Lower Back pain-Disk Herniation:
The spine is comprised of bony vertebra separated by disk.
Condition of lumbar spine including disc herniation is the main course of low back pain.
The lumbar spine (lower back) consists of five vertebrae numbered L1 to L5.
These vertebrae are attached to the sacrum at the lower end of the spine.
The disks between the vertebrae are round cushioning paid which act as shock absorber.
Inner disk layer – soft gelatinous tissue called nucleus pulposer.
Outer disk layer – Thick, strong tissue anulas fibrosus.
A disk herniation of the lumbo-sacral region could involve the nerve roots, Could affect the nerve roots.
In 95% off all disk herniation cases, the L4-L5 or L5-S1 disk levels are involved.
Herniation of the L4-L5 disk will affect the L5 nerve roots.
Herniation of the L5-S1 disk will affect the S1 nerve roots.
Type or causes of Lower Back pain-Disk Herniation
1 A bulging disk or slipped disc withintact annular and posterior longitudinal ligament fibers.
2 Disruption of inner annular fibers with intact outer annular fibers.
3 Disrupted annular with trail of disk material extending into the disk space.
4 Free fragment without trail extending into disk space, fragment may be reabsorbed spontaneusly.
Typical location of lower back pain-disk herniation:
location of lower back pain-disk herniation is given below:
Involve multiple nerve roots.
Predominantly causes low back pain more then leg pain,back spasms. May severe back pain.
Can happened sciatic nerve pain.
May cause incontinence of the bladder and bowel.
Usual location, most commonly involving one nerve root (lower one).
Exemple L4-L5 posterolataral bulging disc will involve L5 nerve root.
Occurs in 8-10% of the cases.
involve the existing nerve.
Exemple: L4-L5 foraminal bulging disc will involve L4 nerve root.
Discogenetic back pain Internal discruption.
Early disc degenaration.
pain worsense with flexion/sitting.
Slightly better with extension.
Forward flexion limited on exem.
No redicular symptoms.
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