Discus hernia

Diseases painful conditions of the spine

Disc herniation or more precisely prolapse of the intervertebral disc itself means "rupture" of the fibrous sheath, which in turn is an integral building material of the same. To start with an explanation of what a herniated disc is, it is good to present the very, relatively simple structure of the disc.

The intervertebral disc is a connection between two adjacent vertebrae, which forms a kind of cartilaginous joint and serves to cushion the daily pressures and movements that the body, more precisely the spine itself, performs. It is built of a connective sheath (annulus fibrosus) that surrounds the gelatinous nucleus (nucleus pulposus) in layers. The discs are present between each pair of vertebrae except between the first two cervical, atlas, and axis. Each spine consists of 24 intervertebral discs and 33-34 vertebrae.

As age progresses, the gelatinous nucleus begins to dehydrate, with a weakening of the connective tissue, thereby reducing the ability to absorb and evenly distribute pressure. If the fibrous sheath ruptures, some people also experience pain. Most often due to repeated trauma, degenerative diseases of the disc itself, the nucleus pulposus can be pushed out of the damaged envelope rings.

It is mainly a shift posterolaterally, due to the position of the posterior longitudinal ligament itself. Generally speaking, a slight minimal protrusion of the disc without rupture of the sheath and displacement of the core is called bulging. If there is a rupture of the fibrous sheath with displacement of the nucleus, we speak of protrusion, and if there is a rupture of the sheath at all levels with "leakage" of gelatin outside the structure, we speak of prolapse or extrusion. The worst-case scenario involves the separation of the contents of the disk, a condition called sequestration, which in turn can move caudally and cranially.

If there is pressure or irritation on the corresponding nerve root, RADICULAR pain, LOSS OF SENSATION and MOTOR DEFICIENCY occur. If the prolapse is medial, compression on several roots can cause caudae oequinae syndrome (sphincter disorder, perianogenital hypoesthesia, erectile dysfunction, etc.).

A typical finding in lumbar disc herniation in most patients of the Nado Polyclinic includes:

• the pain is more pronounced in the leg than in the back and intensifies when straining
• there is an analgesic or functional scoliosis whose focus depends on whether the root is compressed on the medial or lateral side
• positive tensile test (Lazarević-Laseguae) on the chemistry side, and if the finding is large or medial then on the opposite side

The diagnosis itself is most easily established by magnetic resonance imaging of the same segment. The symptomatology depends mostly on the location of the chemistry and the intensity of the mechanical damage. In most patients of the Nado Polyclinic, the pain varies from mild to extremely sharp severe pain in the neck and lower back with irradiation of pain in the dermatomes (areas innervated by the affected roots). In addition to pain, patients at the Nado Polyclinic regularly describe a feeling of tingling in the extremities, paresis, a feeling of numbness, and muscle weakness. One side of the body is most commonly affected.

Radiculopathy is a condition or disease of the spinal nerve root, usually as a result of pressure on a nerve in the area of ​​the cervical and lumbar spine. The degree of damage to the nerve itself is best examined and proven by EMNG. Electromyoneurography (EMNG) is a modern neurophysiological method of examining muscles, neuromuscular junction and peripheral nerves. Nowadays, it mainly causes immobility of the spine itself, which consequently causes and accelerates degenerative changes of the disc itself and surrounding structures (sedentary lifestyle, unhealthy diet).

Furthermore, disc herniation also occurs as a result of trauma, usually after an awkward, sudden movement (bending and lifting a load with the legs outstretched, with the back bent at the waist).

Treatment with classical physical methods usually does not give the desired results. The problem is that all of these methods work to alleviate the discomfort, but not to the cause of the problem itself, which is mechanical pressure on the nerve root. After painstaking drug therapy, surgery is usually followed, but only after all other options have been exhausted. Then it would be good to come to us at the Nado Polyclinic for a detailed treatment / examination and after the examination non-operative decompression therapy of the spine can be started .

Decompression therapy is the only non-surgical treatment that is really effective in severe cases of disc herniation, degenerative joint diseases, arthritis, stenosis (narrowing of the spinal canal) and pressure on the nerve roots. It is a non-operative traction therapy for relieving pain in the back, legs and arms. Through cyclic phases of distraction and relaxation and proper positioning, the spinal disc (intervertebral disc) can be isolated and placed under negative pressure thereby causing a vacuum effect within it.