Centre for Joints, Spine & Childrens Orthopaedics

Hello,

My name is Dr. Madhur Mahna and I'm an orthopedic surgeon. Today we will discuss about one of the commonest problems which is encountered by a spine surgeon and an orthopedic surgeon, it is known as a prolapsed intervertebral disc. It is commonly known as a disc prolapse or a slip disc. To understand slip disc we first need to understand what a spine is exactly made of? our spine is made up of 31 such bones and in between those bones are these cartilaginous structures known as the disc or an intervertebral disc this is what the normal disc looks like and this is a disc which has been slipped or prolapsed looks like. A slip disc commonly occurs in young individuals especially young males because their discs are very well hydrated and they are thicker in size, while in old age that disc becomes much thinner and much more dehydrated.

The reason for a disc to slip is anything which increases the intra-abdominal pressure like lifting heavy weights or coughing or straining such as in conditions such as constipation etc. The patients commonly come with the excruciating pain in the back which travels down to the legs along the path of the nerve and they very commonly give a history of lifting heavy weight or a sudden jerk. The patient also typically complains that the pain worsens on coughing, straining or sneezing anything in which the patient has to apply strain on the abdominal muscles. The most common examination or most common investigation which we need to do to diagnose a prolapsed intervertebral disc is an MRI, an x-ray can not give you the complete picture of a prolapsed disc you have to do an MRI to diagnose a disc prolapse.

In 90% of cases, disc prolapse heals by rest and skeletal muscle relaxants and some heat and hot fomentation and some mild physiotherapy, but in around five to ten percent of cases surgery is required. In the surgery the part of the disc, this part of the disc which is impinging on the nerve which is hitting on the nerve, which is causing the pain which is radiating to the legs, this part of the disc is removed. Now the latest technology which has been developed in the treatment of a slipped disc is known as endoscopic surgery. In the endoscopic spine surgery we do not completely open the spine rather we put in an endoscope and directly view the disc and remove the disc which has been impinging on the on the nerve till the nerve has been completely cleared. The reason why I have discussed this particular problem today is because it is one of the commonest condition which we come across these days because we see many youngsters who joined the gym, they lift heavy weights, they do a lot of exercises and due to that many times they come up with the prolapsed disc and they are in severe pain.

So one thing which I would like to tell everybody through which they can prevent a slip disc is that they should always wear support while they are lifting heavy weights especially in the gym, especially while doing the exercises such as deadlift or even while doing a bench press or a dumbbell press because any strain on a young healthy disc can lead to a disc prolapse. Second is that we should always do regardless of the age of the patient right from a young age we should always do exercises to strengthen your back, especially many exercises, many asanas which we do in yoga right from a very young age we should start doing exercises to strengthen our back. Many postures or asanas in yoga they help strengthening the back because even when there is an increase in intra-abdominal pressure or intradiscal pressure, the muscles around the spine, they will protect the spine and they will protect the discs and they will protect you from a disc prolapse. So it is one of the most common conditions which we encounter and it is important that people should know how to prevent a disc prolapse and how to protect their body from it.

Thank you

Hi,

I am Dr. Madhur Mahna, Orthopedist. Today I will talk about the benefits of PRP therapy. It is used to treat the number of conditions not only in orthopedics but in various treatment modalities. In this, we take the blood of the patient and we centrifuge it. As a result, red blood cells and plasma get separated in which we separate platelet rich and poor plasma. They contain a large number of growth factors which help in rapid healing of tissues, joints and various other parts of the body. Before, we were waiting to worsen the condition like in osteoporosis where we require knee replacement. In such cases, PRP is the best to avoid surgery.

What are the conditions for PRP treatment? Any kind of degenerative condition like arthritis, frozen shoulder, tennis elbow, tendinitis, avascular necrosis, hip arthritis. Osteoarthritis is the common condition and in this PRP is directly given inside the joint. In this, the cartilage which has been damaged gets healed because of various growth factors. Instant result will not be noted as this is a healing procedure. The results are only visible after 3-4 weeks of giving the injection. Many times, multiple injections are required. Ideally, 3 injections are given at a gap of 6-8 weeks for proper results. So, the first prerequisite is that the patient should have an adequate amount of platelets in the blood.

In many diseases, there are adverse effects. In the case of PRP, we are taking the patient's own blood and inserting in the patient's joint. So, there are no side-effects of the treatment. Only 1 side-effect it has i.e. if PRP enters in the soft tissue, it might give the discomfort or pain for 2 days to the patient. In case of any pain or swelling, the patient may apply ice. Other then that, there is no allergic reaction or an adverse reaction. So, the final message I would like to give is PRP treatment is a natural treatment, highly effective, no side-effects and it can avoid large and major surgery.

Thank You!