Also called: Bulging disk, Compressed disk, Herniated intervertebral disk, Herniated nucleus pulposus, Prolapsed disk, Ruptured disk, Slipped disk
2. Symptoms
Back pain that spreads to the buttocks and legs, when the herniated disk is in your lower back
Neck pain that spreads to the shoulders and upper arms, when the herniated disk is in your upper back
Tingling or numbness
Muscle spasms or weakness
3.What are the causes?
Your backbone, or spine, is made up of 26 bones called vertebrae. In between them are soft disks filled with a jelly-like substance. These disks cushion the vertebrae and keep them in place.
Discs can bulge or herniate because of injury and improper lifting or can occur spontaneously. Aging plays an important role. As you get older, your discs dry out and become harder. The tough fibrous outer wall of the disc may weaken, and it may no longer be able to contain the gel-like nucleus in the center. This material may bulge or rupture through a tear in the disc wall, causing pain when it touches a nerve. Genetics, smoking, and a number of occupational and recreational activities lead to early disc degeneration.
4.What treatments are available?
With treatment, most people recover. It can take a long time. Treatments include rest, pain and anti-inflammatory medicines, physical therapy and sometimes surgery. Losing weight can help, too.
Conservative nonsurgical treatment is the first step to recovery and may include medication, home exercises, rest, nutritional supplements, massage, physical therapy, acupuncture, acupressure, hydrotherapy, chiropractic care, and pain management.
Epidural steroid injections and nerve blocks may provide short-term improvement of pain symptoms.
Spinal injections are considered immediately for patients with severe, incapacitating pain or patients who have reached a plateau with conservative treatments yet continue to have moderate or severe pain.
Surgical intervention is considered when a patient with a cervical herniated nucleus pulposus continues to have pain, weakness, and/or numbness, and has failed conservative modalities.
5.What is the Difference between Acupuncture and Pain Medication?
Non-steroidal anti inflammatory drugs (NSAIDs) have several well-known potential detrimental effects in your system such as gastric irritation and liver damage while acupuncture has virtually no side-effects. In terms of the action on your muscle and joint pain, acupuncture works in a completely different manner than medication does.
Most pain-relief and anti-inflammatory medications provide excellent short-term pain-relief by blocking the production of pain-causing substances called prostaglandins. In addition to inducing pain, however, prostaglandins are vasodilators which help enhance circulation. By inhibiting the production of prostaglandins, there will be decreased sensitivity to pain but blood supply to the muscles and joints will also be decreased, thus creating problems and prolonging true recovery.
Acupuncture technique, however, produces the complete opposite effect. Except in a few very acute cases, we attempt to enhance blood circulation, especially in the area that there is pain or discomfort. This desired action can be achieved by regulating the autonomic nervous system (which is responsible for internal organ system functioning, regulation of blood circulation, and production of relaxation effects) using specific acupuncture techniques. When circulation in the tissue improves, muscle relaxation occurs and immediate pain reduction follows in many cases. In some other cases, however, when circulation improves, the pain in the affected area occasionally intensifies, and is then followed by repair of tissue and muscle relaxation.
Proper circulation in the tissue is important not only for blood to nourish the tissue but also in enhancing the elimination of muscle fatigue and pain-causing substances (e.g., lactic acid) thus resulting in healthy tissues. On the other hand, tight muscles with poor circulation are fatigued easily and are more prone to injury.
6.Prevention
The key to avoiding recurrence is prevention:
1. Proper lifting techniques. If your regular job cannot be done initially, it is in the patient's best interest to return to some kind of modified (light or restricted) duty. Your physician can give prescriptions for such activity for limited periods of time.
2. Good posture during sitting, standing, moving, and sleeping
3. Appropriate exercise program to strengthen weak abdominal muscles and prevent re-injury
4. Healthy weight and lean body mass
5. A positive attitude and stress management
6. No smoking