International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Vol. 8, Issue 1, pp: (30-37), Month: April 2020 - September 2020, Available at: www.researchpublish.com
LUMBAR PROLAPSED INTERVERTEBRAL DISC & ITS MANAGEMENT Simranjeet Kaur (PT) Adesh University, Buchu Kalan, Bathinda, Punjab, India. College of Physiotherapy
Abstract: Prolapsed Intervertebral Disc (PIVD) is a major cause of disability in developing countries. A herniated nucleus pulposus is most common in those aged below 40 years, whilst degeneration of discs tends to affect those aged over 40 years, with the prevalence increasing with advancing age. Initial management should include rest as indicated, physical therapy, and appropriate use of pain medication. In most instances, radicular symptoms will abate or resolve within six weeks. Keywords: PIVD, Herniated nucleus, Pain, Sciatica, Numbness, LBP.
1. INTRODUCTION The term ―Prolapsed disc‖ means the protrusion and extrusion of the nucleus pulposus through a rent in annulus fibrosus. It is the sequence of changes in the disc which lead to prolapsed and these changes are.[1] Nucleus degeneration. Nucleus displacement. Stage of fibrosis. Herniated nucleus pulposus is most common in those aged below 40 years, whilst degeneration of discs tends to affect those aged over 40 years, with the prevalence increasing with advancing age. Disc lesions of the lumbar spine are more common than the cervical spine and disc lesions of the thoracic spine are rare. The term sciatica is used for the pain, tingling, and numbness that arise due to nerve root entrapment in the lumbo-sacral spine. The symptoms may be felt in one or more of the lumbar nerve roots. About 90% of cases of sciatica are caused by a herniated intervertebral disc. This most commonly occurs at the L5/S1 level.[2] Herniation of disc or nucleus pulposus is the main cause of low back pain.[3] The back pain is a major public health problem in western industrialized societies. It causes suffering and distress to patients and their families, and affects a large number of people. The prevalence rates in a number of studies ranged from 12% to 35% with around 10% of suffers becoming chronically disabled.[4] Low back pain affects about 80% of the population at some time in their lives and is one of the most frequent reason for consulting a primary care physician.[5] It may cause 20% - 35% of low back pain creating a public health burden of considerable socioeconomic cost.[6] The prevalence rate of low back pain in a number of studies ranged from 22% to 65% in one year and the lifetime prevalence ranged from 11% to 84%.[3] Approximately 5% of adult population, low backache becomes a persistently disabling condition. It affects men and women equally, with onset most often between ages of 30-50 years. In the state of Uttarakhand and adjoining states, the combination of low backache and radiculopathy is a very common orthopedic presentation and in this the reason may be hilly terrain with difficult work and living conditions.[7] Degenerative disc diseases should be applied to a degenerate disc that is also painful.[8] The choice of investigation for suspect the intervertebral disc prolapsed is.[9] Plain X-rays- These are usually taken to rule out any fracture or malalignment.
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