Herniated Nucleus Pulposus Definition, Reason, Symptoms, Treatment & Prevention
Understanding
Hernia nucleus pulposus (HNP) or herniated disc is a condition when one of the discs or discs ( cartilage ) from the spine protrudes out and clamps a nerve. This disease is often referred to by laypeople as a pinched nerve.
HNP often attacks people aged 30–50 years. HNP is twice as common in men as in women. HNP most often occurs in the lower back.
Symptom
Not all herniated nucleus pulposus (HNP) give symptoms. Many suffer and do not realize it. Symptoms of HNP generally include back pain and neck pain. Pain can be more intense when there is more pressure on the nerves, such as when sitting, sneezing or coughing. Pain usually improves within one to three months. However, HNP can also become chronic or at risk of relapse.
Other symptoms that are often complained of include:
- numb or numb
- tingling
- weakness in several areas of the body
- moderate to severe pain in the leg, thigh, and buttocks (if pinching the sciatic nerve)
- urinary incontinence and fecal incontinence (if it pinches the lowermost nerve of the spine – cauda equina syndrome)
Reason
Hernia nucleus pulposus (HNP) occurs when the ring of connective tissue that surrounds the disc is damaged, causing the padding inside the disc to bulge out. Damaged discs can put pressure on the entire spinal cord or on a single nerve. As a result, hernias can cause pain in the protruding disc area and also in areas of the body that are controlled by these nerves.
The cause of disc damage is still unclear. However, age is a common factor in most cases. Spinal discs will lose their water content with aging. So the disc becomes less flexible and makes it easy to break. Smoking can also cause discs to be less flexible.
Other factors that can cause disc weakening causing HNP, namely:
- Bend awkwardly
- Lifting weights awkwardly or with heavy weights
- Sitting for long periods of time especially when driving a car
- Are overweight or obese
- Strenuous exercise such as weightlifting
- Accidents that injure the spine such as during a car accident or fall
Diagnosis
Doctors can usually determine the diagnosis of herniated nucleus pulposus (HNP) from the symptoms and history of the disease. A physical examination is carried out to check body posture, reflexes, muscle strength, ability to walk, and sensations from the locomotor such as pain, tingling or numbness.
Investigations to provide an overview of the bones and muscles of the spine and show damaged areas. Tests include X-rays, CT scans, MRIs, and discograms .
Treatment
Treatment for herniated nucleus pulposus (HNP) varies from conservative to surgical. Treatment depends on how severe the symptoms are and how far the disc has protruded.
Most people with HNP will improve by doing an exercise program that includes stretching and strengthening the spine and surrounding muscles.
Patients should also avoid positions that cause pain and avoid lifting heavy weights. However, try to stay active because inactivity can cause muscle weakness and joint stiffness.
Over-the-counter pain medications can usually help. Doctors can give stronger drugs such as muscle relaxants, narcotic painkillers or nerve pain medications.
Surgery may be performed if symptoms do not improve within 6 weeks or when the hernia is affecting muscle function. The doctor will remove the protruding or damaged disc without removing the entire disc. The procedure is called a microdiscectomy. In severe cases, doctors can replace the discs with artificial ones and fuse the vertebrae. These procedures are called a laminectomy and spinal fusion.
Prevention
It is almost impossible to prevent herniated nucleus pulposus (HNP). However, there are several tips to reduce the risk of HNP, namely:
- Use proper lifting technique (bend and lift from the knees, not the waist)
- Get regular exercise
- Maintain ideal body weight
- Always maintain good posture when sitting and standing
- Don’t sit for long periods of time, try to stand up and stretch periodically
- Do exercises to strengthen your back, leg, and abdominal muscles