Low back pain, Sciatica, Disc Herniation - Everything You Need To Know - Dr. Nabil Ebraheim

Dr. Ebraheim’s educational animated video describing disc herniation of the lumbo sacral spine, the etiology, signs and symptoms, diagnosis , and treatment options.
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The spine is comprised of bony vertebrae separated by discs.
Spinal cord ends at level of T12-L1. Conus Medullaris is the lower end of the spinal cord. Cauda Equina is a division of multiple nerve roots beginning at the level of L1.
Conditions of the lumbar spine including disc herniation are a main cause of low back pain.
The lumbar spine (lower back) consists of five vertebrae numbered L1 to L5. These vertebrae are attached to the sacrum at the lower end of the spine. The discs between the vertebrae are round cushioning pads which act as shock absorbers. Inner disc layer is soft gelatinous tissue (Nucleus Pulposus). Outer disc layer is thick and strong tissue (Annulus Fibrosus).
A disc herniation of the lumbosacral region could involve the nerve roots. In 95% of all disc herniation cases, the L4-L5 or L5-S1 disc levels are involved. Herniation of the L4-L5 disc will affect the L5 nerve root. herniation of the L5-S1 disc will affect the S1 nerve root.
Types of disc herniation include:
1-Protruision/Bulge: a bulging disc with intact annular and posterior longitudinal ligament fibers.
2-Disc herniation:
Type A
•Disruption of inner annular fibers with intact outer annular fibers.
Type B
•Disrupted annulas with tail of disc material extending into the disc space.
3-Sequestration
•Free fragment without tail extending into disc space.
•Fragment may be reabsorbed spontaneously.
Typical locations of disc herniation
Central
•Involves multiple nerve roots.
•Predominantly cause low back pain more than leg pain
•May cause incontinence of the bladder and bowel.
•Urgent surgical treatment if patients present with neurological deficits.
Posterolateral
•Usual location, most commonly involving one nerve root (the lower one).
•Example: L4-L5 posterolateral herniation will involve L5 nerve root.
Foraminal
•Occurs in 8-10% of the cases
•Involving the exiting nerve.
•Example: L4-L5 foraminal herniation will involve L4 nerve root.
Discogenic back pain internal disc disruption
•Early disc degeneration.
•Pain worsens with flexion/sitting.
•Slightly better with extension.
•Forward flexion limited on exam.
•No radicular symptoms.

[@preethum17]

Am extremely grateful for this fabulous video explanation dear doctor. 🙏. My mother suffers from sciatic pain. This video helps understand the condition. I wish we had Godly doctors like you everywhere so that our loved ones don't suffer so much. God bless you always. 🙏

[@tman5634]

Perfectly explained.
I suffered with chronic sciatica 11yrs ago, it was so painful all the time that I asked my Dr if I could have my leg removed...I wasn't joking I couldn't stand the pain that had built up over many weeks any longer. I was given an emergency MRI scan which showed L5/S1 disc bulging & within 24hours I saw a surgeon. He told me I needed an operation ASAP. Meanwhile he also prescribed me 3.6grams of Gabapentin (12× 300 per day) & Coedine medication. The result of this medication helped with the pain within 7 days until my pre-operation appointment.
At the pre-op appointment I discussed the operation in length with the surgeon & due to the risks involved & a (now) manageable pain 5/10, I decided not to have the operation & stick with the medications instead & slowly taper down over many months.
11 years on I've had a few flair ups of sciatica enough to cause me to take more higher dose medication again, but the pain hasn't been anything like it was 11yrs ago & so I've persevered with work & day to day tasks much of the time.
For me it's been a managed pain which at its worst was unbearable & brought a strong grown man to many tears.
I keep my fingers crossed for the future.
All the very very best to all Sciatica sufferers.

[@user-tr1if6yx5v]

شكرا د.نبيل لمجهودات حضرتك الدائمة ❤️❤️

[@Johnny-sg5tc]

Dr you are the best on utube.

[@Madhumitamandal27]

Sir mindblowing

[@fisioterapimandala]

In clinic, we combine lumbar extension with core muscle strengthening exercises....
Lumbar extension will stimulate posterior longitudinal ligament to pressure back the disc to its position
Core strengthening to makes lumbar joint stability..
What a clear explanation....
Thanks, Doc
🙏🏻👍🏼❤️

[@weisong1589]

If you ever touched the herniated disc with your fingers during spinal surgeries, you will know that it is not possible to put it back by doing lumbar extension.

[@sagarshukla9900]

Thankyou so much sir wonderful explanation

[@Caperhere]

Thank you.

[@abdifitaax9089]

thank you sir

[@AngelRoseAngel1980]

Thank you 😊

[@ajoydey147]

If secondary inflammation development then is called tinglin pain or fibromylgia???

[@maheshchowdhary3354]

1) focal hyperintensity in the cartilage 3x1mm with underlying subchondral marrow contusion/edema measuring 1.2x1.1cms in size in the lateral femoral condule - s/o low grade osteochondral injury.
2)small sized pockets of fluid collection under the LCL and FCL with diffuse increased signal intensity of LCL seen however fibre continuity is maintained - s/o grade II injury.
3)inflamatory/edematous changes with fluid signal intensity in the hoffa's fat pad.
4)focal grade I signal intensity in the anterior horn of lateral meniscus.
5)Tiny hyperintense signal(4mm) involving cartilage of medial femoral condyle.
6) Minimal joint effusion seen extending into medial and lateral recess and adjacent to anterior horn of lateral meniscus

[@ImranAli-sv4yz]

Best video 👍👍

[@nabilebraheim]

Thanks

[@AbdurRahman-dy6vd]

What is Tarlov's Cyst, is it dangerous or not, can it be treated and what is the treatment of this..? Plz sir make a detailed video on this topic thank you very much for your informative and helpful videos...

[@Its-07]

Please doctor can you please tell me that does a dynamic hip screw need to be removed?
I had this surgery a week ago..😢
I am very worry about it.

[@saadbodla]

I have pain in L4 , L5 kindly any exercise plz.

[@RRRR-lc5ex]

Sir from your previous video,i have Lumbor Lordosis symptoms.. when i try to straighten after bending for few mins i feel pain near hip. Whats the treatment for this..my age 34.. also i feel strain in genital nerve occasionally

[@babulbarman7384]

Hi

[@Shrisiddhivinayakmedicose]

Sir foot drop problem is cured

[@Madhumitamandal27]

Sir please explain the treatment

[@Madhumitamandal27]

Sir please name of the exercise 🙏 please

[@Mariahlb]

Hello, trinayani, can, i shares my treatment? I have for almost 4yrs suffering all thoses dr.nabil, explaining. I had for 3yrs of 'infeltiration" means, i have every 2weeks, 4 injection of needle on my back. And i get tired doing many cures; physio therapist, chinese "acupuncture", ect. ect. Until one of my dr. Telling me, why? I don't try take the oil of canabis. I said, i have to think about it, and do more research. I said,i am tired of all thoses, injection,psysio thyraphy ect. Until i ask to my health insurances; if, that will rembourses they said, No. And i went to the shop and i bought. the shop here in geneva, recomended of one my dr. with dr., prescriptions And about 5months now, i taking. Called here in switzerland is CBD, oil of canabis. and helps me, alot. In the morning; i take 10drops and in the evening it's the same. I can have my regular of walking and stop all thoses pain killers, injection(fr: corteson). Sorry, my english is not very good. Goodlucks🙏🙏🙏

[@hihe4265]

Can we use red light as cure to sciatica?

[@m_m786]

Nice 👍💲💝🩺

[@nabilebraheim]

thanks

[@Shrisiddhivinayakmedicose]

Plz tell me sir

[@YummyFoodSecrets1]

👍👍❤

[@muhammadzafarullah3957]

PL translate in Urdu. Thanks