• Slip Disc / Disc herniation / Disc Bulge /Bulged Disc/ Herniated disc is the term used to describe the leak of soft disc gel-like material from within the disc between bones , into the spinal canal causing compression of nerves resulting into leg pain, buttock pain, back pain or pain traveling down the leg called Sciatica.
• Slip disc is the result of daily wear and tear ongoing process of the disc in the spine. This wear and tear process is called Degeneration and is related to daily activities over a period including poor posture and weak muscles. Slip Disc can also be linked to the injury and trauma to spine sudden jerk or weight lifting or bending. Slip Disc/ Herniation of a disc can occur slowly over time, taking weeks or months or pain may occur suddenly from incorrect lifting or twisting that aggravates a weak disc.

There are four stages to the formation of a herniated disc which can decide the symptoms in a patient afterslip disc.

• Disc Degeneration: Gel like material nucleus pulposus weakens with chemical changes in the disc.
• Disc Prolapse or Bulge disc or Disc bulge: Slight bulge or protrusion begins to form, which might begin to crowd the Nerves.
• Extrusion: gel-like nucleus pulposus breaks through the tire-like wall of the annulus but remains within the disc.
• Sequestration: the nucleus pulposus or soft gel like substance breaks through the anulus and moves outside in the spinal canal causing compression of nerve roots.

• A herniated disc may cause various symptoms and does not have similar complaints in all patients. The symptoms include include dull or sharp pain in back , Low Back Pain , Back Pain , muscle spasm, Locked back , stiffness in back , Morning stiffness , Leg pain , Numbness in calf or, Pain in back travelling down to legs with numbness and weakness, tingling, or referred pain to leg commonly referred as sciatica . Bulging disc or a Herniated disc can cause similar symptoms as extruded or ruptured disc. Usually, just one leg is affected.
• If you have a herniated disc in your neck (cervical spine), you may have referred pain down your arm and into your hand. Leg and arm pain caused by a herniated disc is also called radiculopathy.
• Although rare but Herniated disc or slip disc loss of bowel or bladder control called cauda equina syndrome and rarely can cause paralysis – weakness of one or both lower limbs. The weakness of foot due to nerve compression is called foot drop and needs surgery at earliest for recovery. These conditions are called surgical emergency as surgery is advisable in emergent situations like this for optimal recovery.

• Your spine specialist may examine you clinically and may ask for investigations like x-ray and MRI scan to diagnose the presence of Slip Disc in the presence of symptoms. MRI can show various grades of Slip Disc and may also suggest if surgery is really needed in view of ongoing compression of nerves in the spinal canal.

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No most of the patients with Slip disc / Disc herniation get better with nonsurgical methods, However one should seek medical attention in consultation with spinal surgeon/spine surgeon /spine specialist. Dr. Vishal Kundnani is one of the best spine specialists in Mumbai and is available for consultation on appointment.

• Not all patients with slip disc/disk herniation or sciatica need surgery.
• Surgery may be required in patients if – Pain is getting worse/Disabling pain/Leg or arm pain, weakness, numbness, tingling/Loss of feeling or weakness in your bladder or anus/Loss of bowel or bladder control.

Nonsurgical treatment options to treat slip disc include physiotherapy, exercises, medication and injection in spine. Meet your spine specialist to decide on which is the best treatment option for you. The best spine specialist in India is Dr. Vishal Kundnani, Mumbai who manages these problems with a scientific approach.

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Normally the type of non-surgical treatment is decided based on the duration and severity of symptoms in consultation with your spine surgeon / spinal surgeon the options available for slip disc treatment are:-

• Medicines – NSAIDS/ Muscle relaxant / Pregabalin / TCA,S /non opiod analgesics.
• Hot fomentation.
• Cold sponging.
• Physical therapy.
• TENS.
• SWD.

However before one resorts to any option one should have advise of spine specialist.

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• Yes. Physiotherapy has a major role in herniated disc recovery. It teaches how to condition your body to prevent further injury and help in the recovery of a painful episode. Physiotherapy shall be taken in the supervision and guidance of spine specialist.

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Physiotherapy has a major role in spinal slip disc treatment. It teaches how to condition your body to prevent further injury and help in the recovery of the painful episode. There are a variety of physical therapy techniques. Passive and active treatments

Passive treatments relax your body and include deep tissue massage, hot and cold therapy, electrical stimulation (TENS), and hydrotherapy. Active treatment involves active stretching and strengthening exercises trunk stability, core strengthening

Passive Treatments:

• Deep Tissue Massage: Deep tissue massage relieves deep muscle tension and spasms, which develop to prevent muscle motion at the affected area
• Hot and Cold Therapy: Both hot and cold therapies offer their own set of benefits, and your physical therapist may alternate between them to get the best results. This reduces inflammation, muscle spasms, and pain.
• Hydrotherapy: gently relieves pain and relaxes muscles.
• TENS (transcutaneous electrical nerve stimulation): uses electrical current to stimulate your muscles and reduces muscle spasms and is generally believed to trigger the release of endorphins, which are your body’s natural pain killers. TENS machine stimulates your muscles through variable (but safe) intensities of electrical current. TENS may increase your body’s production of endorphins, your natural pain killers. The TENS equipment your physical therapist uses is larger than the “at home” use machine.
• Ultrasound: By increasing blood circulation, an ultrasound helps reduce muscle cramping, swelling, stiffness, and pain. It does this by sending sound waves deep into your muscle tissues, creating a gentle heat that enhances circulation and healing.
• Traction: reduce the effects of gravity on the spine. the intent is to reduce the disc herniation and is usually performed in the cervical or lumbar spine.

ActiveTreatments:Help to reduce recurrent pain but will also benefit your overall health

• Core stability: Many people don’t realize how important a strong core is to their spinal health. Your core (abdominal) muscles help your back muscles support your spine. When your core muscles are weak, it puts extra pressure on your back muscles. Your physical therapist may teach you to core stabilizing exercises to strengthen your back.
• Flexibility: Learning proper stretching and flexibility techniques will prepare you for aerobic and strength exercises. Flexibility helps your body move easier by warding off stiffness.
• Muscle strengthening: Strong muscles are a great support system for your spine and better handle pain and strengthening of muscles which can cause your back stretches and strengthening along with pelvic tilt, which helps you find a neutral spine position

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Most patients with slip disc respond well to non-surgical treatments (such as medication), Indications for spinal surgery in slip disc / herniated disc are –

• No response / partial response to non-surgical treatments.
• Progressive radiculopathy – pain, numbness, and tingling in the arms or legs.
• Loss of power sensation in your arms or legs.
• Lost bowel or bladder control.

• Surgery for Slip Disc is safe and simple Surgery involves freeing of the nerve from compression caused by the Slip Disc or herniated disc or bulge disc and this surgery for a herniated disc is called discectomy. And involved removal of part of the damaged intervertebral disc.
• Minimal Invasive Spine Surgery is the gold standard for discectomy in patients with Slip Disc / herniated disc. Slip disc surgery performed with small incisions and with endoscope and microscope is the best way to perform disc surgery. This results in less pain, no blood loss, no need for bed rest after surgery. This is also called microendoscopic discectomy – Micro endoscopic Discectomy.

Various options of spine surgery include conventional open spine surgery and minimally invasive spine surgery or MIS surgery for Slip Disc / Herniated disc. These options of surgical management of slip disc and spinal stenosis are available at Spine Clinic Mumbai – Best Spine Clinic in Mumbai for treatment of Slip Disc and spinal stenosis.

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Meet your doctor and know more about your problem, possible solutions and pro’s and con’s of all the solutions including surgery offered to you.

• After the surgery is planned, plan your hospital stay and discuss discharge plan with the doctor.
• Maintain Good nutrition for healthy immune system.
• Eat a balanced diet and take a vitamin supplement, with the advice of your doctor in the weeks before your surgery.
• Weak muscles and low cardiovascular endurance prolong recovery from surgery. Talk to your doctor about how to start an exercise program that is right for your condition before and after spine surgery. Get your lungs and heart checked up by a physician, in consultation with your surgeon, to get surgical fitness.
• Back Pain can make losing weight or weight maintenance a challenge. If you are overweight, it is a good idea to slim down before your surgery.
• Quit Smoking to prevent prolonged recovery and wound healing.

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• Minimal invasive spine surgery leads to a fast recovery and makes the patient walking after surgery within 24 hours. in fact in slip disc and spinal stenosis, minimally invasive surgery and microendoscopic surgery results in early return to work without any need of bed rest after surgery.
• After surgery patient is mobilized out of bed within 24 hours, and pain medications are continued for 5 days. After the surgery, general do’s and don’ts instructions are given about. With Minimal, Invasive spine surgery patient can go home within 48 hrs and can resume job within 2 weeks however Contact sports is generally avoided for 6-10 weeks.
• One should follow :-
• Follow your doctor’s treatment plan.
• Sit and stand properly and maintain posture.
• Learn to lift correctly
• Exercise regularly (low impact aerobic exercise is especially good, but check with your doctor first)
• Attain and maintain a healthy body weight
• Eat healthy foods (a well-balanced, low-fat diet rich in fruits and vegetables) and get enough calcium
• Stop smoking.

Dr. Vishal Kundnani is the best spine consultant in Mumbai and is available on appointment in Mumbai on appointment for spine specialist.Dr. Vishal Kundnani is the best spine Minimal invasive spine specialist in Mumbai and best Minimal Invasive spinal Surgeon in Goregaon, Malad and Kandiwali.

• Have regular spinal check-ups, and tell your spine specialist right away if you are not getting better.
• Lifestyle changes are the best road to wellness
• Stop Smoking, Eat healthily, lose weight, start some physical activity in the supervision of a physiotherapist with guidance from spine surgeon / spinal surgeon.
• A diagnosis of a herniated disc or degenerative disc disease is not the end of your active life. You can have a healthy and active lifestyle if you follow all the instructions of the spine surgeon / spinal surgeon.
• To know more about prevention modalities meet your spine specialist in nearby locality. Dr. Vishal Kundnani is the best spine specialist in Goregaon, Mumbai

Dr. Vishal Kundnani is one of the best Spine Surgeons for slip disc surgery and is available in various hospitals for consultation and for surgery. Dr. Vishal Kundnani is the best spine specialist with a considerate approach to patients with an honest opinion and ethical spine practice.

Dr. Vishal Kundnani is the best microscopic and minimally invasive surgeon for slip disc surgery in Goregaon, Malad, Kandivali.