Steemit Learning Challenge-S21W6; Disc Herniation
AssalamuAlaikum & Greetings Everyone!
AssalamuAlaikum & Greetings Everyone!
It's me @amjadsharif
From #pakistan
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:
- Nucleus Pulposus: A gel like interior that can effectively reduce impact forces.
- 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.
How to Perform:
Begin with getting into a supine position with knees flexed, and soles planted firmly onto the floor, about shoulder width distance apart.
- Stand in formal position – your arms should be down at your sides and your palms should be turned down.
- Carefully pulling your hips up to the ceiling with the power of your heels. At the top of the movement ensure that your body is aligned as a straight line from the shoulder to the knees.
- So, you will need to stay this way for a few seconds but try to squeeze your butt and to tighten your abdominal muscles.
- Finally, slowly bring back up your hips down to its original position.
Benefits:
This exercise is useful in building the lower back and hips muscles as well as improving posture and easing lower back aches.
2. William Flexion Knee to Chest Stretch
Also called the Knee to Chest Stretch, the William Flexion is another good method of stretching the lumbar region of the spine.
How to Perform:
To start with, stand on a flat surfaced with your back facing it then gently lie down flat on the floor putting your feet on the floor.
- Move a leg slowly towards your body, grasp it with your hands and hold your knee.
- Slowly slide the knee towards you by holding your chest and ensuring your other foot rests on the floor.
- The stretch for the leg should typically be held for 20-30 seconds before the person should lower the leg down.
- Rotate your leg gently and use the other leg to push again in the same direction on the ball.
Benefits:
This stretch also helps in easing tension and stiffness on lower back and hips a thus helps the spine to be more flexible and not cause any discomfort that comes with tight muscles.
3. Piriformis Stretch
The Piriformis Stretch decPrime science Pine is used to release the piriformis muscle at the core of the butPrime sciPrime CT and sciPrime CA muscles and is therefore useful for the release of sciatic nerve pain and tension.
How to Perform:
- The therapy robot; Start by lying down on the back with flexed knee and flat feet on the ground.
- The position can be achieved by placing one ankle over the other leg’s knee thus forming the figure of four.
- The bottoms should be as close to each other as possible- grasp the inside of the thigh of the bottom leg and pull it up towards the chest. You should experience a stretch in the hips and the butts.
- Keep the stretch for about twenty to thirty seconds and then switch sides.
Benefits:
This stretch is helpful to those who are experiencing discomfort in their gluteal muscles and lower back particularly those with problem with their sciatic nerve or those who have tight piriformis muscles.
Practice of these underlaying exercises: Hip Bridging, William Flexion and Piriformis Stretch exercises; should help in giving some relief to lower back pain, increased flexibility and better mobility. Including them in your regime could assist in keeping off injury on the joints and also keeping them healthy.
While doing these exercises, encourage good posturing and try to breathe as calmly as possible. Moreover, it is also very possible to dedicate isolated clippings like gifs or videos that would be useful when practicing and it’s also valuable in making sure that the person or kotaba is doing it right.
Q.4 - Share your review after performing these exercises either on yourself, healthy individual or patient.
The following is a review of three physical exercises. Hip Bridging, Knee to Chest Stretch, and Piriformis Stretch. Such exercises are usually advised for enhancing joint movement, reducing pain, and increasing muscle mass in those with knee osteoarthritis, lower back pain or hip pain.
1. Hip Bridging Exercise:
The Hip Bridging exercise can be highly useful for constructing the lower extremities focusing majorly on the gluts, lower back and the hip flexors and the added advantage is that it also stretches the hip flexors. I conducted this with an apparently healthy person with slight Stiffness in the lower back region. It aimed at giving a good contraction to the glutes and lower back muscles so that tension along the lower spine can be eliminated and good posture adopted.
Execution:
The individual was positioned supine with the knees in flexion and planted firmly on the floor with the forearms beside the individual. They raised the hip off the ground by contracting the buttock muscles and abdominal muscles to get a straight line from the shoulder to the knee. The hold at the top was countenanced for 2- 3 seconds before lowering the hips back to the ground slowly.
Results:
It only after the 3 sets of 12 repetitions that the individual felt a slight pulling sensation in the lower back and hips. Nonetheless, participants did not complain of discomfort in the lower extremities, but rather reported a high sensation in the gluteal muscles. This exercise appeared to help the development of the posterior chain and the subject reported less pain in the lower back after going through the exercises.
2. Knee to Chest Stretch:
It is for this reason that the Knee to Chest Stretch is usually suggested to enhance flexibility in the muscles at the lower back and hips. I carried out this stretch on a normal, nonPAF participant and a patient with a mild low backache. Keep the servings largely on the target- the lumbar spine and glutes.
Execution:
The individual sat in a chair with back facing the monitor while their legs were flexed at the knee joint and planted on the floor. The person was standing on one foot while also pulling the other knee towards the chest. The stretch was performed for 20-30 seconds on each limb, the movement should be slow and smooth.
Results:
Again, for the healthy person as well as the patient of lower back pain, the type of stretch offered much reprieve to this region. The alleged healthy man said that he had positive feeling when he executes the movements because it his hip flexors felt relaxed and uncontracted. The patient with back discomfort got a little relief in her lower back pain. I was not uncomfortable at all during the stretch and it was helped in enhancing the ability to move in the lumbar spine.
3. Piriformis Stretch:
The Piriformis Stretch is for the piriformis muscle, which, if short, can cause sciatica pain like muscle to be tight. I did this stretch with a typical healthy person and a person with mild sciatica pain. The idea was mainly to help ease the contraction of this muscle called piriformis and to reduce pressure on the tissues of the sciatic nerve.
Execution:
The individual slightly bent and rested on the back with one leg placed over the other leg and pulled the knee towards the opposite shoulder. The stretch was held out for as long as 20-30 seconds deep feeling the stretch around the hip’s and buttocks region.
Results:
Depending on the person, the stretch was comfortable for a healthy person and helpful in relieving tension of the hip and butts area. For the patient who complaint of sciatica-like-symptoms, they complained of mild discomfort in the beginning of the stretch and remarked a lessening of pain and tension on the completion of it. There was an increased capacity to move around and the stretch appeared effective in dealing with piriformis syndromes.
Conclusion:
Each of the three exercises provided excellent core flexibility and relief from tension in those muscle groups. The exercise that proved durable for the muscles was the Hip Bridging for the lower back while all the participants enjoyed the Knee to Chest and Piriformis Stretches because they eased tightness in the lower back and hips. The following exercises will not only be easy to do but can be done regularly throughout the day to help with mobility, strength and to prevent the feeling of discomfort.
I am inviting here some of my friends @max-pro, @josepha, @wilmer1988, and @sduttaskitchen to participate in this engagement challenge of teacher @ashkhan.
Thank You
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Thank you for understanding the lesson and sharing your assignment; I hope that you will enjoy this week's lesson and try to implement it in your life if you see any such case.
Observations
Task 1 (2.6/3)
You have shared a great knowledge about disc herniation, its symptoms, and and causes, but didn't add its types. I appreciate your effort.
Task 2 (2.6/3)
In the second question, you tell us about how you have to assess a patient by doing physical examination and history taking, performing investigations and special tests. It would be better if you add explanation of one special test of each region to assess the disc herniation separately. Great.
Task 3 (4/4)
You try the hip bridging, William Flexion and piriformis stretch exercises . You did the hip bridging, William Flexion and cat & cow stretch correctly. Always remember to apply heat pack before performing exercises to relax the muscles and reduce stiffness. I appreciate your efforts.
Overall you made a great attempt to answer all the questions. I appreciate your efforts. But next time try to avoid the above written suggestions. Keep learning and try to implement your knowledge to the people suffering from disc herniation or any type of back pain. Thank you.