Cause

Disks are soft rubbery pads that are found between the vertebrae. The spinal cord and other nerve roots are located in the spinal canal. The disks are between the vertebrae and act as shock absorbers and allow flexibility. When a herniated or ruptured disk occurs, a portion of the nucleus center pushes through the outer edge of the disk and back toward the spinal canal where the nerves are located. The nerves are very sensitive even to the slightest pressure. When we are young, disks have high water content and the content lessens as we age. The disks become less flexible, decrease in size and the space between the vertebrae narrows.

Often a herniated disc by itself does not cause pain. Pain occurs when the membrane on the outside of the spinal cord or spinal nerves is irritated. Loss of function, such as weakness or altered sensation, can be caused by pressure from the herniated disc on the nerve roots or spinal cord. Pain or numbness may occur in the area of the body to which the nerve travels

The sciatic nerve is formed by the nerve roots coming out of the spinal cord into the lower back (lumbar region). Branches of the sciatic nerve extend through the buttocks and down the back of each leg to the ankle and foot.

A herniated disc may compress one or more of the nerve roots that form the sciatic nerve. Pressure on one of these nerve roots will often produce distinctive symptoms of sciatica, such as pain, numbness, weakness, and tingling in the affected leg. Although a herniated disc is the most common cause of sciatica, sciatica can also be a symptom of other problems, such as narrowing of the spinal canal (spinal stenosis), nerve root compression resulting from injury, and certain rare tumors.

Risk Factors

Age – Middle age is the most common age group 35 – 45, due to degenerative disks.

Weight – Cause more stress on the disks

Smoking – Decreases oxygen levels in your blood, which deprives them of vital nutrients

Height – Men taller than 5’ 11” and women taller than 5’ 7” have increased chances of a herniated disk Physically demanding jobs that require repetitive movements or sitting or standing too long.

 Signs and Symptoms

Symptoms include pain, numbness or weakness in neck chest, arms and hand. Sometimes there will be pain in the legs. Also, muscle spasm or cramping, sciatica. Sciatica is a symptom frequently associated with a lumbar herniated disk. Pressure on one or several nerves that contribute to the sciatic nerve causing pain, burning, tingling and numbness that extends from the buttock into the leg and sometimes foot. Diagnosis is made by a medical exam from a doctor, X-Rays, MRI or CT Scan.

Treatment

Herniated disks are usually first treated with non-surgical treatments including rest activities, physical therapy, medicines to relieve pain and inflammation. A doctor will recommend surgery if there are nerves being pinched or spinal pain.
Alternative treatments
Acupuncture
Acupressure
Massage
Non-Invasive Treatment
Chiropractic Care
Drugs – OTC
Acetaminophen (Tylenol)
NSAIDS (non-steroidal anti-inflammatory drugs (aspirin, ibuprofen, naproxen)

Treatment Continued

Prescription Medications Prescription NSAIDs Muscle relaxants (i.e.. Valium) alleviates spasms Oral steroids – used to reduce swelling Uploads Codeine, morphine – alleviates intense pain Anti-depressants – block pain messages from being received by your brain and increase the effects of endorphins, which are your bodies natural pain relievers. They also help you sleep better. Spinal Injections – Epidural steroid Injections contain corticosteroids which are potent anti-inflammatory agents. May take a few days to work and no more than three injections can be given in a year.

Exercise

Exercise is an effective way to strengthen and stabilize low back muscles, helps prevent further injury and pain. Being at your ideal weight is important. Extra weight constantly strains your back. Simple stretching and aerobic exercises can effectively control pain. Stretching programs such as yoga and pilates, moderate aerobic activities like waling, bicycling, swimming. Start any new aerobic activity slow and gradually increase. Active Treatments Improve flexibility, posture, strength, core stability and joint movement. Surgery most common is discectomy which removes all or part of the damaged disc.

Dr. Ryan Lambert-Bellacov, chiropractor in West Linn, OR

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