Steemit Learning Challenge-S21W6; Disc Herniation

AssalamuAlaikum & Greetings Everyone!

It's me @amjadsharif
From #pakistan

Q.1 - What's disc herniation? Write in your own words after getting knowledge from the lesson post.

Disc Herniation

Disc herniation is common in the spine area and may cause severe pain, in the backbone area, in the back, or in the neck. The spine consisting of a series of twenty-four small bones called vertebrae arranged one above the other. In between these bones are situated the intervertebral discs, which provide, as it were, springs or buffers for the back. These discs keep flexibility and enable ease in the actions and movements of the body.

Each disc has two main parts:

1. Nucleus Pulposus: A gel like interior that can effectively reduce impact forces.
2. Annulus Fibrosus: Overall a tough skin that contains the nucleus within it.

The herniated disc results when the annulus fibrosus portion becomes thin or ruptures to reveal the inner gel. This protrusion can work on close lying nerves and cause the patient to complain of pain or other conditions. This condition is also known as a ‘slipped’ or ‘ruptured’ disc – even though the disc itself does not literally slip.

Causes of Disc Herniation

Disc herniation is often caused by:

• Aging: Aging results in the fact that discs become devoid of water and therefore become stiffer and more susceptible to being damaged.
• Injury: Herniation can be as a result of awkward movements, falls or lifting odd objects in improper ways.
• Repetitive Strain: Those that put extraordinary load on the spinal cord over time.
• Genetics: It’s also important to note that in some cases one can be born with the genes that increase one’s risk of developing disc issues.

Common Symptoms

The symptoms of a herniated disc depend on its location in the spine and whether it presses on nearby nerves:

• Localized Pain: Shooting pain in the low back or buttocks and down the leg into the foot or pain in neck and shoulders and down the arm into the hand.
• Radiating Pain: In some cases, the material that has herniated will compress the nerves and the resulting pain can extend to the limbs, including the arms and legs. For example a prolapsed disc in the lower back may lead to sciatica – this is a shooting pain in the leg.
• Numbness or Tingling: Sometimes, the nerves that are affected may lead to numb feelings or tingling in given parts of the whole body.
• Muscle Weakness: Pressure on any nerve will cause it to reduce it power and muscle groups connected to the nerve will become weakened.

Diagnosis

MRI, CT or X-ray might be used to diagnose disc herniation and then a physical examination to determine where it is on the spine.

Treatment Options

Treatment varies depending on the severity of symptoms:

• Rest and Activity Modification: Pain can be prevented if one avoids situations that trigger worsening of the symptoms.
• Medications: Non steroidal anti inflammatory drugs NSAIDs , analgesics or muscle relaxant may offer some relief.
• Physical Therapy: Specific movements that build muscles surrounding the spine to ensure that people do not bend or lean forward when standing.
• Epidural Injections: Corticosteroids administered through injections help to control any inflammation that may be surrounding nerves as well as pain.
• Surgery: However conservative treatments provide little relief, sometimes the only option available is surgery in which the bulging section of the disc or pressure on the nerve is removed.

Prevention

While not all cases can be prevented, adopting healthy habits can reduce the risk of disc herniation:
It means that one has to sit, stand and lift with a right posture.
Exercising is another recommended step in that one should train his back and belly muscles in order to firmed them up.
The patients should also avoid regular smoking because this habit contributes to disc degeneration.
It is important to use the correct way to carry large loads.

Disc herniation can also limit people’s daily activities; however, if the problem is found and treated, people are usually able to work and live normally again.

Q.2 - How would you diagnose a disc herniation? Any clinical investigation or assessment tests?

Diagnosis of Disc Herniation: Clinical Investigations and Assessment Tests you have currently stored include the following:

A disc herniation, more frequently known as a slipped or ruptured disc, is the disease where the nucleus pulposus of a spinal disc herniates through the annulus fibrosus. This condition can also cause oppression of the nerves around and these causes pain, numbness and weakness to the affected part. Disc herniation diagnosis depends on clinical examination, physical examination and imaging studies.

Patient History

The first line of approach to diagnose the situation of a disc herniation involves assessment of the history of the patient. This includes asking about:

• The onset of symptoms: Whether the pain is acute or chronic.
• Pain characteristics: Pain, which may be sharp, shooting, or dull, and whether it spreads to the limbs.
• Previous history of back disorders or injury.
• Movements that aggravate or help to relieve the symptoms (such as flexing to bend or pick something up or remaining seated for long periods).
• Other symptoms which are related and may be present include; lims or leg pains or continuous numbness/ tingling or weakness of the legs.

Kernig’s Sign

The test performed here entails placing the hip and knee at 90 degrees and then attempting to pass a straight leg. Pain and stiffness against increase in operation or against full extension tends to harbour nerve root impingement seen in disc herniation.

Imaging Studies

While physical tests and clinical history provide important clues, imaging studies confirm the diagnosis and help assess the severity of the herniation:

X-ray

Although disc herniations do not appear in an X-ray, which are essential forms of back pain due to fractures or spinal abnormality. Sometimes, reassuringly, an X-ray may show signs of degenerative disc disease or any other structural pathology regarding the disc.

MRI (Magnetc Resonance Imaging)

MRI is the best survey proctor for confirming disc herniation. It produces detailed sectional images of soft tissues, but particularly the intervertebral discs and can describe the position, dimension and levels of herniation. MRI also turns out to be very useful when it comes to deciding if nerve roots are compressed or not.

Computed Axial Tomography / CAT

If an MRI is not possible, a CT can be done which will show the bones and discs. Like MRI, it’s not as detailed but it can provide some info.

Myelography

This is somewhat invasive in that a dye is injected through a needle into the spinal canal, then an X-ray or CT scan is taken. It is usually performed when MRI cannot be carried or when MRI is inconclusive.
In this position, the patient is supine and the examiner flexes the patient’s leg at the knee joints while holding the knee joint stiff.
If the patient complains of pain which pulses down the leg, especially in the sciatic nerve area of distribution at 30 good 60 degrees, then it is suggestive of nerve root tension sign or radicular compression seen in disc prolapsed.

Slump Test

This test is performed to apply tonic pressure on the nerve roots in the spine. For this task the patient is supposed to sit, slouch a little and then try to extend a leg. Any kind of pain or discomfort during this test may well be indicative of a herniated disc.

Electromyography (EMG)

Sometimes, for the assessment of nerve dysfunction, electromyography (EMG) test is performed to determine the extent of nerve root compression. It assists in determining the presence or otherwise of nerve compression resulting from disc herniation.

Disc herniation can be diagnosed by the review of the patient’s history, physical examination and imaging studies. A supplementary and basic assessment including a Straight Leg Raise test in addition with MRI scans is essential in order to diagnose a herniated disc and the level of nadir involvement. A correct diagnosis is critical in determining which therapy approach will work best in treating the patient.

Q.3 - 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.

The exercises should therefore be done regularly to enhance flexibility strength and motor power in the body. Here, I’ll be sharing how to practice three key exercises: Some of the exercise names include: Hip Bridging Exercise, William Flexion (Knee to Chest Stretch) and Piriformis Stretch. Most of these exercises are good for strengthening the joints, as well as relaxing tensed up muscles of the lower extremities.

1. Hip Bridging Exercise

It is possible to perform the Hip Bridging Exercise for people who want to develop their glutes, lower back, and strengthen the primary core muscles and enhance hip mobility.