PLID stands for prolapsed lumbar intervertebral disc. In this video Prof. Dr. A. F. M. Momtazul Haque explains what it is and how to tell it apart from ordinary back pain.
What is the disc?
Between the five bones of the lower back sits a cushioning “cementing” substance called the disc. It has a hard outer coat and a soft, gelatinous centre called the nucleus pulposus. When it bulges out, it can press on the nerves — one of the main causes of back pain.
Ordinary back pain
Ordinary back pain stays in the lower back and usually does not travel down the leg. Two or three days of bed rest with painkillers and muscle relaxants usually cures it completely.
Signs of PLID (red flags)
- Pain that travels down the leg
- Numbness in part of the leg or foot
- Weakness of a toe or part of the leg
Spinal stenosis in older patients
Older people may develop spinal canal stenosis: tingling and numbness in the legs after walking a short distance, so they must stop and rest before they can walk again.
Emergency: cauda equina syndrome
The most dangerous situation is cauda equina syndrome — leg weakness with difficulty passing or holding urine. This is a neurosurgical emergency: reach a neurosurgeon as quickly as possible, because the chance of recovery falls with every hour of delay.
Treatment
For stenosis, the usual treatments — bed rest, physiotherapy, medicines and exercise — come first. If the patient still does not improve, intervention is needed; modern options such as microscopic foraminotomy and microscopic spine surgery are now done in Bangladesh. Always consult a specialist.
This article is for general awareness only; it is not a substitute for direct medical advice.
