When herniated disk part of nucleus pulposus (nucleus pulposus) passes through the fiber ring (annulus fibrosus) and caused by pressure on the spinal nerve (nervus spinalis) complaints. Recent reports suggest that the severe pain may not go back for pinched nerves, but on an immune response and inflammation (spinal disc herniation Ashburn VA). The pain radiates typically made along the dermatomes and interpret it indicates the affected nerve roots. Many herniationss are asymptomatic and require no treatment. With old healthy patients such. As are found in about 60% of cases herniated disks as an incidental finding. It is therefore important to determine, prior torapy, whether your patient's symptoms explained by the affected intervertebral disk.
Typically, herniated disks causing back pain (lumbago) with or without radiation into legs (sciatica) or in arms (brachialgia). Depending on the severity of symptoms it can also lead to numbness or muscle failure in supply area of pinched nerve root. A herniated disk can lead to a positive characters and Kernig's sign. In extreme cases, it can cause a spinal cord injury, thereby z. B. A chair and / or urinary incontinence and a saddle anesthesia occur.
Disk are bradytrophic tissue, that is, they are not supplied directly from the bloodstream out with nutrients through diffusion. This play semipermeable membranes that separate the cartilaginous rings of each other, the decisive role. By shear forces, these membranes can tear, thereby losing their function and the disk in addition to nucleus pulposus of disk (nucleus pulposus) dries (black disk lesion).
When it comes to disk, the nucleus pulposus is practically non-existent in its original form. So the disk occurs mostly at the bottom of a long-term pre-damage the disk. The nucleus pulposus (about 80% water) and is in healthy disk from a jelly-like, cell-poor tissues and accepts load together with the cartilage rings and the membranes of function of a hydraulic ball ("water cushion"). The vertebral bodies and disk front allow, together with the small facet joints at the back ("facet joints"), the high mobility of entire spine and high stability.
Physiotherapy (Physiotherapy) in chronic and subacute pain helpful. In acute stage, no benefit could be proven so far. Among the many therapeutic and diagnostic approaches are also the Feldenkrais Method, Alexander Technique, Hatha Yoga, the McKenzie method, the spiral dynamics and acupuncture. A behavioral therapy is helpful in terms of pain management for chronic back pain.
The main method of conservative treatment herniated disks is a systemic anti-inflammatory therapy with the use of nonsteroidal anti-inflammatory drugs (NSAIDs). In some cases, the efficiency of delivery of topical administration of corticosteroids.
The investigation in health patients is usually not paid by the statutory health insurance. If necessary, the costs are covered if a painrapist the patient transfers to radiologist. Because of high complication rate applies strict indications for surgery. In 2013, the AOK hospital report has shown that the number of disk operations has doubled between 2005 and 2010.
Spine Patient Outcomes Research Trial) came to conclusion that because of persistent sciatica due to a herniated disk surgery even after 8 years an advantage over the conservative treatment brings. Because of difficult assignment to different treatment groups and the summary of a number of different studies to a large study, there is some room for interpretation. Even so-called minimally invasive surgery and microsurgical procedures such as percutaneous laser disk decompression (PLDD), are mentioned in this context. Since the so-called "connective tissue" as the primary cause is hereditary, can a herniated disk only partially prevented by building muscle. The prevention of accidents can not always achieve.
Typically, herniated disks causing back pain (lumbago) with or without radiation into legs (sciatica) or in arms (brachialgia). Depending on the severity of symptoms it can also lead to numbness or muscle failure in supply area of pinched nerve root. A herniated disk can lead to a positive characters and Kernig's sign. In extreme cases, it can cause a spinal cord injury, thereby z. B. A chair and / or urinary incontinence and a saddle anesthesia occur.
Disk are bradytrophic tissue, that is, they are not supplied directly from the bloodstream out with nutrients through diffusion. This play semipermeable membranes that separate the cartilaginous rings of each other, the decisive role. By shear forces, these membranes can tear, thereby losing their function and the disk in addition to nucleus pulposus of disk (nucleus pulposus) dries (black disk lesion).
When it comes to disk, the nucleus pulposus is practically non-existent in its original form. So the disk occurs mostly at the bottom of a long-term pre-damage the disk. The nucleus pulposus (about 80% water) and is in healthy disk from a jelly-like, cell-poor tissues and accepts load together with the cartilage rings and the membranes of function of a hydraulic ball ("water cushion"). The vertebral bodies and disk front allow, together with the small facet joints at the back ("facet joints"), the high mobility of entire spine and high stability.
Physiotherapy (Physiotherapy) in chronic and subacute pain helpful. In acute stage, no benefit could be proven so far. Among the many therapeutic and diagnostic approaches are also the Feldenkrais Method, Alexander Technique, Hatha Yoga, the McKenzie method, the spiral dynamics and acupuncture. A behavioral therapy is helpful in terms of pain management for chronic back pain.
The main method of conservative treatment herniated disks is a systemic anti-inflammatory therapy with the use of nonsteroidal anti-inflammatory drugs (NSAIDs). In some cases, the efficiency of delivery of topical administration of corticosteroids.
The investigation in health patients is usually not paid by the statutory health insurance. If necessary, the costs are covered if a painrapist the patient transfers to radiologist. Because of high complication rate applies strict indications for surgery. In 2013, the AOK hospital report has shown that the number of disk operations has doubled between 2005 and 2010.
Spine Patient Outcomes Research Trial) came to conclusion that because of persistent sciatica due to a herniated disk surgery even after 8 years an advantage over the conservative treatment brings. Because of difficult assignment to different treatment groups and the summary of a number of different studies to a large study, there is some room for interpretation. Even so-called minimally invasive surgery and microsurgical procedures such as percutaneous laser disk decompression (PLDD), are mentioned in this context. Since the so-called "connective tissue" as the primary cause is hereditary, can a herniated disk only partially prevented by building muscle. The prevention of accidents can not always achieve.
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