Find the PIVD from the root
Lower back pain may be a quite common complaint in all age groups. We all have experienced back pain at some time in our life time. It may be calls for PIVD. Sometimes, it persists and affects our routine and becomes a matter of concern. But, in fact, most of the days it simply stiffness or muscle strain because hard work, prolong standing, sternuous excercise, play, or after lifting some heavy object. Such back pain isn’t because to any underlying disease. Gentle or moderate level of pain gets relieved by taking analgesics (like an adult may take Diclofenac 50 mg after meal, SOS) and after taking rest. The other causes of backache are muscle sprain, muscle pull, strain, wrong posture, etc.
Pain could be a subjective sensation and the complaint of backache may vary from person to person. For example, for an athlete the lower backache after a prolong run or play may not be of an excellent concern but similar intensity of pain could also be terribly draining for an old age person.
So, delicate back pain which can be explained on the premise of obvious cause like prolong walk and play should not be investigated. Bed rest is the best medical recommendation for relieving backache.
However, severe persistent backache without any obvious precipitating factor may warrant a consultation with the medical specialist. Orthopedicians, Physiotherapists, Sport medicine physicians, Neurologists and Neurosurgeons commonly encounter patients with complaints of lower backache.
The human spine is formed of alternating vertebrae and intervertebral discs extending from the neck to the tail bone. The intervertebral discs are the ‘shock absorbers’ of the body and are composed of an outer strong fibrous membrane and an inner ‘jelly-like’ nucleus giving both strength and elasticity. A disc prolapse occurs when there is a weakening in the outer membrane which leads to a protrusion of the inner nucleus. This protrusion usually heads towards the spinal canal thus compressing them giving rise to the symptoms.
Disc herniation can occur in any disc in the spine, but the two most common forms are lumbar disc herniation and cervical disc herniation As we grow older, our intervertebral discs begin to lose water content and betray years of stress and pressure. For the same reason, the body’s natural aging process is the prevailing underlying cause of prolapsed discs. However, several other factors may encourage or exacerbate prolapsed discs in both the young and the elderly, such as:
• Repeated improper movements that place stress upon the spine, often due to sports, improper lifting and even sitting for too long
• Sudden injuries or traumas, such as might occur during a high-impact sport, fall or car accident
• Smoking or the excessive use of alcohol
• Obesity
• Lack of exercise
• Excessive driving
The prevalence of a symptomatic herniated lumbar disc is about 1% to 3% with the highest prevalence among people aged 30 to 50 years, with a male to female ratio of 2:1. In individuals aged 25 to 55 years, about 95% of herniated discs occur at the lower lumbar spine (L4/5 and L5/S1 level); disc herniation above this level is more common in people aged over 55 years.
Symptoms include mild to sudden severe back pain which can be caused by muscle spasm and may radiate to buttocks and calves or in the hand and palm in case of cervical disc herniation. There may be pins like sensations, tingling in the affected area and associated limbs accompanies by numbness and weakness in the same. Lower back pain that is accompanied by incontinence of the bladder or bowels or the inability to walk may indicate that the bottom of the spinal cord is being compressed. ( cauda equina syndrome).
Physical examination including special tests along with an MRI scan can confirm the diagnosis.
Medical treatment would include muscle relaxants, anti-inflammatory pain-killers.
Physiotherapy Management
- Controlled rest with activity modification and ergonomic advice.
-manoeuvres like dry needling, taping , soft tissue manipulation to reduce the spasm and pain.
- exercises to maintain and improve the mobility of neural tissues
- list correction ( side shift correction)
-hydrotherapy
- a good core , back and hip strengthening programme for strengthening and maintainance of the same and to prevent re-injury.
What Are The Symptoms Of A Prolapsed Disc?
The pain is often severe and commonly comes on suddenly. The back pain is generally eased by lying down flat and is often made worse if you move your back, cough or sneeze.
Nerve Root Pain (Usually Sciatica)
Nerve root pain is pain that occurs because a nerve coming from the spinal cord is pressed on (trapped) by a ‘slipped’ (prolapsed) disc, or is irritated by the inflammation caused by the prolapsed disc.
Other Nerve Root Symptoms
The irritation or pressure on the nerve next to the spine may also cause pins and needles, numbness or weakness in part of a buttock, leg or foot. The exact site and type of symptoms depend on which nerve is affected.
a) Rest: Rest and Anti-inflammatory and analgesics.
b) Reduction: Continue bed rest and traction for just two weeks may lessen the herniation in over 90% cases. If no improvement with rest and traction, epidural injection of corticosteroid and native anaesthetic are given.
c) Chemonucleolysis: dissolution from the Nucleus Pulposus by percutaneous injection of the proteolytic enzyme (chymopapain). This enzyme has got the property of dissolving fibrous and cartilaginous tissue.
Indications for operative elimination of disc.
i) cauda equina compression syndrome that doesn't clear up with Six hours of starting bed rest and traction (emergengy).
ii) Neurological deterioration while under conservative management.
iii) Persistant pain and signs and symptoms of sciatic tension after 30 days of conservative treatment.
The disc is taken away by following techniques.
a) Hemilaminectomy/Partial laminectomy- Area of the lamina and ligamentum flavum on one side is taken away, taking great care to not damage the facet joint.
b) Laminectomy- Laminae on sides with spinous process are removed. Such wide exposure is needed for big, central disc producing cauda equina syndrome.
c) Microdiscectomy- completed with an operating microscope. Exposure is extremely limited. Morbidity and hospitalisation is less.
d) Fenestration- Ligamentum flavum bridging the 2 adjacent laminae is excised and spinal canal at affected level exposed.
e) Laminotomy- Along with fenestration, a hole is made within the lamina for wider exposure.
Physical rehabilitation Management in PIVD
Before coming up with the medical care, verify the position of comfort or symptom reduction.
Actually what happens in PIVD?
The spine or back bone is comprised of range of vertebrae which are placed over one another with support of inter vertebral disc. The disc is filled with a pulpy matter surrounded by a fibrous sheath. When the gap between two vertebrae is reduced due to some external or internal reason the inner matter is compressed and prolapsed at a soft part of the sheath. That causes pressure over the adjoining nerve roots and ligaments giving rise to pain, low back pain, sciatica pain, lumbar pain, lumbar spondylosis, stiffness, swelling, numbness, dysfunction, muscle wasting, burning sensation etc.
PIVD (Prolapsed Inter Vertebral Disc or IVDP) is a common disease. We can manage and treatment with Ayurveda.
For the PIVD disease, you can find the best Ayurveda hospital in India. So, here you can find the best Ayurveda treatment.
Take care yourself and avoid such kind of works which not good for you.
