What is a herniated disc? What are the causes and types?

– Herniated disc is one of the most common causes of low back pain. You can also hear it among the people with names such as slipped back, slipped disc, spinal cord compression.
– Lumbar hernia is a disease that occurs as a result of the cartilage between the vertebrae slipping from its place due to excessive stress and entering the spinal canal, putting pressure on the nerves coming to the legs and spinal cord. It is called by the name of the region where it is formed between the bones of the spine.
– Herniated disc occurs most frequently between L4-5 and L5-S1 distances below it.
– Some branches of the nerve roots originating from the lower 4 lumbar vertebrae unite to form the sciatic nerve. After running a short distance in the abdomen along the posterior wall of the pelvis, the sciatic nerve emerges from the middle of the hip and descends along the midline at the back of the leg. For this reason, in some diseases of the lumbar spine (such as herniated disc, some tumors), the pain is felt from the inside of the hip to the leg.

REASONS OF lumbar hernia

 Genetic factors: In recent years, the idea that there may be a possible genetic disorder in patients with lumbar hernia has been seriously emphasized and some clues have been obtained in studies.
 Familial tendency: Although there is no clear data on this subject, a familial tendency can usually be detected in disc diseases.
 Age: Discs contain a high percentage of water. As people age, the water content decreases and the disc becomes harder and its height decreases. Harder discs are more prone to herniation.
 Excess weight: it compresses the jelly core in the middle of the disc, forcing it to come out by breaking the ring.
 Poor posture-sitting position
 Incorrect lifting

TYPES OF WAIST HERNIA
Herniated disc is practically seen in 3 ways. This distinction is important in treatment.

1. Beginning lumbar hernia
2. Moderate lumbar hernia
3. Advanced-stage lumbar hernia

1. Incipient Lumbar Hernia: The cartilage has not yet ruptured the surrounding capsule. Therefore, it puts pressure on the nerve like a balloon. The patient has only leg and lower back pain. During this period, the patient benefits from medication, rest or exercises. If the treatment in this period is not done properly, the hernia may progress.

2. Mid-Stage Hernia: The capsule around the cartilage between the vertebrae pushed further and overflowed into the spinal canal. This overflowing part enters under the nerve coming to the legs and puts pressure on the nerve and causes pain. At this stage, treatment and precautions are more important.

3. Advanced Stage Hernia: It broke the capsule around the cartilage between the vertebrae and went into the spinal canal. This displaced part enters under the nerve coming to the legs, puts pressure on the nerve and causes severe pain. At this stage, it is generally not possible to remove the cartilage piece that goes into the spinal canal with medication or manual therapy. We recommend microsurgery to our patients, especially if there is a loss of strength in their feet, without wasting time.

DISC PROBLEMS

SYMPTOMS OF WASTE HERNIA

4 out of every five people suffer from low back pain at some point in their life. Pain alone is not enough to say herniated disc.
– Pain: Patients complain of pain radiating from their lower back to their hips and legs. This pain can extend to the heel and toes. Especially in lumbar hernia, the complaint of pain increases with coughing or straining. This is an important finding for the diagnosis of herniated disc. Some patients say that they are pulled from the back of their legs by a rope. The patient’s waist can be tilted to one side.
– Loss of strength: In some cases, loss of strength begins to develop in the ankle. When instructed to walk on toes and heels, patient cannot stand on toes or heels. There was a loss of strength in the ankle due to the pressure on the nerves coming to these areas. If left untreated, paralysis of the ankle can occur. Patients complain that their ankles turn when they walk on a small obstacle in front of them.
– Loss of feeling: The patient has a defect in feeling (numbness) in the toes and toes of the leg that he feels pain.
– Urinary or stool incontinence: In rare cases, difficulties in urinating and defecating or incontinence may occur in very advanced cases.
– Loss of sexual function: In very advanced cases, sexual functions are adversely affected. Especially in men, problems with penile erection may occur.

DIAGNOSIS OF HERNIA

– History: The medical history provides the most important clues in diagnosis. Usually, there is a history of pain in the leg followed by more or less low back pain. Although the first symptoms are usually felt after an event such as heavy lifting, cases of sudden onset of low back pain and stiffness after long mornings are not uncommon without any obvious strain.
– Physical examination: Usually provides the diagnosis. Examination can easily determine which nerve root is compressed and the severity of this compression. Examination findings are essential in the selection of the treatment method.
– Radiological examination: With a simple radiological examination, congenital spinal diseases that affect spinal mechanics and are characterized by low back pain (may be seen at rates of up to 5-10%), calcifications, spinal shifts, some tumors can be diagnosed.

MRI and EMG examinations may be required in terms of differential diagnosis and operation strategy in cases that do not respond to treatment, have frequent recurrences, and are decided to undergo surgery based on examination findings.