Prolapse of Intervertebral Disk

Subject: Medical and Surgical Nursing I (Theory)

Overview

Prolapse of intervertebral disk, A spinal disk is a little like a jelly donut, with a softer center encased within a tougher exterior. Sometimes called a slipped disk or a ruptured disk, a herniated disk occurs when some of the softer, pushes out through a crack in the tougher exterior. Numbness or tingling, weakness, etc its symptoms. Disk herniation is most often the result of a gradual, aging-related wear and tear called disk degeneration. As you age, your spinal disks lose some of their water content. That makes them less flexible and more prone to tearing or rupturing with even a minor strain or twist. Electromyograms and nerve conduction studies measure how well electrical impulses are moving along nerve tissue. This can help pinpoint the location of the nerve damage. Nerve pain medications. Drugs such as gabapentin (Neurontin, Gralise, Horizant), pregabalin (Lyrica), duloxetine (Cymbalta), tramadol (Ultram) and amitriptyline often help relieve nerve-damage pain.

Prolapse of intervertebral disk

Definition

A herniated disk refers to a problem with one of the rubbery cushions (disks) between the individual bones (vertebrae) that stack up to make your spine.

A spinal disk is a little like a jelly donut, with a softer center encased within a tougher exterior. Sometimes called a slipped disk or a ruptured disk, a herniated disk occurs when some of the softer, pushes out through a crack in the tougher exterior.

A herniated disk can irritate nearby nerves and result in pain, numbness or weakness in an arm or leg. On the other hand, many people experience no symptoms from a herniated disk. Most people who have a herniated disk don't need surgery to correct the problem.

Symptoms

The most common signs and symptoms of a herniated disk are:

_ Arm or leg pain. If your herniated disk is in your lower back, you'll typically feel the most intense pain in your buttocks, thigh, and calf.

_ Numbness or tingling. People who have a herniated disk often experience numbness or tingling in the body part served by the affected nerves.

_ Weakness. Muscles served by the affected nerves tend to weaken. This may cause you to stumble, or impair your ability to lift or hold items.

Causes

Disk herniation is most often the result of a gradual, aging-related wear and tear called disk degeneration. As you age, your spinal disks lose some of their water content. That makes them less flexible and more prone to tearing or rupturing with even a minor strain or twist.

Risk factors

Factors that increase your risk of a herniated disk may include:

_ Weight. Excess body weight causes extra stress on the disks in your lower back.

_ Occupation. People with physically demanding jobs have a greater risk of back problems. Repetitive lifting, pulling, pushing, bending sideways

_ Genetics. Some people inherit a predisposition to developing a herniated disk.

Tests and diagnosis

During the physical exam, your doctor will check your back for tenderness.

Your doctor may also perform a neurological exam, to check your:

- Reflexes

- Muscle strength

- Walking ability

- Ability to feel light touches, pinpricks or vibration

Imaging tests

_ X-rays. Plain X-rays don't detect herniated disks, but they may be performed to rule out other causes of back pain, such as an infection, tumor, spinal alignment issues or a broken bone.

_ Computerized tomography (CT scan). A CT scanner takes a series of X-rays from many different directions and then combines them to create cross-sectional images of your spinal column and the structures around it.

_ Magnetic resonance imaging (MRI). Radio waves and a strong magnetic field are used to create images of your body's internal structures. This test can be used to confirm the location of the herniated disk and to see which nerves are affected.

Nerve tests

Electromyograms and nerve conduction studies measure how well electrical impulses are moving along nerve tissue. This can help pinpoint the location of the nerve damage.

Treatments and drugs

i.Medications

_Over-the-counter pain medications. If your pain is mild to moderate, your doctor may tell you to take an over-the-counter pain medication, such as ibuprofen.

_ Narcotics. If your pain doesn't improve with over-the-counter medications, your doctor may prescribe narcotics, such as codeine or an oxycodone-acetaminophen combination (Percocet, Oxycontin, others), for a short time.

_ Nerve pain medications. Drugs such as gabapentin (Neurontin, Gralise, Horizant), pregabalin (Lyrica), duloxetine (Cymbalta), tramadol (Ultram) and amitriptyline often help relieve nerve-damage pain.

Therapy

A physical therapist may also recommend:

- Heat or ice

- Traction

- Ultrasound

- Electrical stimulation

- Short-term bracing for the neck or lower back

 References
Things to remember
  • A herniated disk can irritate nearby nerves and result in pain, numbness or weakness in an arm or leg
  • People who have a herniated disk often experience numbness or tingling in the body part served by the affected nerves
  • Disk herniation is most often the result of a gradual, aging-related wear and tear called disk degeneration
  • Electromyograms and nerve conduction studies measure how well electrical impulses are moving along nerve tissue.
  • Drugs such as gabapentin (Neurontin, Gralise, Horizant), pregabalin (Lyrica), duloxetine (Cymbalta), tramadol (Ultram) and amitriptyline often help relieve nerve-damage pain.
  • A physical therapist may also recommend:- Heat or ice, Traction, etc. 
  •  
Questions and Answers

An issue with one of the soft, rubbery disks that sit in between the individual vertebrae that make up your spine is referred to as a herniated disk. Similar to a jelly donut, a spinal disk has a softer interior and a harder exterior. A herniated disk, also known as a slipped disk or a ruptured disk, happens when some of the softer material pushes through a tear in the more robust exterior.

An arm or leg may experience pain, numbness, or weakness as a result of a herniated disk irritating nearby nerves. On the other hand, many people with a herniated disk show no symptoms. The majority of people with herniated disks don't require surgery to treat the condition.

An issue with one of the soft, rubbery disks that sit in between the various vertebrae that make up your spine is referred to as a herniated disk. Similar to a jelly doughnut, a spinal disk has a softer interior and a harder outer. A herniated disk, also known as a slipped disk or a ruptured disk, happens when some of the softer material slips through a tear in the more robust shell.

An arm or limb may experience discomfort, numbness, or weakness as a result of a herniated disk irritating adjacent nerves. On the other hand, many persons with a herniated disk show no symptoms. The majority of people with herniated disks don't require surgery to treat the condition.

Symptoms:

The following are the main warning signs and symptoms of a herniated disk:

  • Leg or arm pain The buttocks, thigh, and calf are often where you will have the most severe pain if your ruptured disk is in your lower back.
  • Tingling or numbness. A herniated disk frequently causes numbness or tingling in the body portion that the afflicted nerves serve.
  • Weakness. Affected nerves tend to weaken the muscles they service. You can become unsteady or find it difficult to lift or hold objects as a result.

Causes:

Most frequently, cumulative aging-related wear and tear known as disk degeneration leads to disk herniation. Your spinal disks' water content decreases with aging. Because of this, they are less elastic and more likely to rupture or rip from even a slight twist or strain.

Risk factors:

Your risk of a herniated disk may be impacted by the following factors:

  • Weight: The disks in your lower back are put under additional strain due to excess body weight.
  • Occupation: Those who in physically demanding occupations are more likely to experience back issues. raising, tugging, pushing, and bending sideways repeatedly
  • Genetics: Herniated disk development is predisposed in some people by genetics.

Tests and diagnosis:

Your doctor will feel for any tenderness in your back during the physical examination. A neurological examination may also be carried out by your doctor to assess:

  • Reflexes
  • Muscular power
  • Being able to walk
  • The capacity to feel vibrations, pinpricks, and light touches

Imaging tests:

X-rays: Herniated disks are not visible on plain X-rays, but they may be taken to rule out other reasons of back discomfort, such as an infection, tumor, problems with the spine's alignment, or a fractured bone.

Computerized tomography (CT scan): A CT scanner creates cross-sectional images of your spinal column and the surrounding structures by combining a number of X-rays taken in succession from various angles.

Magnetic resonance imaging (MRI): The inside structures of your body are imaged using radio waves and a strong magnetic field. This examination can be performed to determine which nerves are impacted and to confirm the herniated disk's exact position.

Nerve tests:

  • The efficiency with which electrical impulses travel along nerve tissue is measured by electromyograms and nerve conduction experiments. This may make it easier to locate the nerve damage.

Treatments and drugs:

  • Medications:

    • Over-the-counter pain medications: Your doctor might advise you to take an over-the-counter pain reliever like ibuprofen if your pain is mild to moderate.
    • Narcotics: Your doctor may recommend narcotics, such as codeine or an oxycodone-acetaminophen combination (Percocet, Oxycontin, etc.), for a brief period of time if your pain doesn't go away with over-the-counter medications.
    • Nerve pain medications: Nerve damage pain is frequently reduced by medications like gabapentin (Neurontin, Gralise, Horizant), pregabalin (Lyrica), duloxetine (Cymbalta), tramadol (Ultram), and amitriptyline.

  • Therapy: A physical therapist may also recommend:

    • Ice or heat
    • Traction
    • Ultrasound
    • Electrical arousal
    • Bracing for the neck or lower back in the short term

 

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