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Lets talk about lumbar disc herniation:
A lumbar disc herniation is a condition affecting the lumbar spine that can be caused by lifting injuries. This occurs when there is a tear in the outer, fibrous ring (annulus fibrosus) of an intervertebral disc this allows the soft, central portion (nucleus pulposus) to bulge out of the tear beyond the outer rings.
If you were to picture pushing down on a jelly donut with the jelly oozing out of the side this is the action that is being described.
Tears almost always occur in the postero-lateral direction, where the annulus fibrosis is relatively thin and is not reinforced by the posterior or anterior longitudinal ligament.
You are most prone to a disc injury during the action of flexion and rotation of the spine (bending over & twisting at the waist). This action places a large amount of pressure on the anterior (front) portion of the disc. As a result this forces the inner part of the disc to the posterior (back). When the spine is straight internal pressure is distributed throughout the whole disc.
While sitting or bending to lift, internal pressure on a disc can move from 17 psi (lying down) to over 300 psi (lifting with a rounded back).
I’m sure that I don’t have to tell you that this is why form on heavy lifts is very important.
A tear in the disc will most often result in the bodies inflammatory chemical response, which may cause severe irritation/pain, even in the absence of the disc fragment causing direct nerve root compression. I would say that about 50% of the lumbar MRI’s that I read indicate that the fragment is not impinging upon the nerve. Yet, the patient will still have symptoms. There is evidence that points to a specific inflammatory mediator of this pain. This inflammatory molecule, is called tumor necrosis factor-alpha (TNF).
symptoms
Symptoms of a herniated lumbar disc can vary depending the severity and on the location. They can range from little or no pain/symptoms, to severe pain that will radiate into the regions served by affected nerve roots that are irritated or impinged (pinched). Other symptoms may include numbness, tingling, muscular weakness and paralysis. You may also experience sciatica, which is a set of symptoms that can run from the back into the butt down the leg to the foot. The symptoms can include numbness, tingling, burning, pins/needles and muscle weakness ect.
Herniation at the L3 or L5 level also have a high chance of experiencing decreased sexual performance (Limp dick ) and also altered sensation in the female counterparts.
Symptoms typically are experienced only on one side of the body. If the herniation is very large and compresses the spinal cord or the cauda equina (the bundle of nerves that comes off the end of the spinal cord) affection of both sides of the body may occur.
*Compression of the cauda equina can cause permanent nerve damage or paralysis. The nerve damage can result in loss of bowel and bladder control as well as sexual dysfunction. This is an emergency situation. If you are crapping & pissing yourself get to the ER asap.
Nonsurgical Treatment of disc herniation
Ice to limit and/or reduce inflammation and muscular spasms
With any acute injury DO NOT USE HEAT
Chiropractic adjustments
- I am very partial to this type of treatment.
Physical therapy
Non-steroidal anti-inflammatory drugs (NSAIDs)
Oral steroids (e.g. prednisone)
An epidural (cortisone) injection
Symptoms of disc herniation will usually gradually improve with nonsurgical intervention. The most common reason to have surgery is to alleviate pain, which has not improved within a reasonable amount of time. Another reason is because their pain will limit them from being as active as they would like.
Lumbar Herniated Disc Surgery
A microdiscectomy is designed to take the pressure off the nerve root by removing the portion of the disc that is pressing on it. Using microsurgical techniques and a small incision, a microdiscectomy can usually be done on an outpatient basis or with one overnight stay in the hospital, and most patients can return to work full duty in one to three weeks. This surgery is minimally invasive.
The success rate of the microdiscectomy is about 95%. In my years of clinical practice I have seen many patients lead an active life style after having this surgery.
Lumbar fusion surgery is usually the result of severe degenerative disc disease with multiple levels of disc herniation. This is a very invasive surgery, which can involve screws, plates ect. I would recommend that if you can avoid this type of back surgery then do so. I have seen very few of these with even fair outcomes.
A lumbar disc herniation is a condition affecting the lumbar spine that can be caused by lifting injuries. This occurs when there is a tear in the outer, fibrous ring (annulus fibrosus) of an intervertebral disc this allows the soft, central portion (nucleus pulposus) to bulge out of the tear beyond the outer rings.
If you were to picture pushing down on a jelly donut with the jelly oozing out of the side this is the action that is being described.
Tears almost always occur in the postero-lateral direction, where the annulus fibrosis is relatively thin and is not reinforced by the posterior or anterior longitudinal ligament.
You are most prone to a disc injury during the action of flexion and rotation of the spine (bending over & twisting at the waist). This action places a large amount of pressure on the anterior (front) portion of the disc. As a result this forces the inner part of the disc to the posterior (back). When the spine is straight internal pressure is distributed throughout the whole disc.
While sitting or bending to lift, internal pressure on a disc can move from 17 psi (lying down) to over 300 psi (lifting with a rounded back).
I’m sure that I don’t have to tell you that this is why form on heavy lifts is very important.
A tear in the disc will most often result in the bodies inflammatory chemical response, which may cause severe irritation/pain, even in the absence of the disc fragment causing direct nerve root compression. I would say that about 50% of the lumbar MRI’s that I read indicate that the fragment is not impinging upon the nerve. Yet, the patient will still have symptoms. There is evidence that points to a specific inflammatory mediator of this pain. This inflammatory molecule, is called tumor necrosis factor-alpha (TNF).
symptoms
Symptoms of a herniated lumbar disc can vary depending the severity and on the location. They can range from little or no pain/symptoms, to severe pain that will radiate into the regions served by affected nerve roots that are irritated or impinged (pinched). Other symptoms may include numbness, tingling, muscular weakness and paralysis. You may also experience sciatica, which is a set of symptoms that can run from the back into the butt down the leg to the foot. The symptoms can include numbness, tingling, burning, pins/needles and muscle weakness ect.
Herniation at the L3 or L5 level also have a high chance of experiencing decreased sexual performance (Limp dick ) and also altered sensation in the female counterparts.
Symptoms typically are experienced only on one side of the body. If the herniation is very large and compresses the spinal cord or the cauda equina (the bundle of nerves that comes off the end of the spinal cord) affection of both sides of the body may occur.
*Compression of the cauda equina can cause permanent nerve damage or paralysis. The nerve damage can result in loss of bowel and bladder control as well as sexual dysfunction. This is an emergency situation. If you are crapping & pissing yourself get to the ER asap.
Nonsurgical Treatment of disc herniation
Ice to limit and/or reduce inflammation and muscular spasms
With any acute injury DO NOT USE HEAT
Chiropractic adjustments
- I am very partial to this type of treatment.
Physical therapy
Non-steroidal anti-inflammatory drugs (NSAIDs)
Oral steroids (e.g. prednisone)
An epidural (cortisone) injection
Symptoms of disc herniation will usually gradually improve with nonsurgical intervention. The most common reason to have surgery is to alleviate pain, which has not improved within a reasonable amount of time. Another reason is because their pain will limit them from being as active as they would like.
Lumbar Herniated Disc Surgery
A microdiscectomy is designed to take the pressure off the nerve root by removing the portion of the disc that is pressing on it. Using microsurgical techniques and a small incision, a microdiscectomy can usually be done on an outpatient basis or with one overnight stay in the hospital, and most patients can return to work full duty in one to three weeks. This surgery is minimally invasive.
The success rate of the microdiscectomy is about 95%. In my years of clinical practice I have seen many patients lead an active life style after having this surgery.
Lumbar fusion surgery is usually the result of severe degenerative disc disease with multiple levels of disc herniation. This is a very invasive surgery, which can involve screws, plates ect. I would recommend that if you can avoid this type of back surgery then do so. I have seen very few of these with even fair outcomes.
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but just to know I will be pain free & not have to restrict my workouts anymore puts a smile on my face... I might start going to chiro again after the surgery.
