में मदद करता है। यह ग्लूकोज जैसे पोषक तत्वों को भी स्टोर करता है और दवाओं और विषाक्त पदार्थों को तोड़ता है।
लिवर कैंसर, जिसे हेपेटिक कैंसर भी कहा जाता है, एक कैंसर होता है जो लिवर में शुरू होता है। जब कैंसर लिवर में विकसित होता है, तो यह लिवर कोशिकाओं को नष्ट कर देता है और सामान्य रूप से कार्य करने के लिए लिवर की क्षमता में दखल देता है। लिवर कैंसर के दो प्रकार होते हैं। प्राथमिक लिवर कैंसर, जो लिवर की कोशिकाओं में शुरू होता है। जबकि, कैंसर जो कि कहीं और से शुरू होता है और अंततः जिगर तक पहुंच जाता है, उन्हें जिगर मेटास्टेसिस या द्वितीयक लिवर कैंसर कहा जाता है।
प्राथमिक लिवर कैंसर के विभिन्न प्रकार
विभिन्न प्रकार के प्राथमिक लिवर कैंसर लिवर के विभिन्न कोशिकाओं से उत्पन्न होते हैं। प्राथमिक लिवर कैंसर लिवर में एक गांठ के रूप में, या एक ही समय में लिवर के भीतर कई स्थानों में शुरू हो सकता है।
1. हेपैटोसेलुलर हेपैटोसेलुलर:
हेपेटोसेल्यूलर कार्सिनोमा (एच.सी.सी), जिसे हेपेटामा भी कहा जाता है, सबसे सामान्य प्रकार का लिवर कैंसर है। एचसीसी मुख्य प्रकार के लिवर कोशिकाओं में शुरू होता है, जिसे हेपोटोसेल्यूलर कोशिका कहा जाता है। एचसीसी के अधिकांश मामले हेपेटाइटिस बी या सी, या शराब के कारण जिगर के सिरोसिस के संक्रमण का नतीजा है।
2. फाइब्रोलैमेलर एचसीसी:
फाइब्रोलामेरेलर एचसीसी एक रेअर प्रकार का एचसीसी है, जो आम तौर पर अन्य प्रकार के लिवर कैंसर की तुलना में उपचार के लिए अधिक संवेदनशील होता है।
कोलेंजियोकार्सिनोमा, जिसे आमतौर पर पित्त नली के कैंसर के रूप में जाना जाता है, लिवर में छोटे, ट्यूब जैसे पित्त नलिकाओं में विकसित होता है। पाचन में मदद करने के लिए, ये नलिकाएं पित्ताशय में पित्त को ले जाने के लिए जिम्मेदार हैं। जब कैंसर लिवर के अंदर नलिकाएं के खंड में शुरू होता है, तो इसे इंट्राहेपेटिक पित्त नलिका कैंसर कहा जाता है। यद्यपि, जब लिवर के बाहर नलिकाओं के अनुभाग में कैंसर शुरू होता है, तो एक्स्ट्राहेपाटिक पित्त वाहिका कैंसर कहलाता है।
एंजियोनेसकोमा लिवर कैंसर का एक रेअर प्रकार है जो लिवर के रक्त वाहिकाओं से शुरू होता है। इस प्रकार का कैंसर बहुत तेज़ी से प्रगति करता है, इसलिए यह आमतौर पर एक और अधिक उन्नत चरण में डिटेक्ट किया जाता है।
हेपोटोब्लास्टोमा एक अत्यंत असामान्य प्रकार का लिवर कैंसर है।
लिवर कैंसर के लक्षण
ज्यादातर लोगों के प्राथमिक जिगर कैंसर के शुरुआती चरणों में लक्षण नहीं होते। जिसके परिणामस्वरूप, लिवर कैंसर बहुत देर से डिटेक्ट किया जाता है। लिवर कैंसर के लक्षणों में शामिल हैं:
- भूख में कमी
- वजन घटना
- एबडोमीनल पेन
- मतली और उल्टी
- सामान्य खुजली
- हेपटेमेगाली (बढ़े हुए जिगर)
- बढ़े हुए स्प्लीन
चूंकि लिवर कैंसर के लिए कोई व्यापक रूप से अनुशंसित नियमित स्क्रीनिंग टेस्ट नहीं हैं, इसलिये बीमारी के परिवार के या अन्य जोखिम कारकों के इतिहास वाले लोगों को उनके डॉक्टर से बात करनी चाहिए ताकि वे अपने जोखिम को मॉनिटर करने या कम करने के लिए सही कदम उठा सकें।
लिवर कैंसर के जोखिम कारक
प्राथमिक लिवर कैंसर के खतरे को बढ़ाने वाले कारकों में शामिल हैं:
- उपचय स्टेरॉयड्स
- कम प्रतिरक्षा और मोटापा
I am an advocate and have got sitting job for long hours and walking job too. I am suffer from slip disc. Any treatment?
Hello, I have very much pain in L5 S1 spine from last 2 months. MRI report says: "Annular tear of l5-s1 disc with diffuse posterior bulge, central & right para central prolapse & mild inferior migration of the prolapsed fragment causing compression of right exiting nerve root. Please suggest me what I do? Pain is very much. Should I go for surgery or any other option available. If surgery then how much time time required to recover & what is accuracy of surgery treatment. Thank you.
I have back pain L4. L5 problem fast in 5 years. I want to reduce pain with out operation is possible. Please Inform
Are you experiencing excruciating headache? you probably didn't know but you could be suffering from brain aneurysms. It is described as bulge formation in the blood vessel in the brain. It is a totally asymptomatic condition as one does not display any symptoms until the bulge vessel ruptures which may result in blood releasing in the skull which may further lead to a stroke. The bulge is often formed in the gaps between the tissues covering the brain and brain itself.
Most common treatment options for ruptured aneurysm
There are two common treatment options for a ruptured brain aneurysm endovascular coiling and surgical clipping. Both these procedures have certain risk factors, therefore it is best to discuss the details with a neurologist. The endovascular coiling is a less invasive process where the surgeon inserts a hollow tube or catheter into an artery and threads it through the body to reach an aneurysm. Then a guide wire is sent to push a soft platinum wire through the catheter. This coils up and disrupts the flow of blood into the aneurysm and leads to blood clotting. The clotting is essential in sealing off the aneurysm from the artery.
The surgical clipping is a process used for closing off the aneurysm, and a section of the skull is required to be removed for assessing the affected part. It also helps in locating the blood vessel that is responsible for the problem. Finally, a metal clip is placed on the neck of the aneurysm to stop the flow of blood. Though endovascular coiling is less invasive and said to be safer, adequate post-treatment care is necessary to minimize risks.
To treat larger aneurysms, a treatment called flow diverters may be useful. Since, the treatment is decided based on the size, location, apperance and your health condition, your doctor will be the best person to take the final call.
Other procedures to treat symptoms
Other than the surgical procedures several treatments might be prescribed to treat the symptoms and to manage complications. A few commonly advised treatments are:
- Pain relievers: To manage headaches
- Calcium channel blockers: One of the most common complications that may arise with an aneurysm is calcium entering the walls of blood vessels which may result in narrowing of walls. Calcium channel blockers are medications may be prescribed by the doctors to deal with the complication
- Anti seizure medications: Medications such as levetiracetam, phenytoin, valproic acid, and others are prescribed to treat seizures associated with aneurysms
- Procedures to prevent stroke: An insufficient blood flow may result in a stroke and to prevent it, the drug vasopressor is injected intravenously, or angioplasty is performed.
- Rehabilitative therapy: Damage to the brain may require the patient to undergo several physical and occupational therapy.
If you suffer from the condition, it is advised to keep a check on the blood pressure and quit smoking as they can help in reducing the risks associated with aneurysms.
In case you have a concern or query you can always consult an expert & get answers to your questions!