By Dr Tony Setiobudi BMedSci, MBBS, MRCS, MMed (Ortho), FRCS (Ortho)
John, 32 year old, complained of sudden onset right leg pain after lifting some weight in the gym. It is severe enough to make walking difficult. Pins and needles were felt all over the right leg.
John suffered from SLIPPED DISC. Many people uses the term “Slipped Disc” loosely. Slipped disc is a spine condition where by the jelly like material inside the disc protrudes out to the spinal canal and pinches on to the nerve. This causes excruciating leg pain. Usually one leg (not two legs) is affected.
What is the chance of getting better?
Some people with slipped disc do get better on their own without surgery within 2-3 months. Those who do not get better after 3 months need surgical treatment to free up the nerve.
What do people need to do in the first 2-3 months after they suffer from slipped disc?
People need to take care of the back. Avoid carrying heavy things and bending down. They need to strengthen the core muscles to protect the spine and to reduce the risk of having another slipped disc. Nerve medications will help with the recovery of the nerve.
What to do if they don’t get better after 3 months?
The chance of slipped disc to recover after 3 months is very low. If the symptom is still significant, the best treatment is surgery to remove the slipped disc to free up the nerve. This surgery is called microdiscectomy. This is a small surgery that is done under general anesthesia. The patient is required to stay in the hospital for only one night.
What is the chance of getting better with microdiscectomy?
90% of people with slipped disc recover after microdiscectomy. The leg pain can reduced significantly or disappear immediately after surgery.
What is the reason why 10% of slipped disc sufferers don’t get better with microdiscectomy?
- The nerve has been pinched for a long time more than 1 year. Long term nerve impingement may cause permanent nerve damage which cannot be resolved with surgery
- The nerve is pinched in two locations. Microdiscectomy is unpinching the nerve in the spine. If the nerve is pinched somewhere else, the patient may continue to experience leg pain even after microdiscectomy
- The slipped disc is not the cause of the leg pain.
Dr Tony Setiobudi is an Orthopaedic & Spine Surgeon at Mount Elizabeth Hospital (Orchard), Singapore. He treats bone, joint, muscle and ligament problems in adults and children. He has a special interest in nerve compression and spine problems such as back & neck pain, scoliosis, kyphosis, spine tumor & infection, spinal cord injury, osteoporosis fracture, spinal stenosis and slipped disc.