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.

Carpal Tunnel Syndrome CTS

Carpal tunnel syndrome is pressure on the median nerve -- the nerve in the wrist that supplies feeling and movement to parts of the hand. It can lead to numbness, tingling, weakness, or muscle damage in the hand and fingers.
Carpal tunnel syndrome is common in people who perform repetitive motions of the hand and wrist.

A number of medical problems are associated with carpal tunnel syndrome, including:
Bone fractures and arthritis of the wrist, Acromegaly, Diabetes, Alcoholism, Hypothyroidism, Kidney failure and dialysis, Menopause, premenstrual syndrome (PMS), and pregnancy, Obesity, Rheumatoid arthritis, systemic lupus erythematosus (SLE), and scleroderma etc.

Symptoms :
Numbness or tingling in the thumb and next two or three fingers of one or both hands.
Weakness in one or both hands.

Diagnosis may be done by Clinical Evaluation, and Electro-diagnostic tests like Electromyography and Nerve conduction velocity.

Treatment
For patient, who are not responding to conservative management, or when there is documented 
neuronal damage, surgery should be performed.
Carpal tunnel release is a surgical procedure that cuts into the ligament that is pressing on the nerve. Surgery is successful most of the time, but recovery depends on how long the nerve compression has been occurring and its severity.

The procedure can be done under local anesthesia. The procedure involves a skin incision of approximately 1 inch, which heals in a week. The patient is discharged on the day of surgery, and can start normal activities in a week.