Disc Herniation and Sciatica
The disc is a major source of pain within the low back. The dual nerve supply to the disc, involving both regular sensory nerves and those of the sympathetic system, results in more profound, diffuse, and complex pain.
'Slipped disc', 'herniated disc', 'sciatica', 'nerve damage' are terms used interchangeably and often inappropriately when dealing with low back and leg pain.
The disc comprises a tough outer shell (annulus fibrosus) and a soft inner core (nucleus pulposus). A weakness in the annulus fibrosus may allow the nucleus pulposus to bulge outward, while a tear of the annulus fibrosus will permit the nucleus pulposus to actually extrude from the disc.
Herniation often results from the gradual aging of the disc, combined with poor muscle strength and improper body mechanics. Due to the close proximity of the spinal nerve roots to the posterior aspect of the disc, herniated nucleus pulposus material can compress or stretch these structures. This may reslut in pain, typically 'sciatica' or nerve dysfunction with numbness or weakness in the leg. Seventy percent of patients with sciatica recover in 6 to 12 weeks.
Sciatica refers to pain in the leg below the level of the buttock fold. It relates to the sciatic nerve, a large nerve supplying most of the leg with power and sensation that arises from numerous roots in the lumbar spine. If the pain of sciatica is specific, relating clearly to one nerve root, then it is called radicular pain. Often accompanied by numbness or tingling, the pain radiates down the leg to a specific area such as the great toe or the outside of the foot.
If the pain of sciatica is more dull, radiating downward but to a more diffuse area, it is called referred pain. Typically, this pain radiates through the buttocks and thighs, sometimes into the calf.
Nerve root compression and damage can also cause the nerve to malfunction. In this case, there may be loss of the skin sensation in the area supplied by the nerve, loss of power in the muscles it supplies, and loss of reflexes as tested by an examiner. Nerve root dysunciton may or may not be associated with pain. Sciatica does not imply damange, just irritation - the nerve is usually able to recover.
'Slipped disc', 'herniated disc', 'sciatica', 'nerve damage' are terms used interchangeably and often inappropriately when dealing with low back and leg pain.
The disc comprises a tough outer shell (annulus fibrosus) and a soft inner core (nucleus pulposus). A weakness in the annulus fibrosus may allow the nucleus pulposus to bulge outward, while a tear of the annulus fibrosus will permit the nucleus pulposus to actually extrude from the disc.
Herniation often results from the gradual aging of the disc, combined with poor muscle strength and improper body mechanics. Due to the close proximity of the spinal nerve roots to the posterior aspect of the disc, herniated nucleus pulposus material can compress or stretch these structures. This may reslut in pain, typically 'sciatica' or nerve dysfunction with numbness or weakness in the leg. Seventy percent of patients with sciatica recover in 6 to 12 weeks.
Sciatica refers to pain in the leg below the level of the buttock fold. It relates to the sciatic nerve, a large nerve supplying most of the leg with power and sensation that arises from numerous roots in the lumbar spine. If the pain of sciatica is specific, relating clearly to one nerve root, then it is called radicular pain. Often accompanied by numbness or tingling, the pain radiates down the leg to a specific area such as the great toe or the outside of the foot.
If the pain of sciatica is more dull, radiating downward but to a more diffuse area, it is called referred pain. Typically, this pain radiates through the buttocks and thighs, sometimes into the calf.
Nerve root compression and damage can also cause the nerve to malfunction. In this case, there may be loss of the skin sensation in the area supplied by the nerve, loss of power in the muscles it supplies, and loss of reflexes as tested by an examiner. Nerve root dysunciton may or may not be associated with pain. Sciatica does not imply damange, just irritation - the nerve is usually able to recover.
posted by Tom and Len | 11:35 PM
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