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The Herniated Lumbar Disc

Posted on 2011-09-20 20:20:29

What is a herniated or slipped disc? Understanding what it is requires knowledge of the anatomy of a lumbar disc and what changes occur when it herniates. First, the inside of the disc is composed of a jelly-like substance called mucoploysaccharide. Inside the jelly substance is a hard nucleus (nucleus polpusus) that acts like a ball-bearing. On the outside of the disc is a crisscrossed pattern of stretchy bands called annular fibers. The crisscrossing annular bands give the disc strength and flexibility and the nucleus rotates within the confines of the jelly substance in concert with spinal movement. The result is a divinely inspired design and the perfect pivot between two vertebras. The two vertebras with the disc in the middle are the basic components of a spinal joint.

So, the disc works like this: Imagine holding a barbell with heavy weights attached over your head. What happens? The entire disc compresses, loses height and widens like an automobile tire gone flat. Now, put the barbell down. As you bend, extend, twist or flex, so do the stretchy annular fibers on the outside of the disc. At the same time, the nucleus shifts within the jelly substance to the opposite side you are leaning. So, if you laterally bend to the right, the nucleus shifts to the left.

With an understanding of disc anatomy, we'll talk about the bones surrounding the disc. With the two vertebras, there is the image of a disc sandwich: The vertebras are like the bread and the disc is like the meat in the middle. Now it's time to add some important bones to the back (posterior portion) of the spinal joint. For our purposes, the most significant of these bones are the pedicle rings because they form an opening for the spinal cord. Through this opening, the spinal cord travels through the spinal joint. Of course, with a joint of any kind there's movement. So, we can add bony (synovial, lubricating) articulations from one vertebra to another enabling movement in many directions. Most importantly, these articulations form holes (neural foramina) where nerve roots, coming off the spinal cord, exit the joint and control whatever tissues they innervate.

I specifically chose a lumbar disc for this article because it has a greater responsibility for weight bearing than any other area of the human spine because we walk upright, called bipedalism. Also, lumbar discs are also required to be very flexible.

So, what can go wrong? How does a lumbar disc herniate? Imagine this: a herniated disc is like a tire with a bubble protruding from its side. The bubble forms because rubber fibers have worn thin and pressure from air within the inner tube finds the weakest point. This analogy is very similar to a herniated disc. The jelly substance inside of the lumbar disc also has pressure. If for whatever reason some of the external annular fibers tare, a protrusion occurs, like the bubble on the side of the tire. A little bubble is like a disc protrusion and a big bubble is like a disc extrusion: two kinds of slipped or herniated discs. A disc protrusion is a very common condition and can normally be treated conservatively, such as with chiropractic adjustments. A disc extrusion is much less common and may require surgery. The most serious kind of herniated disc is called sequestration, the segmented disc. Simply stated, a portion of the disc becomes completely separated from the main body of the disc. This condition almost always requires surgery. In all these disc conditions, the herniated disc material can pin the sensitive nerve root against the bony wall of the vertebra. This, in turn, inflames the nerve root.

The signs and symptoms of a herniated disc vary with the different kinds. However, there are several common symptoms, such as antalgic posture. It's when a person stands and walks slanted to one side like the Leaning Tower of Pisa. They lean to the side opposite the herniated disc taking pressure off the nerve root. A good sneeze often results in a sharp, breathtaking pain. After sitting awhile and then attempting to stand, the disc victim can be seen pushing up their legs in order to achieve a standing position. While trying to stand still, people with a herniated lumbar disc perform the famous low back dance swaying from side to side, weighting and unweighting from one foot to the other. And there may be other unpleasant signs, like nausea. Of course, pain radiating into one leg, and muscle spasm are very common.

These are typical symptoms of a disc protrusion, the least serious type. With a disc protrusion, symptoms come on like a cyclone, full of sound and fury. And, surprisingly, weeks later all symptoms can be entirely gone. This is not the case with a disc extrusion or disc sequestration. Symptoms persist and often worsen. Lack of bowel control and/or bladder incontinence accompanied with intractable pain at night are often experienced. But, as I mentioned, these last two are much less common.

Lumbar disc symptoms transcend typical low back pain in intensity. They're nasty and they demand attention. In closing, here are several tips for treatment and relief. First apply ice, never heat to the low back. Ice relieves pain and is anti-inflammatory. Second, a low back support can relieve and immobilize the area. [Hint: it's not for everybody with a disc condition.] Chiropractic adjustments are designed to restore proper spinal joint function and are known to offer a quick recovery. And in some cases, physical therapy can be effective.

This article is about a slipped or herniated lumbar disc. The article shows the difference between pain resulting from the typical herniated disc low back pain and symptoms experienced from an actual herniated disc. The article discusses the anatomy of the spinal joint with the emphasis on the disc. In addition, the article explains what happens when a disc herniates, the different kinds of slipped discs and the most likely symptoms.



Article Source: http://EzineArticles.com/6517061

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Low Back Pain

Posted on 2011-06-16 10:04:46

There is still a lot of debate around acute lower back pain remedies. Within 30 days of pain starting point, 90% of cases of acute pain in the low back either improved or became absolutely solved without any pain treatment, which was established in some scientific studies. Doctors seldom request exams for spinal health or low back issues within the 30 day period. Of course, chronic lower back pain relief is another subject- treatment may incorporate nerve repair, spinal surgery, or decompression therapy. When it concerns this condition, seldom is there a single treatment. Simple prescription drugs, without the necessity for a prescription, are offered which a doctor will suggest to folks who are suffering from acute pain that disrupts their daily lives. For back pain relief, Non-Steroidal Anti-Inflammatory Drugs or NSAIDs are the medicines of choice. Some good examples of NSAIDs are ibuprofen, naproxen and ketoprofen. Depending on what works ideally with a patient, a doctor may change medications or alter the doses to establish the best treatment. It is crucial to note that long-term application of NSAIDs may cause liver and kidney damage and gastric irritation, so these medications must only be employed when certainly required. These medications should not be used as a daily remedy to pain. Every bit as efficient as NSAIDs as a lower back pain cure for slight flare-ups is acetaminophen (Tylenol). Occasionally, muscle relaxants have been provided to take care of the pain. However, unless the cause of the pain has been shown to be muscle spasms, muscle relaxants generally have little to no effect on this case. One of the newest trends of NSAIDs is the COX-2 inhibitors like celecoxib or Celebrex. Though quite effective, prolonged application may amplify the risks of heart attacks and strokes. Other medicines being given for lower back pain are steroids and opioid analgesics. However, suggested only for short-term use, a physician needs to monitor the intake and dose of these drugs. Opioids have the additional chance of drug reliance. Though epidural steroid injections have formulated different outcomes in different studies, it is being employed to treat patients who have responded well to this drug in pain elimination.

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Neck Pain

Posted on 2011-06-16 10:03:24

Neck pain has become a very common medical problem. Common causes include sedentary lifestyles, poor posture and sitting hunched over for hours at a time. There are certain simple exercises that can be done that will help to alleviate neck pain.

The human body was designed to have a slight anterior curve in the cervical spine which places the head squarely between the shoulders. This curve can become altered due to continuous poor posture. When the vertebrae come out of alignment, strain is placed on the nerves and pain is the result.

You may not be able to avoid sitting hunched over a desk, work bench or computer, especially when it is a requirement of your job. However, there are exercises that will help to counter-act the effects of prolonged poor posture. By forming the habit of regularly stopping and spending a few minutes stretching, you will help to avoid and alleviate the effects.

After 20 to 30 minutes of work, just take a few minutes to do one exercise. Every hour or two, stand up and walk around for a couple of minutes to stretch out your back, shoulders and legs. A great back stretch is achieved by touching your toes, with knees an little bent, and holding it for a count of ten.

The simplest stretch you can do is to sit upright in your chair with both feet flat on the floor, hands on your thighs and your back in contact with the back of your chair. Now, push your belly button back towards your spine at the same time as you stretch the back of your neck by pulling your chin in and down. Gently pull your shoulders down and back as well. You will feel a stretch along the back of the cervical spine, across your shoulder blades and down towards your waist. Hold for the count of 5 and relax. Repeat 5 times and then return to work

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The Anti-Inflammatory Diet: A Key to Eating Well

Posted on 2011-06-09 10:37:21

‘You are what you eat’ implies that what you eat can be good or bad for you. But why is it?
Look, I’m a chiropractor treating low back pain, neck pain, knee and shoulder pain. So, I want to know if what you eat can help or hinder in the process of getting well; the process of being pain free. The answer is a resounding ‘yes’. What patients eat can affect their outcome. Why? The reason is that eating some foods can actually make things hurt worse-increase inflammation-while eating other foods can actually help lessen pain and promote faster healing. These are known as anti-inflammatory foods because of competing omega fatty acids.
As an aside, when this writer first heard about the anti-inflammatory diet and competing omega fatty acids, none of it sounded very appetizing? However, upon further investigation, I discovered that red wine is high on the anti-inflammatory food chain. Viola! I became an instant convert.
First, what is meant by inflammation? It’s not to be confused with an infection which requires a pathogen, a germ, a little, microscopic bug. Now, an infection may also result in an  inflammation. But for the purposes of this article, we’ll confine our discussion to inflammations resulting from tissue damage, like a sprain, or your low back going out, that kind of thing. So, think of what happens with a sprained ankle: swelling, redness, heat and pain. The same thing can happen inside of you, like in your stomach, were you can’t see it. However, you sure can feel it.
So, what foods should or shouldn’t be consumed and why?
An example of inflammatory foods are those high in refined or hydrogenated vegetable oils, like potato chips and many baked goods. Refined oils and trans fats are used by manufacturers to extend the shelf life of their products. They are notorious preservatives. On the other hand, olive oil, avocado oil and grape seed oil are natural and are known to be anti-inflammatory. Salmon is very high on the list of ant-inflammatory foods. The reason has to do with competing omega fatty acids.

“A healthy diet contains a balance of omega-3 and omega-6 fatty acids. Omega-3 fatty acids help reduce inflammation, and some omega-6 fatty acids tend to promote inflammation. The typical American diet tends to contain 14 - 25 times more omega-6 fatty acids than omega-3 fatty acids,” according to an excerpt by the University of Maryland Medical System.

Now, red meats, such as a good, juicy steak, are high in omega-6 fatty acids. So, does that make it bad? No! It’s extremely good for you. It’s loaded with essential amino acids and other nutrients. It’s just that the key to improving health is to balance the amount of omega-6 fatty acids (e.g., nuts, eggs, poultry, cream, cheese, butter) against the omega-3 fatty acids (e.g., salmon, tuna, turkey). The saturated fats in omega-6 fatty acids compete with the omega-3 fatty acids for vital digestive enzymes, like seagulls fighting over french fries on the boardwalk.

As a post on the University of Maryland Medical System commented, “Omega-6 fatty acids are considered essential fatty acids: They are necessary for human health… Along with omega-3 fatty acids, omega-6 fatty acids play a crucial role in brain function as well as normal growth and development.”

Anti-inflammatory foods include colorful, high fiber vegetables like sweet peppers, celery, raw carrots, onions, garlic, broccoli, cauliflower, cucumber, apples, pears, berries, nuts, grapes, bananas, citrus fruits and so on (omega-3’s).

Okay, here’s the  bottom line: Limit fatty animal products like red meats and dairy products. Instead, eat more lean cuts of chicken, turkey and fish. Olive oils and avocado can and should replace unhealthy oils from corn, soybeans, safflower, sunflower and other vegetable oils. Sweets should be limited, including all bakery products like cookies, cakes, pies and breads.

We all know that our modern diet of processed and fast foods tends to generate inflammation and other evils, like obesity. To counteract bad eating, give close consideration to the competing omegas. Here is a suggestion:

Quinoa and avocado salad:

INGREDIENTS: (SERVES 4)

  • 1 cup red quinoa
  • 2 avocados (cut up in pieces)
  • A few dried tomatos
  • 2 fresh basil leaves
  • 1 green onion

Dressing:

  • ¼ cup olive oil
  • Juice of 2 lemons
  • 1 garlic clove (minced)
  • Salt
  • Cayenne (very small amount)

DIRECTIONS:

  • Rinse quinoa in cold water and drain well
  • In saucepan, bring 2 cups water and ½ tsp. salt to boil. Add quinoa. Cover and reduce heat to low. Cook until water is absorbed (about 20 minutes).
  • In a bowl, mix together the ingredients in cooled quinoa. Toss with dressing.
  • Serve with fresh parsley on top.

Good luck!

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Chiropractic Management of Low Back Pain and the Herniated Lumbar Disc

Posted on 2011-05-19 09:26:41

In chiropractic management of low back pain, we have an old adage, “There are only two kinds of people in the world: those that have low back pain and those who are going to get it.” A little bit of an exaggeration? Just ask as many people as you know if they ever had low back, and you will be regaled with horror stories.
So, what do you do if you suddenly get low back pain? Most people run for the heating pad and some kind of OTC, over the counter medication. Could be a big mistake! First, a heating pad, contrary to public opinion, usually makes the pain worse. It increases inflammation. Heat draws more blood to the already inflamed area. The increased blood flow results in the depositing of more substances that increase inflammation, like lactic acid, histamines and prostaglandins. Combined, these substances increase pain, swelling and redness. Of course, when it comes to the low back, sometimes it’s hard to see these things. Low back pain usually exists where you can’t see it: beneath the skin around the spine, ligaments and tendons.
So let’s examine what often happens in a severe cases, like in a herniated lumbar disc. You may have been a victim of such an event. If you were, you know the symptoms well. They go like this:
1. When you stand, you’re bent to one side like the Leaning Tower of Pisa.
2. If you cough, it’s like the end of your world: the sharp, excruciating pain is unbearable.
3. The muscle spasm is unreal, like somebody has got you in a vise grip.
Have you been there? If you have, you probably wanted to go straight to an emergency room. Barring that, what should you do? To begin with, you should apply ice to the area. Never place the ice directly on your skin because it can burn like fire. Instead, place a towel between the ice and your skin. Keep the ice on your low back for about 25 minutes and then off for about 45 minutes. Ice reduces inflammation by forcing blood, and thus the products of inflammation, away from the low back area. Next, you need some kind of pain pill, especially one that combines anti-inflammatory ingredients. Any OTC product that contains ibuprofen will work.
That’s all good for temporary relief, but what about more long term relief and something approaching a cure? That’s where chiropractic needs some close consideration. The first thing is to determine what’s causing these terrible symptoms. Actually, one of the most common causes, especially if you have the symptoms cited above, is a herniated lumbar disc: a slipped disc. A slipped disc occurs when the jelly-like substance inside the disc breaks through the elastic fibers containing it. It’s sort of like when a bubble forms on the outside of a tire that’s worn thin. But this bubble pinches down on a critical nerve root. Ouch!
Does this condition require and operation? Well, according to research, only a very small percent meet the criteria for an operation: intractable pain at night and loss of bowel and bladder control. This occurs when the tire is flat: the jelly-like contents of the disc has completely leek out.
With proper chiropractic treatment, this condition can be managed successfully. In our chiropractic office, treatment begins with ice and the distraction technique. This totally painless treatment, which is preformed on a specially designed table, decompresses the lumbar disc: reduces the pressure inside the disc. With reduced pressure, there’s less protruding material to pinch or irritate the nerve root. As pain lessens, our doctors begin spinal manipulation, the chiropractic adjustment. This treatment is designed to restore proper spinal joint function: full alignment and complete movement.
Spinal joint function is the key to a successful outcome. Chiropractic adjustments restore proper movement. Proper movement is the function of any joint. If a joint does not move as much as it should, it is a diseased joint. Often patients tell me that their back has seized up. With the inflammation gone and joint function and motion restored, symptoms are usually totally alleviated.
Even in severe cases, proper chiropractic care can quickly reduce and eliminate all symptoms associated with a herniated lumbar disc.

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