Herniated Disk Syndrome

When an individual has had a protracted period of chronic low back or neck pain that has interfered with their daily activities and or occupation, the possibility of a herniated disk needs to be positively considered. Knowing exactly what a herniated disk is, and what you are possibly dealing with, is important so that you will be able to deal with it properly. Explaining the anatomy of the disk in the simplest way would be to take a raw egg and flatten it to about 3/4 inch thick. Of course that can’t be done, but for the sake of this demonstration, let’s say we can. Okay then, the outer shell would be the cartilaginous portion of the disk, called the “Anulus Fibrosus” and the yolk would be the soft nucleous center, called the “Nucleus Pulposus”. When the nucleus pulposus escapes or leaks through the cartilaginous outer ring, for any reason, that would be called a “Herniated Disk”.

These disks called,” Intervertebral Disks”, are inserted between each of the 24 vertebrae that constitute the spine. The sacrum is the large triangular bone that completes the spine. These disks in their normal state act as shock absorbers to make each and every body movement fluid and as painless as possible. Next you have to consider that your body is like an automobile or any piece of machinery. The longer you use your automobile or that piece of machinery, there will be wear and tear on its parts. Your body is no different, so as you age, parts of your body will start to wear out. The intervertebral disks, over the years are constantly under a great deal of pressure. They are involved in our every movement. This is part of the aging process. Below are shown the 4 phases of degeneration that the intervertebral disks go through as part of the aging process. That does not mean that we all will go through a radical degenerative process such as shown below, that will depend on how we lived our lives. The more activities, such as our occupation, sports, etc., and the strenuousness’ involved will determine the amount of degeneration that will occur.

THE 4 DEGENERATIVE PHASES OF THE DISKS

Other than the aging process, there can be many causes that will cause a herniated disk. These are causes that can occur at any age. Most often during the early years, trauma would be the chief cause. A trauma to the spine can occur during an automobile accident, a severe fall from a height no matter how high it is, as in a fall off a ladder, or an on the job accident. Those engaging in sports, especially professional athletes, and even the weekend athlete, can sustain an injury to the spine, resulting in a herniated disk.

As explained above, when there is a tear or weakness in the annulus fibrosis (cartilage), and the nucleus pulposus (soft center) leaks or bulges out, it will cause compression or pinching against one of the nerves emanating from the spinal cord. There are nerves all along the spinal cord on each side that pass through a foramen (opening), formed by 2 vertebras, and this where the bulging occurs. The compression of a nerve usually occurs on one side, however, it can also occur on both sides if there is a very large bulge. If the disk affected is one of the lower lumbar disks, it can also affect nerve roots called the“Cauda Equina” that will affect many nerves.

When a nerve root is compressed or pinched, it causes radiating pain from the point of origin, following along the distribution of that nerve. For example in the lower back, if the sciatic nerve is compressed or pinched, the end result for the individual is that they will have radiating down the leg (sciatica). In the neck, a pinched or compressed nerve affecting the brachial plexus can cause radiating pain down the arm (brachial neuritis). These are just 2 examples of how a herniated disk can affect and individual. Cervical herniated disks can cause major muscle problems and severe weakness of the muscles. The problems can eventually extend down to the lower extremities as well. There are 2 self-tests that you can perform that almost certainly can tell you that you are having a problem with a disk in the lower back. One is called the “Valsalva Maneuver”. In this maneuver, you cough, sneeze, laugh, or when straining at stool, you get a sharp. It is then considered to be a positive sign. In the second test, while lying flat, have someone hold your ankle and raise you leg straight up without bending the knee. If you get a sharp pain, the disk will be affected on that side. Do the same with the opposite leg to check for disk problems on that side. In the neck, place both hands with entwined fingers on the top your head and press downward. If you get a sharp radiating pain into the shoulder or arm, you can consider that as having a disk problem.

Anyone that has been having pain for any length of time, and especially if it has gotten progressively worse, and you elicited positive signs when you performed the above tests, should see their healthcare provider for consultation and to get a definitive diagnosis. He or she will perform these tests any many, more to arrive at a definitive diagnosis. If this condition is not treated, the muscles involved will become, flaccid and wasted. The patient will have difficulty walking, working and doing their normal daily chores.