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

1. 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

2. 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.

3. 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.

4. 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.

5. 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?

6. 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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