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Back Pain ...Disc Hernation ..part 1




Lumbar backache is one of the most common causes of chronic debility in the world  .

Acute lumbar disc prolapse or chronic degeneration with disc-space narrowingat L4/5 or L5/S1 are the most common pathologies.

 In acute prolapse, the disc may bulge beneath the posterior longitudinal ligament in the mid line (central disc) or posterolaterally with consequent distortion of the spinal canal or nerve-rootcompression.

Local edema may exacerbate the problem.

Symptoms result from distortion of the posterior longitudinal ligament (chronic pain), pressure on the nerve-root sheath(sciatica) and compression of the nerve itself (muscle weakness, numbness and paraesthesia).

Cauda equina compression may cause urinary retention, but is relatively uncommon.

 Management may include rest, analgesia and physiotherapy, but the prolapsed disc can be treated effectively only by bed rest, disc reduction (including epidural injection or chemonucleolysis) or surgical discectomy.

Cervical disc prolapse may be precipitated by sudden unexpected flexion or rotational movements.

In most cases, there is probably a pre-existing disc abnormality.

The most common levels for prolapse are C5/6 and C6/7, and symptoms are similar to those of lumbar disc prolapse.

Treatment of the prolapse may be effected by rest, reduction using bed rest and traction, or surgical removal, if the symptoms are severe
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