Posterior median disc herniation of the spine

As it is already well-known the disc herniation is very unpleasant, if not to say more. And one of the most unpleasant variant of the diagnosis is the posterior median disc herniation of the spine. What are its manifestations?

Why the posterior median disc herniation is dangerous?

In general we use term “median” if the breakage of the disc goes strictly along its radius. If we talk about anterior median disc herniation, it is not so dangerous and the worst possible is the pain syndrome. And if we talk about posterior median disc herniation, this case is very underhand and much more dangerous to the patient.

zmdYou should remember that the posterior back disc herniation penetrates into the spinal canal, and as a result there appear compression of the spinal cord or horse tail, and because of it there is an innervation of the internal organs and limbs. There is no sense to recite all negative consequences in details, but it is very easy to understand that a neglected case of this disease will do the patient a lot of harm.

There is one more problem; treatment of this type of the disc herniation is much more complicated. It turns out that it is hidden and it is quite difficult to reach it. Even if you can reach the place where it is, the situation does not become much easier, because the surgeon is to operate in a very close position to the spinal cord. Any incorrect movement will lead to permanent consequences.

Moreover this particular type of the disc herniation requires urgent surgical interference. Pain is a surgical indication under other types of disc herniation, in the above mentioned case it is much worse, because we talk about proper functioning of many internal organs. On the other hand the doctors do not want to risk to the last (and there is always a risk while operation on such type of the disc herniation) and they try to eliminate the problem with the help of conservative methods of treatment. It should be noted that in major case it is possible to eliminate the problem because our organism has great abilities of   self-restoration.

Why does this type of the disc herniation occur?

This question arises in minds of almost all patients, who got this diagnosis. The irony is that this question should bother them before the problem appeared. Then, more probably it would be possible to avoid it.

If to consider this question in details, first of all you should understand what is a vertebral column; it is a perfectly balanced and very reliable mechanism. But, the same as other mechanisms, it has an ability “to brake” and “to become weak”, if the conditions of its application and use far from being ideal. We should concentrate our attention on the intervertebral disc as on the most hurtable part of this mechanism under the ills of life.

What is necessary for normal functioning of the intervertebral discs? Sufficient nutrition (water, nutrients and  microelements)  and sufficient physical activity. Exactly with these components we face problems nowadays most often, and modern life is the main reason for these problems.  Exactly this disease is “getting younger”, if before only aged people suffered from this disease, now it is widely spread among young people.

So, what is insufficient? First of all there is lack of necessary nutrients and microelements. It is not a secret that nowadays a lot of people “sin by” not very proper meals, content of necessary for the organism components in such meals is below normal.  But it is only one problem, and it is possible for people to settle it more or less easy.  There is one more, and it is much more serious. Particularly, it is a sedentary life style. Why is it so critical?  For the sole reason that the intervertebral discs do not have their own blood vessels, respectively, nutrition they have to get in a very strange way with the help of diffusion from the neighboring tissues.  And physical load and movements are necessary for this process to go in a proper way. Otherwise, even if your nutrition is absolutely correct, and all necessary microelements are present in your organism, they are not able to get to the intervertebral discs.  And now, please, think is there sufficient physical activity in your life? And in this case we do not mean excessive physical load, they also can lead to the disc herniation formation, we mean usual movements, walking, running and so on and so for.

Which processes do take place in the intervertebral disc in the situation, if it does not get sufficient nutrition? Everything is very simple it starts to lose its properties. Among other things the nucleus pulposus of the disc starts to lose water, and as a result it the disc loses its absorbing ability. In the fibrous ring under condition of lack of nutrients some problems also appear; the fibrous ring keeps the disc in its natural place. This fibrous ring starts getting weak, cracks starts to appear in it gradually. At the same time load on the disc is not decrease and in some cases it even increases (if the patient has gained some weight).

It is easy to understand that sooner or later the fibrous ring will not be able to bear the pressure of the nucleus pulposus and it will start to “retreat”, to bulge, in the result of the last protrusion appears, it is the first stage of the disc herniation formation. As the protrusion formation almost never is manifested by some symptoms, so the person does not even guess about the problem. Some more time passes, the fibrous ring “retreated” and the person acquires a true disc herniation.

How to treat the disc herniation?

Nowadays conservative methods of treatment are most widely spread; they give an opportunity to avoid surgical interference. But to tell the truth in some cases it is impossible to avoid operation, nevertheless it is prescribed by the doctor only as a last resort, only if it is really necessary, the conservative methods are not effective and the disc herniation starts to influence the internal organs functioning.

Conservative methods of treatment, how do they work?

Conservative treatment is prescribed for almost all patients. And only in case that they are not effective an operative interference can be prescribed.

Usually such treatment starts from a bed rest prescription for several days, after which a regime of limited physical activity is prescribed. This prescription must give an opportunity for the spine to relax and to rest, and as a result the compression of the nerve roots decrease.

Also pharmaceutical treatment is started. In this case the most widely nonsteroidal anti-inflammatory medicines are applied.  They remove inflammation and swelling quite effectively, and thanks to this the pain syndrome is also cut.  But such medicines have some disadvantage; they cannot be used for a long period of time, because side effects start to appear, mainly in the area of the gastro-intestinal tract. That is why the doctor should weigh expected effects against the risk of such side effect appearance.

For cutting very strong pain syndromes except nonsteroidal anti-inflammatory medicines some analgethics are used. But there are also some precautions in their use. According to human psychology if there is no pain so there is no disease. That is why, when the pain syndrome is cut, the patient starts to move actively and to increase the load on the back. But indeed the disease has not disappeared somewhere and when the medicines stops to work, the pain syndrome will return back and it will be more intensive. Doctors try to use analgesics as less as possible, they prescribe them only if it is necessary to cut very strong pain syndromes.

When the pain syndrome is under the control, it is possible to start the next stage of treatment. In this case different physiotherapeutic methods of treatment are applied, but the main method is massage and therapeutic exercises.  Just individually selected exercises give an opportunity to bring into order the muscles corset, and also to provide sufficient physical load, which creates all necessary conditions for optimal interchange of elements in the area of the spine.

As a rule, this method of treatment will give an opportunity to the majority of patients to get rid of problems, but they are to understand that have to change first of all their life style.