Slipped Disc, Disc prolapse, Sciatica, Disc Degeneration

Lumbar and Cervical discs are prone to degeneration and prolapse due to their secondary acquired curvatures.
Each disc consists of Outer Annulus, and Inner Nucleus pulposus. As annulus becomes weak, or becomes degenerative, or ruptures secondary to an injury; the nucleus pulposus material extrudes into the spinal canal or the nerve root region. This produces pressure on the nerves producing Sciatica like symptoms.

Technically called a Prolapse Intervertebral disc syndrome; traditionally, it has been labelled as Slipped disc.
A disc protrusion can produce pressure on the spinal cord itself, or on one of the exiting nerve roots producing the typical symptoms.

Treatment of a herniated disc depends on a number of factors including:
•Symptoms experienced by the patient
•Age of the patient
•Activity level of the patient
•Presence of worsening symptoms or neurologic deficit

More than 90 percent patients of new onset Sciatica or disc prolpase, can be satisfactorily treated without surgery. However, there is small chance of recurrence.
Activity and lifestyle modification is important to prevent recurence.

A word of caution to be remembered in such cases: Any patient with neurologic deficit, or worsening pain despite adequate conservative trial, or those presenting with loss of bladder/ bowel control are candidates with significant pressure on the spinal cord or the exiting nerve roots.
Such patients MUST seek Orthopedic opinion, and may require surgical intervention.

High Heels and backache

Women using high heels often complain to be suffering from back pain. There is a definite co-relation in terms of the body mechanics.
When using high heels, the forefoot comes early in contact with the ground compared to the hindfoot. This causes abnormal stresses at multiple joints including the foot joints, ankle, knee and the lower spine.
Noe, the posture attained resembles that of a pregnant lady or an obese lady with protuberant abdomen.
This produces hyper-lordosis at the lower spine, and consequently the facet joints at the back of the vertebral column come under stress. This stress produces secondary degenerative changes in the facet joints, so called as Facet joint arthritis.
Similarly, the knee goes into Hyper-extension producing abnormal strain on the cruciate ligaments.
The ankle and foot also suffers excessive strain and presents as pain under the forefoot or at the front of ankle joint.
These changes may be prevented by reducing the duration of usage of such footwear, or by appropriate exercises to avoid damage.