Prolapsed intervertebral disk
Individuals who do not have a tendency for lbp preserve the low lumbar disc wedge angles even when the spine is flexed. . It has been suggested that they may not have used upright chairs when young. People who are liable to lbp, some 70 of the uk population, do not have this ability to preserve the wedge angle on spinal flexion and the angle may even become 0 or reversed, resulting in retropulsion of the nucleus of the disk towards sensitive structures. The wedge angles depend on the configuration of the lower lumbar joints which has been extensively studied and are r elevant to chair design. Note, in the diagram above, that the upper surface of S1 forms part of both the sacral horizontal angle and the wedge angle of L5/S1. . The tilt of the pelvis therefore modifies L5/S1 angle. .
, including iv disc prolapse. This effect is shown on pmri scan. . This study suggests that bipedalism requires a high wedge angle for protection of the lower lumbar discs (IVDs).
pictures are derived from, francis. in lumbar flexion (left) shows posterior nuclear shift of the nuclear disc contents. In lordotic extension (right) the nucleus is in the safe mid position. The vorfall joints at risk of breakdown are the lower lumbar (L4/5, L5/S1 to a lesser extent L3/4). Approximately two-thirds of total lumbar lordosis occurs at the inferior two segments (L4-L5-S1). The total and segmental lumbar lordosis at L4-L5 significantly decreases with age. As explained these mobile joints are under greater mechanical stress as they adjoin the fused sacral joints which form the posterior wall of the mass of the pelvis. having a greater wedge angle than the upper joints, it is likely that this has a protective function which would be lessened if this angle be reduced so that the disc surfaces become parallel or if the wedge is reversed. The lumbo-sacral disc angles in sedentary groups liable not liable to lbp. Gorman muggen jd reviewing the x-rays from work by (Pearcy.) noted that in the cohort of 11 non- lbp sufferers, a sedentary group who had not experienced backache in the previous twelve months the standing mean wedge angles were 18 at L5/S1 increasing.
Spinal disc herniation - wikipedia
Spinal configuration of the intervertebral disc angles at the lumbar-sacral beste junction is important for preventing iv disc pathology and developed as a result of hominins adopting an upright (orthograde) stance for efficient bipedalism. Lordosis at the vulnerable lumbar-sacral junction increased and this also protected the joints. The lordotic wedging of the Inter Vertebral Discs (IVD) have an important function in protecting the discs ( (Cyriax. 1946, harrison dd 1998 ) on the preservation of the wedge shape of the disc to prevent retropulsion of the disc contents and is compromised iphone by some sitting positions. These views were based. These angles are shown outlined in white on the pmri scan (left). ) They are measured more accurately by the shape system used by meakin et al, shown (right) with dotted outlines. The wedge angles of iv discs are the simplest to understand. It is this angle at the vulnerable L4/5 l5/S1 ( known as Pre sacral, ps, 1 2 in paleoanthropology) discs that must be preserved if retropulsion and protrusion are to be avoided.
Prolapsed Intervertebral Disc - laser Spine Institute
Some osteopaths also perform surgery for herniated disks. Acupuncture involves the use of fine needles inserted along the pathway of the pain to move energy through the body and relieve the pain. Neurological irritation is considered to be a frequent source of pain with a herniated disk. Many believe acupuncture is particularly effective for pain management and addressing this neurological irritation. Acupuncture can also help break the cycle of pain and muscle spasm that often accompanies a herniated disk. Massage therapists focus on muscular reactions to the herniated disk. Neurological irritation that comes with a herniated disk will often cause excessive muscle spasms in the lower back muscles. These spasms will perpetuate dysfunctional movements in the joints of the spine and may exaggerate compressive forces on the intervertebral disk. By relaxing the muscles, massage therapists will attempt to manage the symptoms of disk herniation until proper movement can be restored.
Therefore, many treatment strategies will be primarily focused on managing symptoms that occur in conjunction with a herniated disk. Unless a serious neurological problem exists, most symptoms of a herniated disk will resolve on their own. Yet, the interventions listed below may greatly speed the time required to resolve symptoms associated with a herniated disk. Chiropractic manipulations are often used to treat herniated disks. There is often significant joint restriction that accompanies a herniated disk and the manipulative therapy is effective at helping to mobilize movement restrictions in the spine. Mobilizing the spine will help the patient get back to moderate activity levels sooner.
The earlier hersentumor an individual can return to moderate activity levels, the quicker they can expect a resolution of their symptoms. Chiropractic manipulations are generally done tandvlees with a greater frequency when a condition is in an acute stage. The frequency of treatments will be reduced as the condition improves. Osteopathic therapy, considered by some to be an alternative treatment, may use manipulations or manual therapy techniques very similar to those of chiropractors. However, osteopathic physicians often employ more manual therapy techniques that focus on the role of the muscles and other soft tissues in producing pain sensations with herniated disks. Osteopathic physicians may also recommend use of the same medications prescribed by allopathic physicians.
Slipped Disc (Herniated or Prolapsed) symptoms and Treatment
X rays show structural changes of the lumbar spine. Myelography is a special x ray of the spine in which a dye or air is injected into the patient's spinal canal. The patient lies strapped to a table as the table tilts in various directions and spot x rays are taken. X rays showing a narrowed dye column in the intervertebral disk area indicate possible disk herniation. Computed tomography scan (CT scans) exhibit the details of pathology necessary to obtain consistently good treatment results. Magnetic resonance imaging (MRI) analysis of the disks can accurately detect the early stages of disk aging and degeneration.
Electromyograms (EMGs) measure the electrical activity of the muscle contractions and possibly show evidence of nerve damage. A number of physical examination procedures may be used to determine if a herniated disk is pressing on a nerve root. While these tests may not identify the definitive presence of a herniated disk, they are very useful for indicating if there is pressure on a nerve root from some structure such as a herniated disk. The straight leg raise test may be used to identify pressure on nerve roots in the lumbar region while the Spurling's test (involving neck motion) may be used to identify compression of nerve roots in the cervical region. Compression of nerve roots in the cervical, thoracic, or lumbar regions may be apparent with the slump test. Treatment, it is unclear if herniated disks cause pain themselves, or if they must press on a nerve root to cause pain. Pain may also occur with herniated disks as a result of mechanical or neurological irritation of surrounding structures such as muscles, tendons, ligaments, or joint capsules.
Disc Prolapse prolapsed (Herniated) Disc - symptoms, diagnosis
A herniated disk may occur suddenly from lifting, twisting, or direct injury, but more often it will occur from constant compressive loads over time. There may be a single incident that causes symptoms to be felt, but very often the disk was already damaged and versleten bulging prior to any one particular incident. Depending on the location of the herniation, the herniated material can also press directly on nerve roots or on the spinal cord. Pressure on the nerve roots or spinal cord may cause a shock-like pain sensation down the arms if diagnose the herniation is in the cervical vertebrae or down the legs if the herniation is in the lumbar region. In the lumbar region a herniation that presses on the nerve roots or the spinal cord may also cause weakness, numbness, or problems with bowels, bladder, or sexual function. It is unclear if a herniated disk causes pain by itself without pressing on neurological structures. It is likely that irritation of the disk or the adjacent nerve roots may cause muscle spasm and pain in the region of the disk pathology. Diagnosis, several radiographic tests are useful for confirming a diagnosis of disk herniation and locating the source of pain.
Herniated Disk in the lower Back - orthoInfo - aaos
Studies have shown that males are more commonly affected than females in lumbar disk herniation by a 3:2 ratio. Long periods of sitting or a bent-forward work posture may lead to an increased incidence of disk herniation. There are four classifications of disk pathology: A protrusion occurs when a disk bulges without rupturing the annulus fibrosus. A prolapse occurs when the nucleus pulposus pushes to the outermost fibers of the annulus fibrosus but does not hernia break through them. An extrusion occurs when the outermost layer of the annulus fibrosus is torn and the material of the nucleus moves into the epidural space. A sequestration occurs when fragments from the annulus fibrosus or the nucleus pulposus have broken free and lie outside the confines of the disk. Causes symptoms, any direct or, forceful in a vertical direction pressure on the disks can cause the disk to push its nucleus into the fibers of the annulus or into the intervertebral canal.
There are seven cervical (neck twelve thoracic (chest region and five lumbar (low back) vertebra. There are intervertebral disks between each of the 24 vertebrae as well as a disk between the lowest lumbar vertebrae and the large bone at femme the base of the spine called the sacrum. Disk herniation most commonly affects the lumbar region. However, disk herniation can also occur in the cervical spine. The incidence of cervical disk herniation is most common between the fifth and sixth cervical vertebrae. The second most common area for cervical disk herniation occurs between the sixth and seventh cervical vertebrae. Disk herniation is uncommon in the thoracic region. The peak age for occurrence of disk herniation is between 20 and 45 years of age.
Disc Herniation Symptoms, causes, and Treatments
Home back/Neck conditions / Prolapsed Intervertebral Disc (Slipped Disc). Gale Encyclopedia of Alternative medicine, copyright 2005 The gale Group, Inc. Definition, disk herniation is a breakdown of a fibrous cartilage material (annulus fibrosus) that makes up the intervertebral disk. The annulus fibrosus surrounds a soft gel-like substance in the center of the disk called the nucleus pulposus. Pressure from the vertebrae above and below may cause the nucleus pulposus to be forced against the sides of the annulus. The constant pressure of the nucleus against the sides of the annulus will cause the fibers of the annulus to break down. As the fibers of the annulus break down, the nucleus will push toward the outside of the annulus and cause the disk to bulge in the direction of the pressure. This condition most frequently occurs in the lumbar region and is also commonly called a herniated nucleus pulposus, prolapsed disk, ruptured disk, or a slipped koelen disk. The spinal column is made up of 24 vertebrae that are joined together and permit forward and backward bending, side bending, and rotation of the spine.