Understanding Herniated Nucleus Pulposus
Herniated nucleus pulposus (HNP) or herniated disc is a condition where one of the cartilage pads or discs of the spine protrudes and pinches a nerve. This disease is often referred to by laypeople as a pinched nerve. Most HNP diseases can heal on their own, without the help of treatment. However, if the pain persists for months, the doctor can provide treatment whose type is adjusted to the severity of the patient’s symptoms.
Symptoms of Herniated Nucleus Pulposus
Not all HNP sufferers experience symptoms. In fact, it is not uncommon for this condition to only be discovered when the sufferer undergoes a scan test. If symptoms do arise, they can vary depending on where the root of the problem is. Symptoms usually worsen with movement and improve with rest.
The most common symptoms are:
- Pain in the legs or shoulders with intensity that can increase when coughing, sneezing, or moving in certain positions.
- Weakening of muscle function, thus reducing the sufferer’s ability to move, bend, or move objects.
- Several points of the body experience a tingling or stiff sensation. Usually around the back, shoulders, hands, legs, and feet.
These symptoms are sometimes also felt by people with mild back pain due to sprains or twists. It is advisable to see a doctor if someone feels the above symptoms, so that the cause can be determined with certainty. If you or someone close to you experiences symptoms of a herniated nucleus pulposus, you can contact a neurologist regarding the right first aid.
Causes of Herniated Nucleus Pulposus
Discs have a soft gel-like center and a firmer outer layer, like a jelly donut. Over time, the outer layer weakens and can crack. Well, HNP occurs when the inner jelly substance pushes through the crack. This leakage can press on nearby spinal nerves.
Several factors can cause a ruptured disc, namely:
- Aging factors.
- Excessive body weight.
- Repetitive movements.
- Sudden strain due to improper lifting or twisting.
- History of trauma.
- History of work that requires lifting heavy loads, sitting, and driving for long periods.
- Frequent bending.
- Body position when walking.
- Spinal structure.
- Weakness of the abdominal muscles, and spine.
Risk Factors for Herniated Nucleus Pulposus
Several things can increase a person’s risk of developing a herniated nucleus pulposus, namely:
- Genetics.
A condition inherited from a family member who has a history of HNP. - Obesity.
Pressure on the spine due to excess body weight. - Smoking.
Cigarette smoke can reduce oxygen levels in the discs and increase the risk of vertebral erosion. - Lifting heavy loads.
Someone who frequently lifts or pushes heavy loads repeatedly with incorrect posture is at risk of experiencing HNP.
Treatment of Herniated Nucleus Pulposus
A specialist doctor can usually determine the diagnosis of HNP disease from symptoms and medical history. A physical examination is performed to check posture, reflexes, muscle strength, walking ability, and sensations from the motor organs such as pain, tingling, or numbness. Supporting examinations are usually performed to provide an image of the bones and muscles of the spine and show damaged areas.
Tests that can be performed include:
- Magnetic resonance imaging (MRI).
The most common and accurate imaging test for diagnosing HNP. - X-rays.
This test helps rule out other causes of back or neck pain. - Computed tomography (CT-Scan).
A CT scan can show the condition of the spine. - Myelogram.
This test involves injecting dye into the spine under X-ray guidance during a CT scan. The dye can reveal narrowing of the spinal canal (spinal stenosis) and the location of the herniated disc. - Electromyogram (EMG).
This test involves placing thin needles into various muscles and evaluating nerve function. An EMG helps determine which nerves are affected by HNP.
Treatment steps for HNP can vary, from conservative to surgical. In addition, treatment depends on how severe the symptoms are and how far the disc protrudes. The following are the treatment steps for Hernia Nucleus Pulposus that are usually recommended by doctors:
- Conservative treatment
After the orthopedic or neurosurgeon makes a diagnosis, the appropriate treatment steps are usually determined. This can begin with conservative treatment, which is carried out depending on the location of the discomfort and the severity of the symptoms.
Conservative treatment usually includes:
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- Physical therapy.
- Chiropractic care.
- Stretching and strengthening of the spine and surrounding muscles.
- Heat or cold therapy.
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- Use of medicine
In addition to conservative treatment, doctors also usually prescribe a number of medicine. The medicine given can be muscle relaxants, pain relievers, and medicine for nerves. - Surgical procedures
If HNP cannot be treated with non-surgical methods and medication, the doctor may recommend surgery or invasive surgery to treat it. Before the procedure is performed, the doctor and the HNP sufferer will usually discuss the surgery, risks, and recovery process. This surgical procedure is called microdiscectomy. In severe cases, the doctor can replace the disc with an artificial one and fuse the spine. These procedures are called laminectomy and spinal fusion.
Complications of Herniated Nucleus Pulposus
Although rare, HNP can press on the cauda equina located in the lower back and cause serious complications, such as:
- Dysfunction of fluid excretion from the bladder, where sufferers will have difficulty excreting urine or feces, to sexual infertility.
- Decreased ability to perform activities due to this condition can worsen symptoms, such as severe pain, muscle weakness, or stiffness.
- Saddle anesthesia, where the sufferer loses the ability to feel or feel in certain areas, such as the inner thighs, hind legs, and around the anus.
- It is recommended for HNP sufferers to immediately see a doctor or go to the nearest hospital if they experience symptoms that indicate complications, so that their condition can be treated immediately.
Prevention of Herniated Nucleus Pulposus
There are several tips to reduce the risk of HNP, namely:
- Use proper lifting techniques (bend and lift from the knees, not the waist).
- Get regular exercise.
- Maintain a healthy weight.
- Always maintain good posture when sitting and standing.
- Do not sit for long periods of time, try to stand up and stretch regularly.
- Do exercises to strengthen your back, legs, and abdominal muscles.
You should immediately see a doctor, especially if the symptoms of HNP interfere with daily activities. Try to consult a doctor, to find out the potential of the disease.
