Steemit Learning Challenge-S21W6; Disc Herniation"
Disc herniation:
If I talk about disc herniation then it occurs as a result of annular tear which is tough layer in which there is a gel like material which is spinal disc centre which bulge out or protrudes from its place and this is we call as disc herniation.
Types of disc herniation
Cervical disc herniation
If disc herniation is at cervical intervertebral disc level which is compressing nerve supply of arm,hands and neck and causing radiating and numbess, tingling there.
Thoracic disc herniation
If disc herniation is at thoracic intervertebral disc level which is compressing nerve supply of chest and abdomen and causing radiating and numbess, tingling there.
Lumber disc herniation
If disc herniation is at lumber intervertebral disc level which is compressing nerve supply of legs,thighs and foot and causing radiating and numbess, tingling there.
Symptoms
• If someone will suffer from this problem then he will complain of feeling pain in back,neck or legs and it will radiate in those areas in which impinged nerve through herniation was supplying.
• If I given example of it then herniation occuring at level of lumber region can cause radiating pain in legs.
• If I talk about severity of pain then patient will complain that pain is where and it is with tingling and numbness like sensations.
• If condition was serious and remain untreated from long time then patient can also have a major sensory loss as a symptom in affected area.
Causes
• If patient is very obese then it means that at intervertebrate disc always there will be more load than actual requirement so it can increase the process of tearing that tough layer which is annulus and disc may herniate.
• If in any wrong posture patient have encountered any activity of lifting a heavy load and it has caused strain within no time then it can also cause disc herniation.
• If due to aging wear and tear process is going on in body then definitely small joints like spine will be at major risk so it will also cause herniation of disc.
Risk factors
• If there is a job which is much physically demanding in which person have to bend excessively.
• If person BMI is abnormal so if he is obese.
• If person is a smoker than calcium will not absolved so demineralisation in body is a risk factor of this problem.
• If person is more than 45 years.
Treatment
• Pain management through applying heating or swelling management with icing.
• Exercises are recommended and postural guidance are recommended.
• If after giving all treatment protocol there is no effect and no recovery within 3 weeks then surgery can be recommended in severe condition.
Prognosis
• If there is a minor problem then through full treatment protocol it can resolve in 3 weeks.
• If there is a normal problem in which there are functional limitations but no severity of condition then it can takes 4 to 5 week.
• If problem is much severe then after 6 weeks observance there are no results then prognosis is not good and patient can be recommended for surgery.
If I talk on making diagnosis of disc herniation then following are the steps you should follow;
Medical history taking
• If I talk about first step then it is about taking medical history from patient that what is working routine of patient,what are symptoms he or she feels or when he feel relief and when he feels increase in pain or symptom.Normally patient suffering from this condition complain that when he tries to bend forward then it becomes difficult for him while lying straight gives some relief in lumber disc herniation case.In cervical herniation patient will feel pain in cervical flexion and extension and in thoracic region patient pain will increase while moving thoracic region in form of thoracic rotation or any other thoracic movements.
Physical examination
• If I talk or move on at next approach then this is to physically examine patient by performing different movements on him and by monitoring that what is pin point in which patient says that now my pain started!
Assessment tests
Special test for cervical disc herniation
• If I talk about assessment tests of cervical region then cervical compression test can be performed by patient at command of doctor in which patient will sit with straight neck and compression at head will be applied by doctor to check if pain is increasing by doing this or not.
• Cervical extension test will be performed by extending neck and doctor will ask if pain is increasing to say that test is positive.
Special tests for thoracic disc herniation
• If I talk about thoracic extension test then for checking thoracic disc herniation this test is performed in which patient thoracic spine will be in extended position and if pain is increasing through this movement then test is positive.
• Second test is thoracic rotation test in which patient will rotate his thoracic level and if pain is increasing by doing so then it means that test is positive.
Special tests for lumber disc herniation
• If I talk about assessment tests that are clinical tests then SLR which is straight leg raise will be performed by patient at doctor command and if patient is feeling pain at 40 degree ROM then this is sciatica which is irritation of sciatic nerve by compression at anywhere in L4-S3 and most likely this is lumber disc herniation result.
• If I talk about other assessment tests then slump test can also be performed out to assess thoracic and lumbar spine mobility.Slump test will be performed by instructing patient to flex his hips and knees and then to lean in forward direction and hold it for 10 seconds.If patient is feeling any pain or tingling, numbness then test is positive.
Imaging tests
• If I talk on imaging studies then X ray is not exactly to see disc herniation because it can only show you bony abnormality like if there is any bony spur that can compress any nerve originating from spine.
• Magnetic resonance imaging would be most effective test to have a proper illustration and picture of spine and disc so bulge or disc herniation is easily diagnosed by this imaging test.
• If I talk about some other accessory tests that can be carried out with this then here are electromyography and nerve conduction studies but these are for nerves functioning assessment.
Bridging is performing by holding a bridge position for minimum of 8-10 seconds
Piriformis stretch is performing by holding figure of 4 stretch position for minimum 10-15 seconds
Knee to chest exercise is performed with minimum 10 repetitions with 5-10 second hold each
• I really like to perform bridging as it's positioning was really very easy as well my core and leg muscles were weak because I was not holding this position much in start but that was good to observe increase in muscular strength by giving it just 2 minutes in which I performed almost 7-8 repetitions
• Piriformis exercise was difficult for me to perform due to its position and then applying stretch technique.Well I performed it and feel good at completion of it.
• Knee to chest was most easy to bring your knee to chest so after performing it for 2 minutes I felt increase in mobility or flexibility of core and glutes and it's positioning was also very easy.
Note :
This is my Link of bridging exercise!It's not showing when I uploaded it in question but in text it is showing as a link so I added it there you can see it from here!
I want to invite @stef1,@mile16,@sduttaskitchen
Hello! This class is great because it allows us to learn about this interesting and somewhat common condition in the population, it is amazing how the annulus fibrosus of the disc has to withstand so much to not herniate, we must help him by leading a good lifestyle and not putting so much pressure on the intervertebral disc.
Have a nice day!
Hola amigo
Gracias por la invitación 😊 ya he preparado mi entrada pronto la estaré compartiendo con todos.
Es cierto es todo un proceso a cosas a realizar antes de diagnosticar una hernia discal.
Los ejercicios recuerda debes realizarlos en camillas o colchonetas pero la superficie debe ser siempre plana, en una cama normal puede que la columna no esté totalmente recta.
Muy buena participación amigo exitos en el curso
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 (2.7/3)
You have shared a great knowledge about disc herniation, its symptoms, and and causes, its types. But you didn't add the vertebrae involves in each region like cervical C1 to C7. A bit more depth require to complete the answer. I appreciate your effort.
Task 2 (3/3)
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's better that you add name and explanation of one special test of each region to assess the disc herniation. Excellent.
Task 3 (3/4)
You try the hip bridging, William Flexion and piriformis stretch exercises . You did the hip bridging, and piriformis stretch correctly. But you didn't add the link of knee to chest or William flexion exercises and 2 times add the link of hip bridging. Be careful before publishing and check the links. 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.