Bulging disc or Herniated disc is a lesion that occurs more frequently in the lower back. This disease is the one that causes the most pain in the back and changes in sensitivity to the thigh, leg and foot. Approximately 80% of people will experience low back pain at some point in their lives. The most common location of the lumbar disc herniation is on the disc between the fourth and fifth lumbar vertebra (L4 / L5) and the disc between the fifth vertebra and the sacrum (L5 / S1).
In most cases, the symptoms improve naturally at three months, but can be aided with clinical and physiotherapeutic treatments. Even if the patient feels well without treatment, it is important that he make a treatment program that focuses on the normal functionality of the spine and its strengthening. The researches are categorical: after the first symptoms of back pain, the muscles that protect the spine begin to become weak and atrophied.
The population needs to know that this disease has no cure. People get better from pain, they get back to normal life most of the time, but it's good to make it clear that rest and medications do not return functionality or strengthen muscles that have become weak with the disease. We believe that this is one of the main reasons for so many recurring pains in the spine. So if you had an episode of severe back pain and those symptoms remained for more than three months, most likely others will come. This rule is valid for 100% of cases.Therefore, the secret is to do a physical activity in appropriate places and with specialized professionals.
EMERGENCE OF DISC HERNIATION
The term "hernia" means projection or exit through a fissure or orifice of a contained structure. The intervertebral disc is a fibrous and cartilaginous structure that contains a gelatinous liquid at its center called the nucleus pulposus . The disc lies between one vertebra and another of the spine. This fibrous ring, when cracked or worn, allows the gelatinous liquid that is maintained at its center to expand or bulge its structure and may also leak out. When this phenomenon occurs in small proportions, we call the disc protrusion . If the lesion in the fibrous ring that holds the nucleus is large, the liquid contained in the nucleus may exit into the external medium, and when this happens, the disk may become smaller and flatter. This is why we call it a Bulging disc. Depending on the location of the "gel", the patient may experience severe pain or not. With this concept, it is clear that the important thing is to know the location of the Bulging disc, not its size.
The disc is composed of two main parts: one of them is the central part, called nucleus pulposo or viscous liquid. The core acts as a shock absorber to protect from the pressures and twists exerted by us on a daily basis. The second part is composed of a cartilaginous tissue called the fibrous ring. This ring maintains the nucleus in the central part and has elastic characteristics that allow and facilitate the movements of flexion, extension and rotation of the trunk. There is a very important structure called the terminal plate that forms part of this complex, but this structure belongs to the vertebra and is located in the upper and lower region of each vertebra. Thus, the integrity of these structures is that it conserves and nourishes the nucleus pulposus. With the degeneration of these structures, the nucleus liquids may migrate to the vertebral bodies. The beginning of this process is called Modic type I. Some authors claim that this inflammatory and degenerative process on the end plate may cause pain in the spine.
Removal of the nucleus pulposus or bulging of the disc may cause pressure on the nerve roots corresponding to the disc herniation or protrusion. This pressure on the nerve root may cause the most diverse symptoms that will be described later.
SEE THE NUMBERS ON BULGING DISC
95% of people who suffer from Bulging disc do not need surgery on the spine, and can treat with non-invasive method.
13% of medical visits involve spinal pain.
15% of the world's population suffers from Bulging disc.
70% of the population over 40 suffers from some type of problem in the spine.
This disease is the third cause of early retirement, back pain are also the 2nd main reason for people taking leave at work.
People with an age range of 25-45 years have the highest index of cases of disc herniation.
CAUSES OF BULGING DISC
The word "spine" already tells us all about the importance of this structure in our body. It is the center of balance of the musculoskeletal system of the human being and provides the basis for the stabilization of our body, allowing a perfect distribution of the forces and gestures exercised in our day to day or in sports practices. It is no wonder that many spinal injuries are attributed to imbalance and misalignment of this structure. In other words, bad posture is undoubtedly the great villain of the problems in the spine.
There is a correct posture for any movement that we perform, even when we are in a static position. With day-to-day running, it is not always possible to obey all the rules, but we can still take the utmost care to not overload our muscles and joints.
TYPES OF BULGING DISC
- Protrusives: The disc widens, but contains the gelatinous liquid in its center. The disc base bulges and becomes wider than the original diameter. The walls of the disc can touch regions and areas of great nervous sensitivity, generating pains and incapacities.
- Extrusions: Extrusive lumbar disc herniation is a very frequent and important orthopedic condition that affects the intervertebral discs of the spine that function as true shock absorbers. Pathology occurs when there is a rupture of this fibrous ring and the internal gelatinous content or nucleus pulposus leaves by means of a fissure in the membrane, with loss of contact of the extravasated fragments with its internal environment.
- Kidnapped: The Bulging disc is the one that ruptures the wall of the disc and the gelatinous liquid migrates into the spinal canal, up or down. In addition to the pressure in the nerve root, it causes inflammation and continuous compression. It is the type of hernia that causes the so-called chemical pain, because this nucleus pulposus, when outside its natural environment, has acidic chemical properties and causes unbearable pains. The patient presents with antalgic posture, tilting the trunk to the side that gives him comfort. In this case, the improvement will only be possible with medication, rest or even surgery.
Keeping the correct posture is not important, just for good appearance, postural changes since childhood, for example, already predispose problems in adult life. Hence the need to prevent incorrect posture habits. See, next.
HOW TO CORRECT POSTURE
The important thing is never to force too much, just a part of the body, the bones have to bear equal weights. When you sit down, for example, you should never support weight on one leg, letting the other one loose. It is fundamental to learn the non-waste of energy during the execution of movements or in a static position, distributing the weight of the body in a balanced way. Some tips to avoid postural problems:
- DOMESTIC ACTIVITIES
When performing household activities, avoid working with the trunk fully inclined if standing; In the act of ironing, the table should be high enough for the person not to lean, another tip is to use a footrest by alternating them whenever there is some discomfort. To put on your shoes do not tilt your body to the floor, sit down and bring your foot to the knee. When lifting a weight above the height of the head, one should lean the weight on the body and climb on a ladder or stool to deposit it properly. When lifting a weight should be lowered by flexing the knees down without bending the spine, get up by transferring the load to the muscles of the legs that are stronger than those of the spine, if it is possible to place the object in a cart and Push.
At bedtime you also need care like choosing a good semi-hard mattress or foam to distribute well the body weight, a good pillow and adopt some correct postures in bed. If you usually sleep on your belly up use a pillow under your knees; When sleeping on the side, a pillow between the legs that should be folded. Sleeping on the stomach is not recommended, but if you can not otherwise use a pillow under the belly and not the head, decreasing the lumbar curvature.
Sitting properly is also very important for good posture. Try to keep your feet flat on the floor; Thighs gently touching the largest possible seating area; Avoid crossing your legs and leave them slightly apart; The spine should be kept upright in order to preserve its natural curves (lean your back completely on the sofa or chair, avoiding spreading). Keeping the spine upright is always better than leaving it tilted in any situation. Adopting a correct sitting posture avoids back pain and serious spinal injuries. When you sit properly, there is a uniform distribution of the pressures on the intervertebral discs and the ligaments and the muscles work in harmony, avoiding unnecessary wear and tear.
At work it is also important to adopt less harmful postures. If you work sitting down, your arms should be hanging over your body or your forearms resting on the work table. Avoid full-body twists, get up or use an appropriate chair that spins easily to grab something, talk to someone or throw paper in the trash. If you work with a computer, try to adjust the screen so that the top edge is at the time of looking at the horizon, keep the chin parallel to the ground. To read, avoid as much as possible to lower your head if you need to get a book holder.