Slipped disc

Each cartilage of the spinal column consists of a jelly-like substance, and when atrophy of these cartilages occurs as a result of aging or as a result of an injury, the inner soft central cartilage nucleus may be subjected to rupture "hernia" and come out of the framework of the outer fibrous ring that surrounds It has (Annulus fibrosus), and this abnormal tearing of the central part of the cartilage is referred to as (disc herniation).
One of the most common places in the vertebrae where a herniated disc occurs is between the fourth lumbar vertebra and the fifth lumbar vertebra in the lower back. It is this area that works to absorb the impact of carrying the upper back, especially while standing or sitting. And the lower back has a very big role in the human movement throughout his daily activities, especially when turning the torso from side to side or when tilting the back or while lifting objects.



The spine consists of the vertebrae (Vertebrae), which are the basis of the great construction in it, and there are discs between each of the two vertebrae, known as the "disc" or cartilage.
The ligaments surround the spine and cartilage. The spine consists of (7) vertebrae in the neck, called cervical vertebrae, 12 vertebrae in the middle of the back, called thoracic vertebrae, and (5) vertebrae in the lower back, called lumbar vertebrae. The vertebra in the middle of the buttock area under the fifth lumbar vertebra is called the "sacrum", followed by the coccyx.
We find that the great structure of the spine is designed so that all the vertebrae are arranged on top of each other, and one of its important functions is to support the structure of the body, but it gives it flexibility and movement, in addition to that these vertebrae are the line of defense and protection for the spinal cord (the spinal cord is the nervous tissue that runs along the length of the spine). "Spinal column" and carries nerve signals to and from the brain) from any injury.
Then comes the "disc" cartilages, which act as cushions between the vertebrae, as they absorb the effect of the movement that a person exerts on the spine. Therefore, we find that these cartilages consist of a jelly-like substance surrounded by rings of fibrous material that protects it (Annulus fibrosus), and its center Soft tissue called the nucleus of cartilage (Nucleus pulposus).
Ligaments are those strong, soft fibrous tissues that connect the bones together. They connect the vertebrae to each other and protect them from excessive movement and surround each of the cartilage of the spine. .

• Lifting heavy objects so that the vertebrae curve incorrectly with them.
• Making an incorrect sudden movement.
• Hereditary weakness of cartilage tissue.
• Lack of exercise.
• An acute attack of coughing.
• Sitting for long periods without exercising.
• Some professions that require great effort are a burden on the vertebrae of the spine.

Symptoms depend on the level of the vertebrae that ruptured the fibrous rings that surround the nucleus of the cartilage, and whether or not there are nerves affected by pressure from these cartilages. Symptoms may not appear with a herniated disc, but it results in local pain in the places of the vertebrae between which the injury occurred.
If the sliding cartilage is large, the tissues of the nucleus of the cartilage "disc" will press on the nerves adjacent to it and exit from between the vertebrae of the spine, causing pain in one side of the body. Below the buttocks in the back of the thigh and in the leg with lower back pain.. Sometimes numbness occurs in the leg and not only pain, and the pain usually gets worse when standing and decreases with lying down and rest.
And if the slipped cartilage is very large, it can put pressure on the nerves on both sides of the body and not on one side only, and the feeling of pain in both the lower extremities “both men together”, which results in weakness in them and the inability to move and injuring the person with involuntary urination or defecation, which is This is called cauda equina syndrome.


The specialist doctor begins diagnosing the symptoms of a herniated disc by knowing the symptoms, and the nerves that show the abnormal reflex are examined. Mostly, pain appears when the leg is raised upright in a lying position on the back or in a sitting position, which is called the "Positive straight leg raising test" where there is an abnormal sensation in the foot or leg. The patient also undergoes blood tests frequently to identify signs of inflammation or infection.
The doctor recommends performing an X-ray that reflects the presence of any rupture or atrophy of the vertebrae.. but it does not clarify the condition of the cartilage, and for this, a CT scan or an MRI is required.
The electrical recording of muscle activity (electromyogram) shows very precisely which nerve is affected by a herniated disc.

Sometimes, a herniated disc is discovered when an MRI scan is performed to diagnose an injury or other condition.
If there are no symptoms associated with a herniated disc, there is no need to prescribe medical treatment.
Depending on the severity of symptoms, treatment options for a herniated disc include:

• natural therapy.
• Muscle relaxants.
• Pain relievers - Anti-inflammatory drugs.
• Local injection of cortisone.
• The last resort is to undergo a surgical procedure.

In any degree of herniated disc, the patient must get some rest and avoid further injury to the disc. There are some people who suffer from severe symptoms, but in the early stages of injury it is possible to respond to traditional treatment methods without the need for have surgery.
There are now many surgical procedures that a person with a herniated disc can undergo, and the choice of type of surgery depends on the individual patient's condition and the condition of the spine around the affected area. One of the surgical options is to remove the slipped disc with a small surgical instrument (microdiscectomy) or through a traditional incision. As for the surgery that is performed immediately and without hesitation or waiting, the person with a herniated disc has involuntary defecation and urination.

• The discs are the cushions between the bony vertebrae that absorb the impact of movement on the spine.
• The cartilage resembles a jelly-like substance surrounded by a fibrous annular framework that serves to protect its inner nucleus.
• An abnormal tear that occurs in the central cartilage nucleus is referred to as a "herniated disc."
• One of the most common areas of herniated disc, which occurs between the fourth and fifth lumbar vertebrae in the lower back.
• If the slipped cartilage is large, it can press on the roots of the adjacent nerve that exits between the vertebrae of the spine (these nerves are extensions of the spinal cord and come out of each of the two vertebrae, one nerve from the right and one from the left).
• Tests that help diagnose a herniated disc:
  a- A physical examination.
  b- Diagnostic tests.
  c- Electrical tests.
• Herniated disc treatment options are multiple, and depending on the severity of the patient's condition, the patient may need:
  a - He received physical therapy only.
  b - or drugs that relax the muscles.
  c - or pain relievers.
  d - or anti-inflammatory drugs.
  e - or local injection of cortisone.
  f - or surgery as a last resort to treat the condition.