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Introduction

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According to some estimates, one to three percent of a given population could be affected by herniated discs. If you, or someone close to you is a member of this group, do not worry. Recovery is both possible and probable. This presentation contains some basic information that will assist you in making the best decisions for your well-being.

The spinal cord is arguably one of the most important structures in the human body. Not only does it house a large part of the central nervous system but it also provides mobility. Therefore, it is not surprising that disorders involving the spine can be the source of great concern for those afflicted. Among those disorders, herniated discs are a somewhat common and treatable issue.

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What is a Herniated Disc?

Disc herniation occurs when the outer ring of the spinal disc degenerates and allows the material inside to spill out of its enclosure, causing protrusion of the material and/or deformation of the disc.

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Before proceeding, let's consider the normal function of a spinal disc.

The spinal disc is found between vertebrae and allows for spinal movement and force absorption. It consists of two key elements:

  • A gel-like nucleus pulposus which is surrounded by
  • The anulus fibrosus, a rigid ring composed of structural fibers.

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Image Source: West Family Chiropractic, © 2014

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In a healthy spine, the discs absorb and distribute pressure put on the spine using a combination of fibrous material and hydrated gel. The viscous nucleus pulposus absorbs force exerted by spinal compression and the cartilaginous anulus fibrosus distributes it across its fibrous composition.

Fibrous Material

Hydrated Gel

However. when the fibers that make up the outer ring are degenerated they lose their structure and weaken or tear, which causes them to be unable to resist the tension created by the nucleus of the disc.

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Spinal Pressure

Disc absorbs and distributes

When the gel inside the disc deforms or exits the boundaries of the outer ring, disc herniation has occurred.

Spinal Pressure

Disc is unable to resist pressure

What Causes Disc Herniation?

Herniation can happen spontaneously in a variety of individuals. However, there are some general factors that increase the risk of disc herniation. These include...

(especially between the ages of 30 and 50)

  • Aging
  • Heritability
  • Smoking
  • Sedentary lifestyle
  • Excessive lifting and twisting
  • Obesity

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These factors cause changes in the structural makeup and water content of the spinal discs.

Weaker fibers and lower water content lead to weakening and rupturing of the anulus fibrosus and a consequent susceptibility for herniation.

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What are the Symptoms?

Symptoms of a herniated disc usually appear abruptly. If the pain has a gradual onset it is unlikely that the cause is a herniated disc.

Common Symptoms

  • Sudden pain in lower back
  • Pain shooting down leg

Less Common Symptoms

  • Weakness in extremities
  • Numbness in extremities.

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Some triggers that may worsen symptoms of herniated discs are sitting or standing for long lengths of time, lifting heavy objects and driving.

Pain, numbness and weakness occur because of the interaction between the herniated material and the nerves in the spine. The protruding spinal disc can affect the signals traveling via the spinal nerve, thus causing symptoms.

Spinal Disc Pathology Basics

How is it Diagnosed?

The symptoms of a herniated disc can be hard to distinguish from those of other spinal disorders. Because of this, a thorough and careful examination must take place in order to rule out other possibilities.

Herniated Discs

When a herniated disc is suspected, a healthcare provider will proceed with diagnosis by:

  • Inquiring about your medical history
  • Including questions about the onset and location of your back pain

  • Performing a physical examination

  • Requesting that you stand, sit or move in certain ways

  • Palpating your spine and areas of pain

  • Observing your posture when standing and walking

  • Assessing your range of motion
  • Especially the range of motion of your legs

  • Using imaging techniques such as an MRI

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Image Source: Mayfield Clinic, © 2014

Treatment

Once you have been diagnosed with a herniated disc, there are two options for treatment.

1. Non-Operative

In many patients, the herniation decreases naturally with time. Your physician may recommend certain kinds of exercise, cutting down on lifting activities, massage and improving your nutrition.

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2. Operative

In cases where the spinal nerve is being affected by the herniated disc, surgical intervention may be recommended. However, because of the self-improving nature of herniated discs, only severe cases will call for surgery. The procedure usually involves removing the herniated material or coaxing it back into the disc.

Presented by: Barbara Martins

Biol 273 - Human Physiology I

Nov 19 2014

Implications

Unfortunately, those who are diagnosed and treated for herniated discs tend to have high rates of recurrence.

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Prevention

Preventative measures are important whether you are trying to prevent the onset of a herniated disc or its recurrence. Some simple changes to your habits make a difference not only in this specific case but for your general health:

Staying active is one of the most significant things you can for your health. In this case, exercises that strengthen your back, hip and torso muscles will help prevent disc herniation. However, activities that cause you to bend and twist frequently and repetitively should be avoided.

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Exercise

When lifting heavy objects, you should always bend at the knees instead of at the waist.

Correct Bending and Lifting

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You should avoid sitting for long lengths of time as it puts undue stress on your back. However, if sitting is unavoidable, it is important to use an ergonomic chair that encourages proper posture and to take frequent breaks for walking and stretching.

Healthy Sitting Habits

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International Society for the advancement of Spine Surgery - Patient Education on Spine Disorders

  • http://www.isass.org/h/patient_resources_spine_conditions.html

PubMed Health - Herniated Disk

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001478/

WebMD - Back Pain Health Center

http://www.webmd.com/back-pain/tc/herniated-disc-topic-overview

As you can see, while a herniated disc may sound intimidating, it is in fact a manageable problem for which you will mind much support. It is encouraged to seek out as much information as you can about your condition in order to make the best choices for your healthcare. This presentation provided some basic facts about the disorder, but should you wish to deepen your search, here are a few informative websites that are available to you:

Conclusion

References

1. Boos N., Aebi M. (2008) Spinal Disorders : Fundamentals of Diagnosis and Treatment. Berlin/Heidelberg, DEU: Springer.

2. Chou, R. 2013. Patient information: Low back pain in adults (Beyond the Basics). Retrieved November 15, 2014.

3. Engstrom J.W., Deyo R.A. (2012) Harrison's Principles of Internal Medicine, 18e. New York, NY: McGraw-Hill.  

4. Humphreys S.C., Eck J.C. (1999) Clinical Evaluation and Treatment Options for Herniated Lumbar Disc. Am Fam Physician.

5. Jordon, J., Konstantinou, K., & O’Dowd, J. (2009) Herniated lumbar disc. Clinical Evidence, 2009, 1118.

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