Dr Nikhil Juneja

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slip disk

The spine is made up of many bones called vertebrae. These are roughly circular and between each vertebra is a 'disc'. The discs are made of strong 'rubber-like' tissue which allows the spine to be fairly flexible. A disc has a stronger fibrous outer part, and a softer jelly-like middle part called the nucleus pulposus.
The spinal cord, which contains the nerves that come from the brain, is protected by the spine. Nerves from the spinal cord come out from between the vertebrae to take and receive messages to various parts of the body. There are also present various ligaments and tissues surrounding.
What is slip disk or prolapsed disk?
Protrusion of one of the shock absorbing pads that lie between the vertebrae of spine is known as slipped disk or herniated disk or prolapsed disk.
Most common between the age of 25 to 45
Slightly more in females
Being overweight and lifting objects incorrectly are risk factors
No significant genetic factor
The shock absorbing disk between the vertebrae of the spine consist of an outer strong and a fibrous coat and an inner soft gelatinous core (nucleus pulposus). A prolapsed disk occurs when the core pushes outwards, distorting the shape of the disk. When the disk prolapsed or herniated, the surrounding tissue become swollen and inflamed. Then together with disk, the tissues may press spinal nerves or the spinal cord causing pain. The thing that is to be noted here is that we make a picture in our mind that a shock absorbent pad or a disk slips away from in between the two vertebrae of the spine, but its not like that, if the disc can slip out in such a fashion then it could equally well slip back again and all should be well. The truth of the matter is that the disc bursts.
Disks which are most liable to be affected
Although the disks in the lower back are most likely to be affected, damage to the disks in the neck and in the upper back are rarely effected.
Any disc in the entire spine can prolapse or burst, the most common ones to which this happens are the lowest two that is between the fourth and fifth lumbar vertebrae and between the fifth lumbar and the top of the sacrum. Although the reasons for this are not entirely clear, the most likely explanation is that the stresses experienced by the spine are the greatest at these levels. Also the sacrum does not stand vertically but is tilted backwards, so producing a sharp curve in this region and giving a wedge shape to the discs. This wedge shape may concentrate the stresses in the back of the disc so making these lower lumbar discs particularly liable to damage. Briefly in a prolapse, the
What are the causes?
For about age 25, the disks begin to dry out. They also become more vulnerable to prolapsed or herniated as the result of normal stress of daily life and minor injuries. Sometimes damage to disk is caused by the bending or twisting movement or by lifting heavy objects incorrectly. What actually happens is that the disc bursts and fragments of the outer fibrous coat (annulus fibrosus), together with some of the inner gelatinous nucleus pulposus, press on ligaments and nerves running close to the disc and produce pain. From about age 45 fibrous tissue around the disk stabilizes them and making them less likely to damaged.
What are the symptoms?
Symptoms of the prolapsed disk may develop progressively over a period weeks or may appear suddenly. This may include:
Back pain.
Nerve root pain usually sciatica due to pressing of the nerve.
Dull pain in the effected areas.
Severe pain, tingling, numbness in leg or if neck is affected, in an arm.
Muscle spasm and stiffness around the effected area that makes movement difficult.
Weakness or restricted movement in arm or leg.
Cauda equina syndrome
The pain is often relieved by rest but can be made worse by walking upstairs, sitting, coughing, sneezing bending or bowel movements. Since impaired bladder or bowel function may indicate pressure on the spinal cord.
Symptoms of the prolapsed disk come upon if some or other nerve is pressed but in some cases the prolapsed is very small which doesn’t effects any of the nerve, so it is not necessary that in every case the symptoms will appear.
Recommendation
Continue with normal activities as far as possible. This may not be possible at first if the pain is very bad. However, move around as soon as possible, and get back into normal activities as soon as you are able. In the past, advice had been to rest until the pain eases. It is now known that this was wrong. You are likely to recover more quickly and are less likely to develop chronic (persistent) back pain if you keep active when you have back pain rather than rest a lot.
How to prevent prolapsed disk?
Evidence suggests that the best way to prevent bouts of back pain and prolapsed disc is simply to keep active, and to exercise regularly. This means general fitness exercise such as walking, running, swimming etc. There is no firm evidence to say that any particular 'back strengthening' exercises are more useful than simply keeping fit and active. It is also sensible to be 'back aware'. For example, do not lift objects when you are in an awkward twisting posture.
What if left untreated?
In the majority of cases, the pain will improve gradually. This may take many months or even a year or more. Permanent paralysis and problems with passing urine will otherwise occur.
Homoeopathic medicines / Therapeutics
• Colocynthis ranks first.
• Chamomilla and Gnaphilum occupies the medium group
• Rhus tox., Phytolacca, Arsenic, Lycopodium, Ammonium mur. are for increasing stubborn and long term symptoms.