Bio 168

• Herniated Discs

AKA →  ruptured disc, slipped disc

• Occurs when a spinal disc ruptures, allowing the fluid in the disc to leak out and irritate nearby nerves.
• This also causes a decrease in ability of the disc to cushion the joints of the vertebrae→back pain and limited mobility
• This occurs most often in cervical and lumbar discs, but herniation of thoracic discs can occur as well = MEDICAL EMERGENCY → may result in paralysis

Risk Factors 

• Herniated discs are most common between ages 30-50, because discs naturally degenerate with age!

OTHER RISK FACTORS INCLUDE

• EXCESS WEIGHT
• REGULAR HEAVY LIFTING, BENDING, AND TWISTING
• PREVIOUS BACK PROBLEMS
• SMOKING
• GENETIC FACTORS→ MALES
• TALL HEIGHT
• BONE DISORDERS
• DEGENERATIVE DISCS

Clinical Manifestations

• Will depend on severity and location of herniated disc
• If herniated disc isn’t compressing a nerve, client may be asymptomatic.
• If nerve compression present, s/s → pain in lower back, buttocks, thigh and leg, numbness and tingling, muscle weakness

• A herniated disc in the lumbar region may cause a condition called SCIATICA
• Sciatica → when irritation or compression of all or part of sciatic nerve, which originates in lower back produces pain and neuro effects.
•  Sciatica nerve is the longest nerve in the body

• Two main branches
• On each side of lower body
• Pelvis→ deep buttock → down leg

• Manifestations

• Pain, burning, tingling, and numbness from buttocks to leg/foot

• Usually affects only one side of the body

• May be more severe when sitting, standing, or walking

• Sciatica may be aggravated by sneezing or coughing.
• Other s/s

• Forward tilt
• Changes in knee/ankle reflex
• Changes in mobility/motor function

• May experience muscle spasms and problem with sexual fx

• OTHER

• Cauda equine syndrome

• Medical emergency
• Requires immediate intervention/surgery to treat pressure on nerves
• May result in permanent neurological impairment including urinary incontinence and paralysis.

• Lifespan considerations

• Herniated discs are rare in children

• When present in children, it is usually a genetic cause or related to trauma/MVA

•  (+) straight-leg-raise test = client lay on back, and clinician raises one leg with knee straight. If pain is present at 30-75® = herniated disc L4-S1

• Diagnostic tests

• Health history
• Physical exam
• Mobility tests        

• Straight-leg-raise test
• Gait test
• Reflex test
• Muscle strength test

• Imaging test

• CT scan – most common
• MRI – used for more severe cases
• Myelogram -