Prolapse / Sciatica / slipped disc

Both in the media and among patients and healthcare professionals so often used herniation / sciatica / slipped disc as designations for the same disorder.

Basically it is a prolapse completely harmless and a natural part of the body's tissues are broken down and rebuilt. Many of the people you meet every day, and that has not hurt either back or neck, have prolapse. So why do some hurt and some do not? It all depends on how dangerous the brain perceives the injury to be. About prolapse pressing on a nerve so there is a greater chance that your nervous system perceives it as being dangerous, than when prolapse is free and not bothering anyone.

Where do we find the intervertebral discs?
As the word describes, we find the intervertebral discs in the neck and back between each vertebra. The spine consists of 24-25 vertebrae of bones. To allow movement between the vertebrae so forming each swirl multiple joints with both vertebral above and below itself. Between each vertebra we find the discs. These are constructed from strong fiber cartilage and a soft core (nucleus). The discs are attached to the vertebrae with powerful ligaments that help to stabilize the spine and protect the spinal cord.

What shall we do with the intervertebral discs?
Intervertebral discs are designed in such a way that they can allow great mobility and receive strong shocks and stresses. In this way gives us a spinal discs that are agile and flexible. To make blade best suited to withstand the loads applied to it, it has very little nerves and corresponding poor blood circulation. A high degree of vasculature would have meant that the blade is also susceptible to damage these blood vessels. Blood vessels are more vulnerable than cartilage cells, and would put the disc prone to bleeding.
To ensure that the disc cells constantly maintained, it must be moved. It so happens that the blade acts as a sponge. When the pressure increases on the dial in that we are standing or sitting, push the blade something together and fluid seeps out of the cells. This must not miss understood with the same happens when the disc ruptures and form a prolapse . When the disc is released, for example, when we move or lie, then seeping fluid into cartilage cells again. When taking this liquid with the nutrients that cartilage cells need to maintain and repair skaderpÄ cartilage cells and the weaving of the fabric.

How damaged intervertebral discs?
Damage to the intervertebral discs can be largely attributed to age and wear. In addition, genetic factors play a role. It is common for an MRI examination on a healthy person in 50 years show significant degenerative changes (wear) of the spine and neck. Even if the person has never had pain in the back and neck.
We know today that the discs have varied load to function optimally. Persistent unilateral load with eg much sitting at work can be a factor that can damage the intervertebral discs. The pressure on the disc is then largely only the front part of the blade, and that mellomvirvelskivens cartilage cells become damaged due to poor maintainability. Fiber cartilage forming the blade edge is broken then steadily reduced, which makes the wheel prone to damage.

What is a prolapse?
A prolapse is as a result of wear or damage to the intervertebral disc. Portions of the soft contents of an intervertebral disc seeps when out of the disc inside and lying on the outside. Although the disc is built up of strong fibers cartilage, as prolonged degradation or greater acute injuries gain fiber ring to rupture. With acute injuries are we talking about quite a large amount of energy, as for example in a car accident. A fresh slice can not burst only at a heavy lift or a simple fall. But a damaged disc may rupture when only simple causative strain as a host or a shift. The term "straw that made the camel over" fits well to describe this process.

Make prolapse pain?
Prolapse in itself does not hurt. In fact, it is so that a large part of the population walks around with prolapses at any time without pain. We know that the outer edge of one intervertebral disc contains some nerve fibers. This enables us to experience the pain associated with damage to the disc fiber cartilage. But when fibers cartilage eventually gives in, so it need not be painful.

Only in those cases where the prolapse is present and pressing or irritate a nerve root, then the prolapse itself cause pain. The fact is that there is no pressure on the nerve that hurts, but the chemical irritation that occurs when prolapse in contact with nerve root membrane.

Should I take painkillers or anti-inflammatory?
Generally, one should use the least amount of these medications. The body is best to clean up yourself, If the pain is very intense and they prevent you from being able to move at all then you should consult a doctor to get help to mitigate the worst pain.

I need pictures of the back? MRI, ultrasound, x-ray or CT?
About plagues of the back is very large over time, then it may be appropriate to take pictures of two reasons.

One reason is to check whether there is any reason other than a prolapse or failure / overload that is causing the pain. We think especially of a tumor or the like. This is very rare, but your doctor or physical therapist may want to deny this if they are unsure of the cause of the pain.

The other reason why you should take a picture will be about the symptoms and the survey provides evidence that one has a proplaps that clamps on a nerve. But it should only take a picture if you think that this provides a much distress that an operation is necessary.

Sometimes it may be sufficient with a single radiograph. In this image you will not see any prolapses . When is the most commonly used MRI (magnetic x-ray). Ultrasound is poorly suited to investigate this disorder. CT is not commonly used in this setting as this allows relatively large radiation doses.

What about exercise and physical activity?
It is very important to recover quickly on their feet when you've got a slipped disc and painful symptoms. It is common for this disorder and most symptoms when sitting still for long, and often eases anything when you get going and going. It is not advisable to train hard or instance run in the starting phase. As described earlier, it is wise to listen to the message body. It is hurt should be avoided, but you must not let the pain control your movement 100%. Physical activity is better than sitting still or hard training.

What is a back or neck kink?
The back and neck protects vital organs such as the spinal cord, spinal nerves and blood vessels. The nervous system is constructed in such a way that in these structures practice "better safe than sorry" principle. When the nervous system receives signals danger from back or neck then activated protection mechanisms to protect the area of ​​injury. A central part of this protection are muscle spasms in the body part, or kink as we call it.

This gives the nervous system a little time to determine the extent of the damage or the danger signal the nervous system received was only a false alarm. In the acute phase, as will the pain brain perceives to be to protect you, and it's important to listen to it. If it hurts to sit a long time, so avoid this. In this way, your body behavior so that the injury can heal as quickly as possible.

What treatment options are available?
In first place is the best treatment only to be diverse in activities and go much traveling over rough terrain. If the pain is so intense you should take either anti-inflammatory or analgesic drugs, but everything in moderation.

There is very little a therapist of different kinds can do with the prolapse. It is like trying to push toothpaste back into the tube. Impossible. But there are a lot of treatments that can be effective on the symptoms that come from such a disorder. Some work well for some, while others work well for others. This is because the pain is individual and therefore very difficult to treat with a "standard method".

Should I "break" back in place?
It is not recommended that, before knukket back in place in the first acute phase. It is very difficult for a therapist to reveal the severity of your suffering at this stage, and you risk making the injury more by such treatment. If the muscles in your back or neck a little later in the process still creates an inappropriately strong "shield", as such manipulation can be an effective treatment. Physiotherapists , naprapaths and chiropractors have the knowledge necessary to assess when such treatment can be used.

When to consider surgery?
About prolapse pressing on nerves to muscles become paralyzed or losing control of urine or stool, then you must immediately call the hospital. These patients should fast for surgery. With the exception of these rare and severe cases, so you should wait as long as possible before considering surgery. It may be some disagreement among the scholars on this point, but you know that most recover completely after the prolapse without further problems. My advice is to wait as long as possible, to see if spontaneous clearing plagues of the road. It is difficult to give any specific advice on what to do here, so good communication between therapist and patient is important.

What can physio help me?
The physiotherapist may primarily provide advice on activity and "home treatment". A prolapse can cause a variety of symptoms such as pain in the back (one or both sides), pain in one or both legs or pain in the hip and buttocks. Some may also find that they lose feeling in parts of the leg or feeling "pins and needles". Numbness in parts of the leg can be a sign that prolapse pressing on a nerve. All these symptoms are things that are being considered in the study. physiotherapist may use different methods or methods to "disturb" the signals from the spine so that you as a patient experiencing minor ailments. This may involve massage or the use of needles , pressure waves and kinesio tape .

How long will it take before I get rid of the pain?
The pain will go in time. You will experience periods in which symptoms disappear completely and the periods in which they become more intense. This is normal. We know that it can take up to one year before the symptoms are completely gone. In very few cases, the body is unable to clean up yourself, and when surgery may be necessary. You will then be referred to an orthopedic surgeon who can assess your symptoms and MRI images to determine whether you could benefit from an operation.

In most cases as "dry" Prolapse up and body "clean" cells removes the disc tissue that has come out of the target nucleus. This can be quite slow, but is the body's natural way to fix the problem. In addition, repaired the damage in fiber cartilage that forms the outer edge of the disc, so that additional tissue from seeping out.

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