The inter-vertebral discs are protective cushion-like shock-absorbing pads between the two bones of the spine called vertebrae. These discs are soft gel filled pads bounded by few layers of membrane called lamella. These discs do not actually “slip,” they may split or ruptured (Slipped Disc is a misnomer). Following this rupture the gel escape’s into the surrounding tissue. The leaking jellylike substance can produce pressure on the spinal cord or on a single nerve root and cause pain either around the damaged disc or anywhere along the area controlled by that nerve. These conditions are also known as a herniated disc, ruptured disc, prolapsed disc, or more commonly, slip disc or slipped disc.
Symptoms of Back Pain
- Patient complains of severe back pain and lower limb pain.
- Pain mainly on walking and standing.
- MRI will show disc bulging and compressing on nerve roots.
- Frequently electric shock-like pain or burning pain associated with some numbness, tingling sensations and sometime some muscle weakness.
Treatment of back pain
- Interventional procedures.
We perform –
a.Transforaminal epidural injection of local anesthetic and steroid methylprednisolone or triamcinolone) to reduce the irritation of the nerve root by the disc (either a mechanical pressure or from the chemicals released from the disc)
b.Caudal epidural injections.
c.Intramuscular stimulation (IMS). Whatever may be pain generator (disc facet etc), muscle spasm is always associated with pain. The muscles go into spasm with any insult which is initially painless and later becomes a painful spasm. This spasm can increase the nerve irritation. IMS of the muscles of back and legs has the potential to completely resolve this problem of paraspinal muscle spasm.d.Physical therapy: Physiotherapy plays an important role in pain management. It is an essential adjunct to the nerve block and IMS. After pain is relieved, physiotherapy will help in strengthening back muscles to have a long term relief