Steemit Learning Challenge-S21W6; Disc Herniation"

Asalamualaikum everyone..

Disc hernia is a disease that affects many of those who are elderly so I will take part in this very useful contest by @ashkhan to learn a little about this disease so that one day my body will avoid this disease.

• What's disc herniation? Write in your own words after getting knowledge from the lesson post.

A herniated disc or better known as a spinal hernia injury is where the spinal cushion bulges out and presses on the nerves, which can cause numbness, pain in the neck, back and legs. This disc itself is a disc that works to support our spine. In the disc there are two parts, namely there is a soft inner part like agar agar and a hard outer ring. Generally, this disease often occurs in those who are elderly due to several factors.

Here are some types of herniated discs that I learned

1. Cervical dischernia(occurs in the C1-C7 neck area)
Cervical disc hernia occurs where the condition in the middle of the intervertebral disc protrudes into the cervical spine so that it can cause symptoms of pain, especially in the neck and one arm or hand.

2. Thoracic disc hernia (occurs in the upper and middle back region T1-T12)
Thoracic disc hernia is a serious but treatable back disease over time. It occurs where the soft intervertebral center pushes through any tears into the hard outer layer and into the spinal canal. A herniated thoracic disc can cause patients to feel upper back and chest pain. In addition, herniated thoracic discs can also cause dysfunction in the thoracic spinal cord.

3. Lumbar disc hernia (occurs in the lower back area L1 -L5)

Lumbar disc hernia is a tear in the outer wall of the nucleus pulposus which causes the inner part of the nucleus pulposus to come out. This condition can cause patients to experience back, buttock and leg pain. lumbar disc hernias often occur in those aged 30 years and over because the spine is more vulnerable.

Causes of herniated disc

1. Advanced age, which can cause the structure and tissue of the spine to become weaker.
2. Certain injuries that make the spine more vulnerable.
3. Excess weight, such as obesity.
4. Ergonomic factors where repetitive movements occur with improper positions.
5. Genetic factors are one of the causes of herniated discs.
6. Sudden strain factors due to lifting something with improper posture.

Herniated disc symptoms
Symptoms of a herniated disc can vary depending on the type of hernia.

1. If it occurs in the lower spine as I mentioned above, the patient will experience pain that spreads from the buttocks to the side of the thigh or to the leg.
2. Tingling and muscle weakness in the legs.
3. Pain that spreads from the shoulders, arms and fingers.
4. Very sharp pain when bending and twisting the neck.
5. Tingling in the hand.
6. Pain between the shoulder blades.

• How would you diagnose a disc herniation? Any clinical investigation or assessment tests?

Like mending diseases in general, especially we must ask the patient about the history of herniated disc disease. because as I mentioned above, this disease can be passed down through the patient's family. After that, physical tests will be done to determine muscle strength and pain.

Then an x-ray may be done to check for bone overgrowth and reduction of space in the disc. Furthermore, we can also perform MRI or CT-scan tests that can show the exact position of the herniated disc in the spine as well as how severe the movement of the disc into the nerve channel is.

Special tests for herniated discs

Cervical disc hernia
A. The spurling test in cervical disc hernias is performed by sitting the body position and then turning the head to the painful area while pressing the head down to see acute radiculopathy.

B. The extension test is a test performed by lying on your stomach with your elbows against your sides and under your shoulders. Next straighten the elbows and push the upper body and let the lower back decline. Keep the pelvis and legs relaxed and hold for 6 minutes.

C. The flexi test is a test performed in a supine position and then the patient straightens the leg shared by the hip while maintaining knee extension.

Thoracic disc hernia
A. The schober test is performed to see the decrease in spinal range most often caused by ankylosing spondilytis.

B. The thoracic spine extension test is performed on the stomach with the head protruding from the table, then the patient is asked to extend the spine horizontally. After that the patient is also asked to raise the head and shoulders to the level of the table.

C. Rotation tests in thoracic disc hernias are performed to assess whether the patient can stand upright, as well as see the assessment of provocation of pain caused.

Lumbar disc hernia
A. Valsalva test in a herniated disc is used to see the hernia more clearly clinically due to increased intra-abdominal pressure.

B. The femoral nerve stretch is performed by kneeling on one knee and stacking the legs on a chair. Then provide the buttocks down and find a little forward until the hips are stretched out. After that bend the upper back and head down slowly

C. Lumbar extension test in herniated discs is performed by positioning the body on the stomach and lifting the legs and knees simultaneously about 30 cm from the place of lying down.

• Try to practice at least 3 exercises that you have learned from the lesson. Share images, gifs or videos while practicing preferably gifs or videos.

Hip Bridging Exercise
This exercise is done by sleeping on your back and then lifting your hips and buttocks up and holding for a few minutes.