The herniated disc is an anatomical mechanism. Herniated disk in fact corresponds to the output of the disc located between the vertebrae of the spine.
Protruding outside its casing, the disc can compress the nerve roots and trigger eg vector sciatica. Thus, the herniated disc is often less known than its main symptom of sciatica.
All regions of the back can be involved, but the lumbar region (lower back) is widely the most affected.
Origins of herniated disks
Disc herniation is common in young subjects between 30 and 40 years.
Some postures like sitting position (drivers ...) or carrying heavy loads (snap-action, wrong move ...) favor herniated discs.
The age or trauma also accelerate aging of the disc and hernia.
Some risk factors are also identified to promote herniated disc: This is overweight and pregnancy. Genetic predisposition may also exist in some families; herniated discs while generally occur earlier than in the general population.
Causes and mechanisms of a herniated disc
The spine or vertebral spine is formed of a stack of vertebrae separated by intervertebral discs.
In case of overweight, improper movement or simply degeneration, this gelatinous disc can deform and break its protective bag. It then projects and forms the herniated disc.
A herniated disc can be asymptomatic if it compresses any nerve.
On the contrary, it can cause inflammation and pain if it compresses certain nerve roots (sciatica or femoral).
Symptoms and signs of a herniated disc
A herniated disc can long remain asymptomatic and cause no discomfort. In favor of a motion or time, it may be in pain, simple backache to the paralyzing sciatica.
These symptoms can appear suddenly and disappear or persist chronically.
Some triggers are often found, such as coughing, laughing or sneezing by increased abdominal pressure or forward leaning position.
The most common disc herniations are located in the lower back, with back pain and leg. The simple "back pain" is called low back pain, while pain that goes down the leg below the knee and is called sciatica or femoral neuralgia according to the compressed nerve root.
The sciatica associates for its pain with lumbar spine pain (irradiation) in a leg.
Herniated discs are possible in the cervical spine (neck area) and then cause arm pain spreading to the fingers.
With what should we be confused herniated discs?
It initially not confuse the word "hiatal hernia" and "herniated disc".
Hiatal hernia is a digestive disease which corresponds to the passage of a portion of the stomach above the diaphragm.
Furthermore, the pains of sciatica or back pain should not be confused with pain caused by another disease such as renal colic. Renal colic (kidney stones) also causes pain starting from the lower back and radiating to the front (towards the external genitalia).
Conducting a dipstick (or urinalysis) will usually very quickly diagnosis.
Will it possible to prevent slipped discs?
Simple lifestyle tips to prevent or limit the consequences of a protrusion or herniated disc.
This is to exercise regularly, to warm up before starting an effort to maintain and ensure a satisfactory abdominal and dorsal (support the spine).
Overweight should be avoided as much as possible by a balanced diet.
Gestures and postures are fundamental steps of prevention:
straight back, straight look, squat by bending the knees to lift a load, rest periods to stretch and stretch when sitting, straight-backed chairs and if possible swivel to avoid torsion.
The backpacks port is preferred to handbags and high heels (above 5 cm) are not recommended.
In addition to these tips and if proven herniated disc, you should not look too far forward or to make efforts (charging port ...).
Some simple exercises improve symptoms (on the back, bring knees to chest ...): consult your doctor.
Weight loss will also be beneficial.
When to consult?
In case of pain in the back or sciatic pain, signs must be warning signs and motivate emergency consultation.
This is the loss of strength (motor deficit) in one leg or paralysis (inability to take off the foot), difficulty urinating or bowel movement or otherwise of incontinence.
This is called medical emergencies which can sometimes require surgery to decompress the nerve roots crushed by the herniated disk.
Similarly, the unbearable pain despite treatment constitutes an emergency.
What is the doctor?
The doctor looks for certain signs suggestive of the original disc pain: increased cough, pain in the leg elevation (Lasegue), pain in the leg pressure between two vertebrae ...
The examination will specify the triggering circumstances (effort, wrong moves ...) and a complete neurological examination eliminate paralysis or complication.
Additional tests such as radiography of the spine or lumbar spine CT (or a magnetic resonance imaging or MRI) may be prescribed and confirm the presence of disc herniation (conflict between the disc and the nerve root). They are not systematic in front of a classic sciatica.
Treatment aims to relieve pain by non-steroidal anti-inflammatory drugs, drugs against pain and muscle relaxants. The local injection of anti-inflammatory corticosteroid is also possible in case of failure of the first treatment.
Strict bed rest is usually offered for one or two days maximum, as it promotes muscle weakening back.
The prescription of physical therapy is also beneficial, especially to prevent recurrences.
Lumbar restraint belts are useful and help to keep activity during treatment.
Radical treatment is offered in second-line in case of failure of medical treatment. Two techniques are possible: surgically remove the disc or dissolve.
How to prepare my next appointment?
It is desirable to distinguish circumstances or movements that trigger pain. In fact, your doctor or physical therapist can offer the amenities of position or posture.
At work, the occupational physician can also help you in terms of ergonomics.
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