Shoulder and neck pain, low back pain, lower back pain, back stiffness, the pain even extends to the hands and feet, and there is a tingling sensation. If it is more serious, there may be symptoms of muscle weakness. At this time, you should suspect that it may be Herniated Intervertebral Disc (HIVD, Herniated Intervertebral Disc)!
intervertebral disc herniation is more common in people between 12-55 years old, but the chance of occurrence under 25 years old is relatively rare. About 80% of them are male patients. These people usually have a history of early trauma.
What is a herniated disc?
Before that, let's first understand what an intervertebral disc is! The position and anatomy of the intervertebral disc:
Figure A: shows that our intervertebral disc is located between two vertebrae; Figure B: The intervertebral disc is composed of two parts, the nucleus pulposus and the annulus fibrosus. The nucleus pulposus is located in the middle of the disc; The ring is wrapped around the nucleus pulposus.
Nucleus pulposus: is composed of highly viscoelastic and flexible polysaccharides and water, so it can absorb shock and reduce the pressure between the spine.
Fibrous annulus: is composed of collagen fibers and elastic fibers intertwined. It is a dense tissue arranged in concentric circles. It has toughness and can protect the nucleus pulposus and limit its protrusion to the surrounding. In simple terms, the intervertebral disc can be regarded as a water polo, filled with water, and the water is wrapped by rubber to prevent the water from leaking. The reason for
intervertebral disc herniation
intervertebral disc is under pressure from the spine. If it is subjected to sudden impact or unbalanced compression for a long time, it may only deform the fibrous annulus at the beginning, and more serious will make the nucleus pulposus possible Breaking through the annulus fibrosus, and then compressing our spinal nerves from the space between the ligaments, these are called disc herniation .
At the beginning, it was said that people aged 12-55 are more likely to have a good hair, because at this time there is more water in the nucleus pulposus, and it is easier to have a herniated disc due to pressure disorder. On the contrary, as the age grows, the nucleus pulposus water Reduced, it is not easy to have herniated disc.
Because of the organization structure (the size of the anterior and posterior ligaments of the spine is different), and human habits (life style with more bending over), usually the anterior side of the intervertebral disc receives more pressure, causing the nucleus pulposus to run back.
did not understand? Take a look at the video shown in this 3D ↓
Classification of intervertebral disc herniation
1. Annular: annulus fibrosus produces deformation under the compression of the nucleus pulposus, and then compresses the spinal nerves.
2. Nuclear: nucleus pulposus is subjected to anterior pressure and runs backwards, compressing the spinal nerves.
3. Mixed: Comprehensive type, in addition to the nucleus pulposus that ran out to compress the spinal nerve, there are also fragmented annulus compressing the spinal nerve.
influencing factors of intervertebral disc herniation
1, poor sitting posture
prolonged pressure on the front side of the intervertebral disc , causing the nucleus pulposus to protrude backward.
Poor sitting posture for a long time will make the spine mobility worse and shorten one side of the muscles, such as the psoas major, which will make our symptoms more serious.
As shown in the figure below, the psoas muscle connects our lumbar spine and femur. When this muscle becomes tight, although the intervertebral disc looks like a posterior force, the nucleus pulposus must be pushed back. But in fact, because of the tightening of the muscles, the pressure on the lumbar spine has increased, and if there is a patient with a herniated intervertebral, it will be more serious because the intervertebral disc behind it is excessively pinched.
2, frequent bending movements
increase the chance of pressure on the front side, so that the nucleus pulposus protrudes back.
3, lack the spine to stretch backwards
stretching backwards can squeeze the nucleus pulposus left behind and reduce the chance of nucleus pulposus protrusion.
4, obesity
, especially those who are obese at the waist, are prone to increase the burden on the lumbar spine, as well as the abdominal and lower back muscles.There is a weaker situation, which increases the risk of intervertebral disc herniation.
Symptoms of intervertebral disc herniation
1. Shoulder and neck pain, lower back pain, pain may extend to the limbs.
2. The affected side feels abnormal.
3. Sciatica or cervical neuralgia, limb paralysis, and even muscle weakness and atrophy in severe cases.
4. Coughing and bending over become worse.
The diagnosis of intervertebral disc herniation
intervertebral disc herniation can be performed by physical examination, motion test (such as repeated bending, sciatic nerve tension test, etc.), and imaging examination (such as X-ray film, magnetic resonance photography (MRI) or computer tomography) Scan (CT) etc.) diagnosis.
Generally speaking, patients with intervertebral disc herniation often have directional symptoms, that is, moving in one direction will aggravate the symptoms, while moving in the opposite direction will reduce the symptoms, such as sitting for a long time and lower back pain (lower curvature), while walking will slow down the symptoms ( The waist is straight).
Treatment and prevention of intervertebral disc herniation
In the principle of treatment, we give priority to the traditional treatment methods of non-surgical treatment. But if there are the following two conditions:
1. Weakness of hands and feet, and more and more serious situation
2. Cauda equina syndrome, there will be weakness of hands and feet, or incontinence.
If you have the above two conditions, you can ask the doctor whether surgery is the priority first. Because the weakness of the hands and feet is caused by the nerve root being compressed by the intervertebral disc, the advantage of surgical treatment at this time is that it can immediately prevent the nerve from deteriorating and provide a good environment for the nerve to heal. Therefore, if you have symptoms of muscle weakness in your hands and feet, and incontinence, you can discuss with your doctor first to decide whether to perform surgery. There are mainly three Ms in
physical therapy intervention:
Modality (instrument), Manul (barehand), and Movement (exercise).
Modality (instrument) treatment:
uses the traction machine to open the spine to reduce the pressure on the intervertebral disc, and the negative pressure is generated when the intervertebral disc is pulled back to return the intervertebral disc.
Manul (hands) treatment:
relaxes tight muscles, such as the psoas major, by massaging the muscles with bare hands. In view of the deterioration of the spine's mobility, use bare hands to increase its mobility.
Movement (exercise) treatment :
>>>> stretching exercise
uses the strength of the arm to prop up the upper body without moving the pelvis. After getting up, do not stay in the highest position of propping up, and then lie back. Do this repeatedly to squeeze back the kyphotic disc.
psoas major muscle stretch: stretches the psoas major muscle
The picture below is stretching the right psoas major muscle. Lie flat on the edge of the bed, hold your left foot with your hands, and pull it toward your chest to make the right foot that you want to stretch naturally sag.
spine rotation movement
lie flat, when the head turns to the right, both knees turn to the left at the same time; when the head turns to the left, the knees turn to the right, and the two movements are done alternately. With this action, stretch the waist and relax the tight muscles.
Use the correct posture during the activity process
①When carrying heavy objects:
If the wrong posture is easy to cause injury to the lumbar spine, you should straighten your chest and waist, use your feet to bend down to lift the heavy objects.
②Sitting posture:
sitting relative to standing, lying down, puts a lot of pressure on our lumbar spine, so avoid prolonged sitting, it is best to get up and move in 20 minutes, and try not to sit on the sofa.
The correct sitting posture should be:
1. Choose a chair with the hip joint higher than the knee joint.
2.The angle of the back of the chair is about 110 degrees, and there are supports at the cervical and lumbar vertebrae to support the spine.
3. Place your hands on the arm of the chair, with your elbows greater than 90 degrees, and keep your forearms level with the ground.
4. Able to step on the ground with both feet.
③Sleeping position:
lying: put a pillow under the knee to reduce the pressure on the spine.
Lying on the side: Put a pillow in the middle of the thigh to make the body and the bed surface in line to reduce the pressure on the spine.
Pillow: The pillow with the correct height of should be able to fully support the cervical spine. When lying down, the chin is level with our body. When lying on the side, the cervical spine can be aligned with the body. And too high or too low will cause pressure on the cervical spine.
Mattress: choose a mattress of moderate hardness and should not sink more than five centimeters when lying down. And make our spine in a straight line.
This article comes from: China Sports and Health Science Network
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