Discopathy and Disc Herniation
After a few days of bed rest with or without treatment, the pain subsides and disappears, but after months or years it reappears mainly with sudden movements or exercise. Colds, focal infections and other inflammatory or toxic causes play a role in its appearance. As a disease, lumbar / lumbar / disc herniation presents with two sharply defined vertebral / vertebral / and root syndromes.
Complications
Vertebral syndrome is manifested by smoothing of the physiological lumbar lordosis / curvature of the spine in the girdle forward /, appearance of scoliosis / S-shaped curvature of the spine in the girdle to the side /, which can tilt the spine to the affected leg, and most often in disc herniation L5 – S1, or to cause the inclination of the spine to a healthy leg, which is more common in disc herniation at the level of L4 – L5. In the vertebral syndrome there is also a reflex tension / stiffness / of the muscles around the spine and difficult mobility in the lumbar region. It is especially difficult to stand in the waist and lower back, which is accompanied by increased pain.
Root syndrome is sensory and is characterized by spontaneous and induced pain, exacerbated by sneezing, coughing, laughing or attempting to move. The last fifth lumbar root and the first sacral root are most often affected. In addition to the posterolateral surface of the thigh and lower leg, the pain often radiates to the back of the foot and the toe (in case of L5-root damage) and to the heel and the toe (in case of S1-root damage). In L4 – L5 disc herniation, the L5 root is affected. The affected area has the shape of a band or “lamp”, covering the anterior-outer surface of the lower leg, the inner part of the foot, II, III and IV toes, and all too often the big toe. In a disc herniation between the L5 and S1 vertebrae, the S1 root is damaged, and the sensation is impaired on the posterior-lateral part of the lower leg, the upper-outer surface of the foot and the V toe.
In lumbar disc herniation, motor disorders are less common and are most often expressed with decreased muscle tone and hypotrophy of the muscles of the buttocks and lower leg. Temporary paralysis or paresis are rare.
Treatment
The treatment of disc herniation is conservative, with the patient being placed on a firm bed and the use of analgesic medications. In case of failure, surgical treatment is resorted to.