Low Back Pain Lumbar Disc Herniation - Everything You Need To Know - Dr. Nabil Ebraheim
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- เผยแพร่เมื่อ 22 ส.ค. 2024
- Dr. Ebraheim’s educational animated video describes low back pain. Lumbar disc herniation.
Sometimes called a ruptured disc, a slipped disc, or a herniated disc and it most often occurs in the lower back.
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Location of disc herniation:
1-Posterolateral: usual location, most commonly involving one nerve root (the lower one). Example: L4-L5 posterolateral herniation will involve L5 nerve root.
2-Foraminal L4-L5 (nerve L4): occurs in 8-10% of the cases. Involves the exiting nerve. Example: L4-L5 foraminal herniation will involve L4 nerve root.
3-Central involves multiple nerve roots. Predominantly causes low back pain more than leg pain. May cause incontinence of the bladder and bowel. Urgent surgical treatment if the patient presents with neurological deficits.
Positive straight leg raise= tension sign: indicates possible disc herniation.
Natural history
•90% improve without surgery
•Usually get better within 12 weeks
•Operative versus non-operative treatment results is about equal in 4 years follow up.
Risk factor
•Worst pressure on the disc bulge with prolonged sitting and bending over.
•Smoking and obesity
•Lifting and vibration
•Job dissatisfaction
•Anxiety and depression.
Red flags
•Infection: fever, diabetes, urinary tract infection and IV drugs abuse
•Tumor: age 50 years, unexplained weight loss, pain at rest and night.
•History of trauma: rule out fractures
•Cauda equine syndrome: back pain more than leg pain with bowel & bladder disturbance.
Abnormal MRI in asymptomatic patients
There is degeneration or a bulge of a disc in 35% of the subjects between 25-39 years of age. In patients 60 years old or older, the majority of the patients will have changes in the MRI. MRI abnormalities are common and must be correlated with the age and the clinical signs and symptoms.
Treatment
•Rest
•NSAID
•Physical therapy and chiropractor
•Massage
•Epidural injections gives some improvement
Indication for surgery
•Positive tension signs with persistent severe pain
•Progressive neural deficit
•Cauda equine (urgent decompression)
•MRI positive.
Ideal surgical candidates
•Sciatica with positive tension sign
•Positive neurological findings with positive MRI findings.
Surgery
•Relief of leg pain in the majority of patients.
•Back pain may persist in some patients
•Neurological improvement: 50% motor & sensory, 25% reflexes.
Discogenic back pain: patients may need fusion (a major procedure).
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Background music provided as a free download from TH-cam Audio Library.
Song Title: Every Step
Hello Dr. Ebraheim, I just wanted to thank you for all your effort in preparing these short and easy to follow videos. As a chiropractic intern, I am finding them very useful for a quick review of conditions I've learned and also as a way to explain to patients what their diagnosis is. Keep doing what you are doing, hope I will get the pleasure of meeting you one day!
as usual another wonderful video Dr Nabil
thank you very much
go on
may Allah bless you thanks again
Nice message for every patient
what is the treatment
sorry my bad, you were right, if paracentral or posterolateral it affect the traversing root at the lower level, whereas if the herniation at the lateral part affect the root below the veerebra
Best explanation, thank you so much Doctor.
I have this problem for the last 30 years. I have occasional back pain and now at the age of78 has bowl inconsistency and tingling in soles and toes. Can you suggest any exercise. There is no pain but the path of sciatic nerve feels numb.
another good one, thanks...
please i need a consultation , 6 months ago i had a bullet in my talus bone and it's still there till now , at first orthopedic surgeons recommended conservative treatment with follow up for the fear of avascular necrosis occurrence and fortunately it didn't occur but now i have pain on using my leg for long periods together withe crepitations which were supposed to be tendinitis and now i would like to ask if i can live rest of my life with this bullet in my talus bone ?! should i do a surgery to remove ?! keeping in consideration that my the bone is away from neck of talus and also away from any articulation line , so please help me :) thnx in-advance
What is meaning LV5 SV1 causing abutment of right transversing nerve root
Dear Doctor , your video help me ...
That I want to know. I am suffering from front Thai numbness and L5 root leg pain for 50 days . But My MARI is normal but CAT scan doctor said that there is a bulge disc in L5 N S1. ..with no back pain
is my surgery will recover in how many days ..
Maybe you should look at motivational. On TH-cam and start practicing stretches and eating better. Most of the time surgeries fail.
@@neilbanerjee2148 I Also habe
sir I have little gap between L 4 and L 5 how I will cover gap please give me some suggestions Thank you
Sir hello Muje bhi bato ..
Dr sahab Meri l 5 disk apni jagah see nikal gai hai ab doctor surgery ke leye kehtey Hain koi suggestion dengain.
I was only 18 aged boy but I have l5 s1 disc bulge what is the reason there is possibility to relief this
Best in symptoms of herniated disc lumbar i have one i think thats L5 best on the symptoms and why is it so hard to make it better im been dealing for almost for months,, any advice sir please 🥺
respected Dr I'm suffering from spondylosis neck ki bone badi hue ha please tell me remedy
Exactly my disk herniated between 4&5.
sir before 12 year my left leg has injured by injaction sir my foot is as a pain full and I can't walk or run without sleeper and shoes my mussels is hard down of neck only left leg sir please helf me I'm so heart about it
bs svp j ai L4 et S1 de lombaire que e que je dois faire j ai vu mon médecin traitant mais le traitement n à rien fait que ex que vous me conseillez svp
И почему в России таких видео не делают ?!?! Спасибо за информацию
L4/L5 herniation shouldnt it affect the exiting root L4?
Dear Doctor........ i woke up today to discover i have some number on leg and toes related to L5( i google) .. and lost some control for a few second before it was back to normal. Normal day it was numb on 3 toes of both leg..
What should i do now? Wilkl i do some stretching like bending of back to help it to recover. Thank.. waiting for your reply.
Are you better now? This happened to me
@@ambermarie1382 I am fine more or less, but i still have numbness though it is lesser. Hope i get better with time,
@@victortancheongwee hope you do to! Thanks for responding. My severe back pain finally died down yesterday and I'm trying to do Mackenzie exercises as much as possible, seems to be helping.
मेरी सलिप डिस्क आपरेशन के.बाद भी नहीं ठीक हुई।
कृपया उचित सलाह दे।
sir my name is Zuber.khan , from-kolkata , i have a problem my problem is , My -L4-L5,L5-S1 Disc is bulging. so How can i slove this problem.
motivastional Doctor on TH-cam. This guy will give you a I'm of cool stretching and decompression exercises. Surgery only makes your problems worse and it's a Fool's errand. MDs are not the gods that Society thinks they are
Nice Video Sir
hi
i am sharif , i have been PLID L4-L5 ,L5-S1 . i'm very upset for this type of pain and problem but how i will overcome this problem . please give me some suggestion
sharif hossain i have answer for u
Sanjeev Puri how can solve the problems
Whatsapp me on +919815157015
Maybe in inversion table and a lot of stretching techniques you can learn at home including additional decompression techniques
@@sanjeevpuri2180 plz suggest me i have sciatica problems
Svp traduction en français
Why do the red flags exist ?
help me
Yeah Ya got to get the medication or surgery. that's the most important thing right? Give the doctors $50,000 for surgery and then you pray it halfway works.
phon nambr
sir I have little gap between L 4 and L 5 how I will cover gap please give me some suggestions Thank you
sir I have little gap between L 4 and L 5 how I will cover gap please give me some suggestions Thank you
sir I have little gap between L 4 and L 5 how I will cover gap please give me some suggestions Thank you
Learn about stretching and decompression techniques you could do at home.