Narayana Health Care

Outline:

A human spinal cord is the central soft nerve controlling part covered under thick bony vertebrae. This, of course, is for protection perspective as injury to the spinal cord can result in paralysis for life. Now between any two vertebras, there lays a small cushion called Disc. At disc level, the spinal cord progresses nerve roots that supply to the whole body enforcing sensation and motor activity.

Each disc comprises of central soft part and outer rubbery part. When this soft inner part herniates out of the outer rubbery part due to any external/internal cause, it is known as Herniated or Slipped Disc or Disc Prolapse or Prolapsed Inter Vertebral Disc. Herniated disc commonly occurs in the back (between lumbar vertebrae 4 and 5) because that part of the body is most prone to wear and tear. This herniated disc might compress the nerve root coming from subsequent vertebrae. The nerve compression can further result in:

1. Localized Pain
2. Shooting / Radiating Pain
3. Tingling
4. Numbness
5. Weakness
6. Thinning / Atrophy
7. Even Paralysis
8. Stiffness in back
9. Burning Pain
10. Cramping
11. Loss of Sensation
12. Incoordination
13. Loss of sexual ability
14. Problems with bowel and bladder
15. Foot drop (weakness and dropping of foot producing a limp) depending on the level of herniation

The symptoms vary from none to all to a combination of a few depending on the extent of herniation.

Triggering Factors:

1. Abnormal weight distribution like an advancing paunch
2. Bodily Demanding jobs like lifting, bending, pulling, pushing, twisting, etc.
3. Genetic Predisposition
4. Smoking, which is directly proportional to osteoporosis and thus herniated disc

Causes:

A herniated disc is mostly caused by age-related wear and tear causing disc degeneration. In some cases, brittle bones or osteoporosis can also lead to PIVD. As age advances your body undergoes gradual wear and tear making back stiff and prone even to a minor strain.

Similarly while performing heavy weight lifting, vocationally or in the gym, a person may use a wrong technique and wrong muscles to endure weight which may cause abnormal strain on the back thus resulting in PIVD.

In extremely rare cases a trauma can also result in a herniated disc.

Prevention:

Prevention is very necessary for the people carrying out active to very active lifestyles, especially sports-people and heavy-weight carriers. There is a correct way to perform a specific heavy activity, which we will discuss here.

1. Exercise: You may be exercising as it is, but make sure to include back strengthening exercises in your regimen. Simple isometric exercises for abdominals and back have no contraindications.
2. Postural Advice: While sitting for long hours keep your back straight. Take breaks every 2 hours, take a stroll and continue. Keep heavy loads close to your body. While lifting from the ground, sit close to weight rather than bending from the back. While performing a machine pull-down make sure to keep your back stable and straight, so in the rest of the dumb-bells or bodyweight training exercises.
3. Weight Control: It is really good to keep in shape. Make sure you eat your dinner early and do not consume excessive water right after your meal.
4. Quit Smoking: Let’s reduce an unnecessary way to cause pollution and prevent our backs from osteoporosis and herniation. You will have to say no to other tobacco products too.

Dr. Anurag Saxena, Senior Consultant Neurosurgery, Spine Surgery, Narayana Superspeciality Hospital, Gurugram