Q: One of my friends suffers from multiple disc prolapse. It was diagnosed after he was 20 or more and determined to be a congenital problem. He has already undergone surgery but has been told recently that he might have to undergo another one. Is there a solution to this problem? He complains of back pain, thigh numbness, knee pain and severe pain in the toes. How serious is his situation? He is around 29-30 years old and has high cholesterol and a slightly high blood pressure. Are these problems interrelated? He is not married. Can he look forward to a healthy family life? He goes for walks and exercises regularly.

A:Some patients do have multiple disc prolapse. This may be linked to early degenerative changes for some people vulnerable for. You have mentioned he had undergone surgery but not mentioned the level. The lower back levels are not as bad (usually) as the upper back discs. Usually it is the upper back disc that presents as multiple disc problems. Depending on symptoms and findings on clinical examination he may need repeat surgery. To answer your questions: 1. There is no way you can prevent this problem. Some life style modification like regular disciplined life controlling weight, regular exercises and avoiding occupations that require recurrent bending forward may help in some cases. 2. If he has persistent numbness or any evidence of paralysis then this could be a significant problem warranting early surgical intervention. 3. His cholesterol and blood pressure problems are not directly linked. 4. If he has no major paralysis or neurological problem as a result of the disc he should have no difficulty in having a healthy family life. However, he has neurological problem he should consult an orthopaedic surgeon or a neurosurgeon for expert advice.