Vertebral pillar has 33 vertebrae and the discs separate each vertebra in cervical , thoracic and lumbar segment . Disc is a shock between vertebra and functions as a shock absorber . Weight is conduct through vertebral newspaper column and thus through disc . Disc is made up of intimate circular karyon pulposus and outer annulus fibrosis . Nucleus pulposus is soft and thick gelatinous substance . Central nucleus pulposus expands with atmospheric pressure and helps to soak up the shock during weight transmission system and movements of vertebral chromatography column . Accelerated pressure change within disc and horizontal expansion of nucleus pulposus lower-ranking to squeeze results in disc bulge into annulus fibrosus . Annulus fibrosus is tough membrane and resist bout in healthy young mortal . Illness such as disk degeneration weakens the fibrous ring and disk bulge herniate through the mangled or broken annulus fibrosus know as herniated disc . Lumbar disk herniation is observed in disk between L1 and S1 vertebra . Most common phonograph recording herniation is observed at point of L4 / L5 and L5 / S1 disc .
platter herniates either into inter - vertebral foramina ( build 1 ) or spinal foramina ( physical body 2 ) . Inter - vertebral foramina is a sidelong bony burrow intend to pass the spinal nerve and lumbar spinal channel accommodates low end of spinal cord and quada equina . Disc hernia into inter - vertebral foramen causes sneak face pain or radicular pain . Large disk herniation into spinal canal causes narrowing of spinal channel orspinal stenosis(figure 2 ) . spinal anesthesia stenosis make insistence on spinal cord or quada equina result in quada equina syndrome .
What Can Cause A Lumbar Disc Herniation?
Lower Back Injury Resulting In Lumbar Disk Herniation-
Diseases Causing Lumbar Disk Herniation
Chronic Smoking – A Risk Factor For Lumbar Disk Herniation
Chronic smoking is associate with disk decadence secondary to weak annulus fibrosis , which is often followed by hernia of nucleus pulposus .
Obesity – A Risk Factor For Lumbar Disk Herniation
Obese patient transmits redundant weight through the vertebral column . Twist , fall , or severe coughing can cause disc herniation .
What Are The Symptoms and Signs Of Lumbar Disk Herniation?
Symptoms of Lumbar Disk Herniation
Lumbar ( Back ) Pain –
Lumbar Radicular Pain
Radiculopathy
Cauda Equina Syndrome
Dermatomal Distribution of Radicular Pain and Radiculopathy
Tingling and indifference
Insomnia
Weight Loss
Clinical Signs- Lumbar Disc Bulge
Paravertebral Muscle Spasm
Muscle Weakness in Lower Leg
Diminished Knee and Ankle Joint Reflexes
How is Lumbar Disk Herniation Diagnosed?
MRI Examination –
CAT Scan –
Sedimentation Rate-
100 - reactive Protein –
White Blood Cell Counts –
X - Ray –
Myelogram –
EMG- Electromyography –
Bone Scan –
Bone Densitometry –
How is Lumbar Disk Herniation Treated?
Medications for Lumbar Disk Herniations-
Nonsteroidal Anti - Inflammatory Drugs ( NSAIDs )
Tramadol ( Ultram or Ultravcet )
Opioids as pain pill
Short Acting Analgesics –
Long Acting Opioids –
Muscle Relaxant-
Anti - Neuropathic Analgesics –
Neuropathic pain is treat with Antidepressant .
Antiepileptic Analgesics-
Neuropathic botheration is treat with Antiepileptics or Anticonvulsant medications .
Most common Antiepileptics used as analgesics to treat neuropathic pain in the neck are as follows-
Anti - anxiousness Medications
Anxiety and muscle pain is treated with anti - anxiety medicine .
Most Common Anti - anxiousness Medications Used Are
Interventional Pain Therapy –
Corticosteroid is injected in epidural space to excuse pain and excitation .
Manual Therapy
Physical Therapy
Types of Physical Therapy-
Surgical Options to Treat Lumbar Disk Herniation
Discectomy –
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