What is herniated disc?
+ Herniated disc is always a great problem for many people because it is a common cause of painful cervical spine, lower back pain, pain in legs and arms, movement limits.
+ Spine is composed of many vertebrae stacked. Between the vertebrae are discs – round shape and flat as a plate – which have functions as shock absorbers for the spine and help the spine become more flexible and easy to bend. The disc is made up of a thick and solid outer fibre shell (which is called “Annulus fibrosus”), and a gel (nearly like egg whites) called “nucleus pulposus” . When the disc is injured (usually by the excessive pressure from the two vertebrae), the outer layers of fibre shell break or tear, allowing some of the nucleus pulposus to leak out, forming a mass called a herniated mass. The herniated mass can press the nerve roots or spinal cord, causing extreme pain, numbness, weakness, paralysis in an arm or leg.
+ Disc herniation may causes harmful consequences to the life and activities of the patients. They can even be maimed for lifelong. But if a herniated mass doesn’t irritate nearby nerves, patient will not feel pain.
+ Herniated disc can occur in any part of your spine. But most herniated discs are in the lumbar spine (lower back). Some happen in the neck (cervical spine) and, more rarely, in the upper back (thoracic spine).
The causes of herniated disc:
1. Direct causes: disc injury. For example, fall and bang the butt to the ground, lift a heavy load, bend the spine suddenly (playing sports). Disc is pressed strongly by two adjacent vertebrae, leads to annulus fibrosus be torn and nucleus pulposus leak out.
2. Underlying causes: The disc is degenerative, not healthy. It is no longer soft, elastic, annulus fibrosus becomes dry, cracked and easy to be torn. There are many causes of disc degeneration, which are divided into subjective causes and objective causes.
a) Subjective causes are made by ourselves – usually the habits – and can change the habits to prevent disc herniation. Subjective causes include:
+ Sitting in many hours with wrong posture (sedentary job). Lack of exercise. To solve this cause, you should not sit too long. For every 1 hour sitting, stand up and walk, do exercise. The best way is to hang on the pull up bar to stretch the spine, reduce the pressure of the body on the spinal discs. You need to have a pull up bar next to the workplace, and if it’s too difficult to make one (can not drill the wall, drill door frame, dig the ground…) please consider purchasing our products: KT free standing pull up bar with height-adjustable and folding design.
+ Lifting heavy loads incorrectly.
+ Due to excessive weight gain (obesity). Look for weight loss methods, such as eating properly (reducing fat food and sweets) and doing exercise regularly.
+ Diet with lack of nutrients. You only need to change the diet and nutrition in a balanced and scientific way.
b) Objective causes are the causes beyond your desire and control, include:
+ The age
+ Congenital malformations of the spine
+ Heredity factor
+ Endocrine and metabolic factors
Symptoms of a herniated disc:
Depending on the location and degree of herniated disc, there are symptoms or not. Thanks to imaging diagnoses, we can find out the disc herniation with symptoms (pain) and no symptoms. The main symptoms of disc herniation are:
- Intense pain which increases when bending the back, coughing, sneezing or trying hard. Pain increases when long sitting, standing, prone. Pain is often recurrent many times, each session lasts about 1-2 weeks, then back to normal. Sometimes dull pain but usually severe pain, also has prickling, numbness, pricking pain corresponding to the pain area. Gradually, the pain becomes frequent, prolonged monthly if not treated
- When the herniated disc occurs at the lumbar area, it will cause the lower back pain and sciatic nerve pain. Pain increases when lying, coughing and defecation. The patient will feel pain at lumbar area, spreading with arc way to the front chest, along the intercostal area. Pain, numbness, loss of sensation in part of the butt, legs, feet – in the severe case the patients can be paralyzed. In addition, the patients may also have movement limit in the spine: no longer capable of the lumbar bending. Lumbar muscle spasticity. The patients must sit, stand, lie with inclined posture to one side to prevent pain. In some cases, severe pain, the patient must lie motionless on one side.
- If herniated disc is in the neck: there will be symptoms of stiff neck and neck pain. Pain spreading to the shoulders and arms (usually on one side), accompanied by numbness, tingling and loss of sensation in part of arm, wrist, hand. weak forearm or arm (arm muscle force decrease). The pain, numbness are increased or decreased according to the wrist movement …
When to go for a medical examination?
In these cases the patient should consult a speciality doctor as soon as possible:
- When back pains more than 1 week, makes difficulty in daily activities.
- Back pain happens after fall or injury
- Be awoken by the pain at night
- Pain accompanied by fever and unexplained weight loss.
If the patient is well cared, bulging disc or herniated disc at mild level will be good after 4-6 weeks of treatment. If not better, continue to check and perform the new treatment.
The cases of back pain is accompanied with some symptoms: having bowel movements difficulty, urinary retention , limb weakness, or defecate and urinate incontinently – should go to see the doctor urgently.
Diagnosis of herniated disc
To treat herniated disc efficiently and accurately, can not skip the image diagnosis methods. Diagnosis of a herniated disc is not easy. In fact, this disease is some times misdiagnosed with other diseases due to the similar clinical symptoms, or is detected late. In the diagnosis of disc herniation, the imaging methods are often used following:
1. Normal X-ray
A series of problems such as fractures, tumors and infections can be confirmed or excluded by means of conventional x-rays. However, this method does not detect a herniated disc because disc injuries are not photoresist, thus not seen on film. They only indirectly assess the damage of the disc when the height of slot between 2 adjacent vertebrae reduce, or the spine is not straight.
To detect the herniated disc exactly, they have to use computerized axial tomography (CT scan) or magnetic resonance imaging (MRI)
2. CT scan:
Result image has high resolution and good quality, so the herniated disc can be viewed more clearly (as well as the shape and size of the spinal canal and its components, and the nearby structures)
In addition to help us view the internal structures clearly as CT scan, MRI method can enable us to see the spinal cord, nerve roots and surrounding structures such as tissues and ligaments. The signs of growth, weaken of them and the tumors may be found in this diagnostic method.
Herniated disc treatment:
The treatment of herniated disc is divided into two main methods: conservative treatment and surgery, depending on how serious or minor of it. Herniated disc at mild level is recommended to treat by conservation methods (taking medicine, rest, physical therapy …). Surgery is the last resort, loath to recommend doing. The purpose of surgery is to remove the herniated mass which press on the nerve roots or spinal cord, or completely replace the damaged natural disc by artificial disc. For severe cases, large herniated mass compresses seriously on the spinal cord or nerve roots, can cause loss of feeling and paralyzed, conservative treatment does not help, the doctor consider ability to treat with surgery. At that time, the surgery need be done as soon as possible, if not the muscle will atrophy, the joints become stiff, difficulty recovering after surgery. Why so? Because surgery carries a risk of execution and possible complications after surgery:
Complications may arise from anesthesia, infection, and bleeding. Spinal surgery can cause medical complications such as heart attack, stroke, injury of spinal cord or spinal nerve (paralysis),thrombophlebitis, pneumonia, retrograde ejaculation (men only), ongoing pain, or possibly death.
After the surgery, if no complications, the conservative treatment methods face many limitations. There are patients who suffer from the recurrence. Therefore, surgery is not always the good choice for the patients. The treatment (surgical or non-surgical method) depends on the decision of experienced speciality doctors, who can advise you the best way. The doctors usually based themselves on two main criteria: clinical symptoms and imaging diagnosis results (mainly MRI)
In the case of disc herniation with mild level, herniated mass is still small, does not press the nerve root and spinal cord, or the herniated mass is big on MRI but not great influence on clinical symptoms (less painful), then conservative treatment is recommended.
Conservative treatment of herniated disc is a long process. The patients must accept to live with it, should have a good sense of preserving, perseverance and willpower. They should exercise regularly to avoid disc herniation gets worse (new herniated disc) or relapse (when there are signs of recovery). The treatment result is good or bad depends largely on the awareness and effort of the patients.
In conservative treatment, no medicine helps the patients recover completely because the annulus fibrosus of disc were torn – can not heal. Also no method to “patch” the torn annulus fibrosus effectively. Medication and physical therapy methods (spine stretching, massage, laser rays, microwave…) can help ending the symptoms (pain, numbness ..) but the disc after treatment on MRI images has no change (compared with it before treatment) because the torn annulus fibrosus can not keep the nucleus pulposus. Assuming that the nucleus pulposus can come back to its original position, but it’s easy to leak out again.
The conservative treatment methods include:
+ Medication: Using analgesic medicine (paracetamol, codeine efferalgan), nonsteroidal anti-inflammatory drugs (Celebrex, Mobic, Voltaren, Tilcotil), muscle relaxants (Myonal, Mydocal), the drugs enhance transmission of nerve impulses (nivalin), Vitamin B group (ancopir, nevramin), Antianxiety (seduxen, rotunda). Severe cases may need to use one of these corticosteroids drugs, such as : Solumedrol, Depersolon. At some clinics with good technical condition, they also perform epidural injection by lidocaine and hydrocortisone
+ Oriental medicine: massage, acupuncture, acupressure. The main effect of oriental medicine is sedation (pain relief), anti-spasticity and improve the function of the spine edge muscles.
+ Chiropractic method (Acting on the spine): to correct the disc for its returning to original position.
+ Stretching the spine (using pull up bar/horizontal bar, stretching bed, swimming): very good for minor herniated disc and bulging disc treatment.
+ Physical therapy: heat treatments such as applying hot compress, cold compress (ice-bag), hot bath, using heated mattress, candles wrapping , electrotherapy. Can use other ways like infrared lamp, laser rays, microwave, magnetic therapy, electrophoresis therapy, sand bath, mud bath, mineral bath, swimming in the sea…
You can ask your doctor about this method: applying cold compress immediately after hot compress to increase blood circulation in the herniated disc area.
+ Wearing the back belt (lower back herniation) or neck belt (cervical herniation) to reduce the load on the disc
+ Getting plenty of rest.
+ Don’t lie on soft cushion. Just lying on the hard cushion (hard bed).
+ Do not carry heavy objects
+ Do not wear high heels (The women)
+ In daily life the patients should eat foods with components of cartilage, tendons, bones, such as pig ears, pig’feet, fins – cartilaginous of fish
+ Exercise: Exercise regularly and gently to make the abdominal muscles and back muscles become strong. Includes: Hanging on pull up bar (horizontal bar), yoga exercises, swimming, walking on a flat road, cycling …
The measures to prevent recurrence of disc herniation.
+ Patients need to leave off bad habits such as drinking or smoking, avoid excessive stress on psychology.
+ Obese people should carrying out weight loss methods
+ Note that riding (motorcycle, car) on the bumpy road is also a risk for herniated disc. Therefore the patients need to avoid riding on the bumpy road. If you have to ride the car or motorcycle, you need to wear a back belt.
The most important notice: You can visit this link: http://khanhtrinhvn.com/news/sciatica-treatment-and-prevention.html
to find more information about:
+ The effects of pull up bar (horizontal bar) in herniated disc treatment (sciatica treatment)
+ The advantages of our product – KT height adjustable folding pull up bar – in herniated disc treatment.
+ Guide to treat herniated disc with pull up bar (horizontal bar)