Steemit Learning Challenge S21W6 Disc herniation

What's disc herniation??

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Disc herniation that is most commonly known as slip disc and it is usually occurring in elderly people the people who are more than 50 years old and what happened there are two main things one which is called annules fibrosis another one which is nucleus pulposus in any case for example if the spinal disc tear that causes space narrowing so when the nucleus in the spinal disc that is very soft butter like structure.

When space is narrow this senerio lead to the compression of so many important structures there is a list of nerves and muscles which are passing through these disc and one very important is sciatic nerve and most people in the OPD always come with sciatic nerve compression and the cause might be due to our life style for example the women who sit in a wrong posture or there job is related to heavy weight carrying.

I will talk about the main three types of disc herniation

Cervical disc herniation

This occurs in the neck and if I talk about the vertebra it involves mainly from C1 to C7.

Thoracic disc herniation

This involves the upper back of the patient and this is mainly the vertebra involving is from T 1 to T12.

Lumbar disc herniation

And this involves the lower back and mainly lumber vertebral L1 to L5.

If I talk about the main causes in our part of country like Pakistan so most commonly the elderly people are suffering the secondly wrong posture is the main cause due to any aspect like the patient who are doing job related to heavy weight lifting or sometime it may be the genetic. The people who use the lumber , thoracic vertebrae very much so they are most commonly affected.

symptoms

How the patient come to emergency this is the main important thing firstly they complaint of lower back pain or neck pain or upper back pain according to the herniation type and most important it there is static nerve compressing they will complain that the pain is radiating from the back and then it is stretching whole leg or sometimes the buttocks and Thigh.

And if the herniation is the cervical they complain of neck pain which mainly radiate to the arms and as we know if there is nerve compression so mainly the symptoms are for example the patient is feeling there is a numbness over that area along with that there is a sensation that something is crawling over the legs which means that tingling sensation.

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

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Diagnosis is the main important part when you made the diagnosis on time so the clinical assessment is very important like you ask the patient important question what kind of pain it is where the patient is able to perform the daily activities or not is there any numbness or tingling sensation feeling whether on the neck, back or lower back and another important thing is the physical examination only to check all the reflexes that what grade of the pain patient is suffering from or what degree of pain.

So some basic test which is really important for example if the patient is complaining of pain whether in the neck ,back or lower back first get the X-ray to check any fracture or anything else second most important thing if you feel the narrowing on the X-ray than go for MRI or CT scan.

If you find the Diagnostic finding any of above then you the must go for emg or ncs.

So there are many and that's we can perform according to the type of herniation I will describe one for each region.

For cervical herniation and there is one important test which is called the spurlings test which I will explain in detail how to perform it and for thoracic region we mainly perform schobers test and for the lumber region there is one important as which is called while valsalva test to check automatic nervous system.

Spurlings test

If my patient visit for the cervical herniation the very common test is spurlings test this is very easy to see any compression the patient is in sitting position and I just put a Little pressure download on patient head while performing this the patient must need to extend or rotate the neck if the patient find any pain while rotating in any aspect so it means that his test positive and then we rule out what is the cause according to the cervical disc herniation.

Valsalva test

This is very simply performed by just patient sitting in a comfortable position and first taking inside a deep breath and then the patient must be exhaled along with that close glottis. Try to take out all the air but should not take it out. In this test the blood pressure and heart rate must be measured before and after the test.

Because in this test we are checking the autonomic nervous system is there any dysfunction or not.

Schobers test

Patient is in standing position while both of feet should have some distance and hand must be placed on hip and the doctor mark two point at L5 level patient must bend forward as far he can goes then the distance is measured.

This is just to check lower back pain or lumber disc herniation whether pain numbness or tightness.

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

All the muscles of back are so much strengthen by doing these exercise but prevention is if you feel any kind of pain numbness or tingling condition than you must need to avoid these exercises.

William flexion

Hamstring muscles magic this will much improve the back pain as well as the muscle stretch more it means pain will also decrease along with strengthing of muscles.

Cat and Cow Exercise

For relaxation and reducing stiffness along with that improves back pain.

Share your review after performing these exercises either on yourself, healthy individual or patient.

I also do these exercise on weekly basis because I have to sit alone time and does sometime my posture is not good I also feel pain in my back and sometime in the neck so it doesn't mean that there is herniation it means that I need to correct my posture and in the long run I can save myself from disc herniation and these exercises will really help you out strong your muscles along with that give you a feeling of relaxation.

If you don't have time then you must need to do at least thrice in a week but twice in a week exercises these are really good your back neck and lower back muscle.

Thank you for all the participation who are really doing hard and bringing such topic work for asking that really help us a lot.