TWEETINAR: Queries and Answers.Topic : Spine Problems – Symptoms and Cure

Date : 30th October 2012 Dr. Dr.Sajan K Hegde

A Question and Answer session was held during a Tweetinar on Spine Problems – Symptoms and Cure, conducted on the 30th of October 2012.

It was a live discussion with Doctor Sajan K Hegde -Senior Consultant, Spine Surgeon, Apollo Hospitals, Chennai

Some Questions Asked:

1) Jyotshana Maurya: Dear sir, my relative is suffering from gallbladder carcinoma for the last 8 months;

what’s the reason for the pain?

ANS: Dear Ms Jyotshana, Carcinomas (cancers) can spread to the spine and cause back pain and weakness

of the nerve supplies by a particular group of nerves. So it would be wise to rule out any spread of the

cancer to the bones. Please contact a spine surgeon to get further test.

2) Payel Sinha: Sir, I am suffering from pain below my right rib cage & upper right hip portion since Feb

2011. Last 2 months it has become chronic. Please suggest whom to consult - an orthopaedic or neuro? It’ll

be great if you can suggest any doctor's name -Kolkata.

ANS: Dear Ms Payel, Lumbar disc slips as they are commonly called can cause severe back pain with pain

radiating down the legs. More often than not they are relieved by medications and physiotherapy. Rarely

do they require surgery. So if your symptoms are bothering you too much inspite of medicines and

physiotherapy, you might need a surgery. However, the decision has to taken after being seen by a spine

surgeon.

3)Satyabrata Shatpathi: Sir, my mother has same problem at her waist. This is chronic disease for her. I had

taken her to many doctors but nothing happened. What can I do now give me the suggestion please.

ANS:Mr. Shatpathi, pain at the waist can be due to a variety of reason, including from the spine. If the

pain is from the low back region with any pain going down the legs and difficulty in walking, then it

would be wise to be seen by a spine surgeon who will probably take x-rays after an examination to

determine the exact nature of the problem.

4)Shayeka Sayyed: My mother is 50yrs of age, she has a spinal cord problem , from 1 year 2 months, what is

the best suggestion to treat this problem?

ANS:Mr. Sayyed, your question is a bit vague and suggests that you are probably

referring to low back pain. It would be nice if you can get back to us with the exact nature of the problem.

5)Shiva Kumar: After spinal cord operation(d1,d2,d3), my dad, 54years old, is not able to walk. What is the

solution for him?

ANS:Dear Mr Kumar, Please mention as to what the nature of the disease for which the surgery was

done, if your father had inability to walk before surgery? We will be in a better position to advise you if

we can see your dad and all the necessary reports.

6)Lokesh Jagwani: Sir, my lumbar vertebrae(L4 and L5)are bigger than normal size(acc to an orthopaedics,

sacralisation of lumber due to which there is severe pain. What's the treatment?

ANS: Dear Mr Jagwani, sacralisation is a normal phenomenon in many individuals. As such they do not

cause any pain. If at all there is pain in the low back it could be because of any adjoining degeneration

that is a normal occurrence with age. It would be good to consult a spine surgeon for appropriate

treatment.

7) Namrata Sharma: My mother is 65. She is having nerve compression at L4 and L5. She is not able to

balance herself. Surgery is suggested please advice

ANS: Dear Ms Namratha, Nerve compression by a degenerated disc especially can be quite bothersome, if

not relieved by medications and physiotherapy. Kindly get back with further details regarding the

duration of the pain and exact reports. We will be definitely able to help treat the problem.

8) Sangbou M Kangshou:

Is there any possibility to cure curve spinal cord at your hospital?

ANS: Dear Sir/Ms. Definitely there is a treatment for the condition you are mentioning. Scoliosis or

curvature of the spine can be treated surgically with the correction of the deformity to the extent

possible. But to suggest specifically we would like to see the x-rays of the patient and the patient too.

However the advent of latest technology like robotic guided surgery has made this surgery much more

accurate and safer. Please send the details and we shall do accordingly.

9) Prasoon Bharghav:

My father has spine problem, sir please give a solution?

ANS: Dear Mr Bhargav, the question is too vague and does not indicate which region of the spine he is

affected with. Please furnish more details about the nature of the problem like the history and the

reports available so that we can have a look at them and revert back to you regarding the treatment

aspects possible.

10) Minaal Iyer:

A friend of mine has a continuous lower back pain, which is intense, also have difficulty in sleeping.

ANS: Dear Ms Iyer, your friend could be suffering from degenerative disc disease which is a age related

process and aggravated by certain activities. Our suggestion would be to consult a spine surgeon so that

after appropriate tests and examination, a treatment can be suggested. Majority of the times the pain

subsides with medications and a good physiotherapy.

11) Nasir Ul Islam:

I have Schmorl's node formatio in L3 and L4. Please suggest some treatment.

ANS: Dear Mr Nasir, Schmorls node can be a normal incidental finding on the MRI. However it would be

wise to see what it the cause of the back pain if any.

12) Shashi Prabha:

My son is suffering from ankyolising spondo arthorightice. Is there some medicine?

ANS: Dear Ms Prabha, Ankylosing spondylitis is chronic gene related arthritis of multiple joints of the

body, which can lead to stiffness and deformity. The treatment has to be medical, physiotherapy, and

surgery if required for the correction of the spine deformity and for the mobilisation of the joints. Please

do get back to us with further details, so that we can advise you more suitably. But there are definitely

medications to slow the progression of the disease process and improve the quality of life.

13) Babali Dhamecha:

My father is 70 years-old and suffering from spinal cords problem. Doctor said L4/L5 between 2 vertebra a

pad is slash that was Nerve press there, as shown in MRI.

ANS :Dear Mr Dhamecha, L4-5 disc slip as it commonly called is a pressure on the nerves coming to the

leg by the disc and might require a surgery if the symptoms are not relieved by the medications and

physiotherapy. However the decision to operate shall depend on the localisation of the pain source and

how bothersome the symptoms are to the patient. So I would like to see the reports and the patient once

before proceeding further.

14) Leena George:

I have pain at the back of my neck i.e. in cervical region. What should I do for that?

ANS: Dear Ms Leena, you require a thorough evaluation of the neck with a x-ray and further test if

required.

15) Nilofar Neemz:

Please give some suggestions to relieve pain from slip disc. Why is the pain more severe in winter?

Dear Ms Nilofar, pain from disc degeneration is often treated with medications and physiotherapy.

However specifically in your case I will be able to suggest only after examining you and the reports.

16) Jayanta Majumdar:

Name of patient- Rina(F), age-3 MRI Report dated 13/9/12 MRI of Lumbo-Sacral Spine reveals1.

1) Circumferential disc bulge at L4-L5 level. Posterocentral & B/L L5 nerve roots, more on right side.

2). Minimal posterior disc bulge at L5-S1 levels. What is her remedy?

ANS: The report you have enclosed in the question is a vague indicator of the problem as often the

findings on the MRI and the symptoms of the patient do not match and so it is imperative to see the

patient once, listen to their complaints and see the films of the MRI before taking a decision on the

nature of the treatment.

17) Vismay Chavda: What is treatment for LBP due to L5 lysis.

ANS. Lbp due to lysis of the L5 is a common occurrence in young adults though it can be seen in any age.

It often causes back pain and radiation down the legs, again the treatment of the problem is based on the

symptoms of the patient and the trouble caused rather than the x ray findings. However the risk of one

vertebra slipping over the other is always there and has to watched out for.

18) Baquer Zaidi: Please tell me what is the management of cervical spendolosis?

ANS: Cervical spondylosis is a broad term encompassing the whole spectrum of the degenerative

changes in the cervical spine causing the pain in the neck radiating down in to the arms, numbness

tingling and unsteadiness in walking in severe cases. It requires a thorough examination and appropriate

tests to find out the exact nature of the degeneration and the treatment necessary for the same. Please

feel free to contact us.

19) Johnson Philem: Hello sir, I'm a paraplegic & the cause of my injury is by a bullet. My level is T12. It’s

been about 12 years old & I'm still taking pain killers. But it’s not helping still. I want to know more about

nerve block. I am thinking of coming to Apollo. I am losing a lot of hair this year. I don’t know what to do. I

am taking a very heavy dose of pain killers.

ANS: Dear Mr Philem, pain in paraplegia can be due to a variety of reasons. And hair fall is not a

connected problem. Having said that, we would be glad to help you in determining the cause of your pain

and better rehabilitation if you can come down with all the reports.

20) Eiffer Goetz: My friend has severe scoliosis. Kindly suggest.

ANS: Dear Mr Goetz, Scoliosis of that degree needs to be corrected. Please furnish further details or come

down so that we can have a look and treat you better.

21)Chanambam Sarita: 62 years old man have a problem between D10-L5. Either it needs surgery or

medicine. How to improve? Please suggest.

ANS: Dear Ms Sarita, the question is vague and needs further details please do mail in further details and

will deal with the problem accordingly.

22) Vishav Puri: Whenever my acidity increases, the next day when I wake up that time my back pains. Any

suggesting sir? One more thing sir I also suffered from disc problem last year till now I feel pain on that

place.

Ans: Dear MR Puri, back pain has to be evaluated and not neglected. Please consult us or any nearby

spine surgeon for further course of action.

23) Rama Krushna Behera: Father (60) is suffering from severe spondilytis and my Mother (45) also suffering

from nil pain since 5 years, I'm practicing at my lab as pathological L.T. and practicing medical practitioner

(R) ,so share some suggestion for my parents.

ANS: Dear Mr Behera, both the conditions can be better treated if we can have a look at the patients and

the MRIs. Kindly furnish more details in terms of reports or further history so that I can suggest further

line of treatment.

24) Chandra Singh: Sir, I have some problem in back Bone since last 2 year? What to do?

ANS : Dear Mr. Singh, Kindly furnish more details in terms of reports or further history so that I can

suggest further line of treatment

25) Innocent Chorey:

My mom is suffering with spinal cord & back pain.

ANS: Back pain has to be evaluated and not neglected. Please consult us or any nearby spine surgeon for

further course of action

26) Yeshika Achumeh: My back hurts a lot, so any tips?

ANS : Back pain has to be evaluated and not neglected. Please consult us or any nearby spine surgeon for

further course of action

27) Nabin Sarkar: I have two problems. 1 year ago I got injury in my hip joint at the right side during long

jump. Then I gave up my practice. Now I have started my practice again and there is no problem there. But

now I am facing a new problem. Now I cannot bend in front. I feel pain in joints of spinal cord & waist.

ANS: Dear Mr Sarkar, you can always drop in to Apollo hospital Road Chennai or contact one of our web

moderators for further assistance.

28) Amit Wadhwani: Want to know any treatment for FSHD ( Fascio Scapulo Humeral Dystrophy) in India or

in other countries?

ANS: Dear Mr Wadhwani, there are multiple issues regarding the treatment of FSHD, please give more

details and report copies.

29) Kuldeep Kumar: I have spinal pain, kindly suggest some remedy

ANS:Dear Mr Kumar, Lumbar disc slips as they are commonly called can cause severe back pain with pain

radiating down the legs. More often than not they are relieved by medications and physiotherapy. Rarely

they require surgery. So if your symptoms are bothering you too much inspite of medicines and

physiotherapy, you might need a surgery. However, the decision has to taken after being seen by a spine

surgeon.

30). Manas Ranjan Nayak manasrn: Not me but my father in law does have Osteoporosis in his lumbar and

suffers acute pain at times. Any tips for relief.

ANS: Dear Mr Manas, Osteoporosis needs aggressive medical, management to improve the strength of

the bones and decrease the pain on the back and the bones all over the body. Please get your father in

law down to the clinic once for appropriate management of the osteoporosis and any related issues. But

overall, osteoporosis is a condition requires prompt medications and a good physical therapy to avoid

complications like fractures of the wrist, hip, spine and also decreased mobility.

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