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Sign and Symptoms of Slip Disc
The spine is made up of bones called vertebrae.Between the bones of the spine are small discs made of a thick layer of cartilage on the outside and a soft and jelly-like material on the inside. The discs act to absorb shocks caused when the spine moves and they allow the spine to bend.
The spinal cord is a bundle of nerves running through the canal within the spinal column. It carries messages to and from the brain via nerve roots that branch out to the body along the length of the spinal cord. A herniated,prolapsed, or ruptured disc happens when the inner material bulges or bursts through the outer lining of cartilage and puts pressure on or damages the spinal nerves.
Herniated discs can occur in any part of the spine, but they are most common in the lower back (lumbar section of the spine). Herniated discs are more common in people between 30 and 40 years old.
Sciatica is defined as mild to severe pain or discomfort in the area of the lower back.
In today's scenario almost 80 percent of adults are affected by back pain at some point in their lives. Almost every family has one or more people suffered with this some time or the other. Reports from various research institutes, different modern class-three level hospitals, and referral centers show that 3 to 5% of the patients visiting annually in India present with Lower back pain. Of them, 1.5% have features of sciatica, in which 62 to 69% are males and 31 to 38% are females. Sciatica affects mostly adult males, particularly those 41 to 60 years old. The ratio of incidence is similar in the people of low income as well as in higher income groups. It is more prevalent in the month from May to July (rainy season) in which Vata Dosha naturally gets vitiated and people become sick. People of Vata Prakruti are more prone to the disease. Annual incidence of low back ache in the U.S. is 2 to 5%, and annual cost of direct medical care for low back ache has been estimated at $13 to $16 billion. Total annual societal costs are estimated at $20 to $50 billion.
Incidents are the same among heavy, light, and sedentary workers, although a higher proportion of heavy workers are incapacitated with Low back pain. Sciatic pain is common in people who either sit or stand for prolonged periods of time.
Sciatica is a disease of the nerves. The sciatic nerve is the largest nerve in the body and has a long course. It is derived from fourth and fifth lumbar (L4 and L5) and first and second sacral (S1 and S2) roots. It provides motor innervation of the hamstring muscles and to all muscles below the knee. It carries sensory impulses from the posterior aspect of the thigh and the posterior and lateral aspect of the leg and entire sole. Any pathological process that impinges upon at this level may cause pain associated with sciatica. The mechanism involved in the disease process is distortion; stretching; and irritation or compression of the spinal root (most often central to the intervertebral foramen), which causes tingling, paresthesias and numbness or sensory impairment of the skin, soreness of the skin, and tenderness along the nerve. It usually accompanies radicular pain, loss of reflexes, weakness, atrophy, fascicular twitching, and occasionally stasis edema if motor fibers of the anterior root are involved.
Causes of Sciatica:
- Lifestyle choices such as tobacco use, lack of regular exercise, and inadequate nutrition substantially contribute to poor disc health.
- As the body ages, natural biochemical changes cause discs to gradually dry out affecting disc strength and resiliency.
- Poor posture combined with the habitual use of incorrect body mechanics, hard physical labor (delivery) can place additional stress on the spine.
- Pregnancy. The changes that the body goes through during pregnancy, including weight gain, a shift on one's center of gravity, and hormonal changes, can cause sciatica during pregnancy.
- Scar tissue. If scar tissue compresses the nerve root, it can cause sciatica.
- Muscle strain. In some cases, inflammation related to a muscle strain can put pressure on a nerve root and cause sciatica.
- Spinal tumor. In rare cases, a spinal tumor can impinge on a nerve root in the lower back and cause sciatica symptoms.
- Infection. While rare, an infection that occurs in the low back can affect the nerve root and cause sciatica.
- Injury unusual and excessive activities of the lower body and legs, such as jumping, climbing, stretching and other movements, and spinal fracture or dislocation resulting from compression.
Combine these factors with the effects from daily wear and tear, injury, incorrect lifting, or twisting and it is easy to understand why a disc may herniate. A herniation may develop suddenly or gradually over weeks or months.
The potential causes of sciatica are myriad, but these account for only 15% of the total cases. The mechanisms of underlying neuropathic pain in 85% of the cases are still not clear. Sciatica is one of the many Vata diseases (nanatmaj vyadhis) Vata Dosha is the main culprit in the disease.
Pain: feels in lower back, one side of the buttock or leg, but rarely both the right and left sides
- Muscle weakness
- Tingling or a pins-and-needles feeling,
- Muscle spasm
- Heaviness in the body
- Loss of appetite
Risk factors for sciatica include health problems, lifestyle choices and inherent qualities, such as age or race that make it more likely you'll develop a particular condition. Major risk factors for sciatica include:
- Age: Age-related changes in the spine are a common cause of sciatica. You're likely to have some deterioration in the disks in your back by the time you're 40.
- Occupation: A job that requires you to twist your back, carry heavy loads or drive a motor vehicle for long periods makes you more prone to develop sciatica.
- Prolonged sitting: People who sit for prolonged periods or have a sedentary lifestyle are more likely to develop sciatica than active people are.
- Diabetes: This condition, which affects the way your body uses blood sugar, increases your risk of nerve damage.
Most people recover fully from sciatica. Sciatica can potentially cause permanent nerve damage. Depending on what's causing the nerve to be compressed, other complications may occur, which include:
- Loss of feeling in the affected leg
- Loss of movement in the affected leg
- Loss of bowel or bladder function
Diagnosis:-Because of the many conditions that can compress nerve roots and cause sciatica, treatment and symptoms often differ from patient to patient Sciatica might be revealed by a neuromuscular examination of the legs by a physician. There may be weakness of knee bending or foot movement, or difficulty bending the foot inward or down. Pain down the leg can be reproduced by lifting the leg straight up off the examining table. Imaging may include either X-ray, CT or MRI. Imaging methods such as MR neurography may help in diagnosis and treatment of sciatica.
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