Category: Back Pain

ABSTRACT

Herniated disc, the most common cause of back pain occurs when nucleus pulposus (located between vertebral bodies) displaces from intervertebral disc. Patients suffering from back pain recite events from the past in which they have suffered from physical trauma reading to herniation of the disc leading to weakness and sensation changes. Incidence of herniated discs is more common in the third to fifth decade ( 30-50 years of age) of life. In India almost 10 million cases of herniated disc are seen every year and most of them go undiagnosed due to patient negligence and many of them become worse due to wrong treatments and medications consumed by the patient as there is lack of knowledge.

INTRODUCTION OF HERNIATED DISC

Herniated disc also known as Spinal Disc Herniation is a condition having damaged annulus fibrosus that leads to disc herniation. The role of the disc is transmission of kinetic energy within the body. Nucleus pulposus (soft jelly like material in the centre and surrounded by a resistant fibrous ring, acting as shock absorber) is located within the centre of the disc herniates and compresses nerves and spinal cord leading to spinal cord dysfunction which is also known as myelopathy. With ageing, this nucleus pulposus tends to degenerate and dries out and there can be cracks in Spinal Disc through which a small fragment of jelly can displace. Herniation is a very painful condition and usually resolves within a few weeks but in only 6% of the cases have sufficient pain after 6 weeks to consider for surgery.

We have 5 cervical vertebrae (also known as neck vertebrae), 12 thoracic vertebrae (also known as chest vertebrae), 5 lumbar or lower back vertebrae, 5 sacral vertebrae and a coccyx bone. Cervical, thoracic and lumbar vertebrates are usually herniated but lumbar and cervical spines are mostly affected.

ETIOLOGY OF HERNIATED DISC

Usually, disc degeneration occurs with ageing is called as normal process but sometimes it can occur at early ages and referred as slipped disc that can be caused by

• Spinal wear and tear due to daily activities like movements (running, walking and bending) that cause shock and this shock is absorbed by our intervertebral discs causing their degeneration. Tough outer layer of disc known as annulus fibrosus starts weakening that leads to bulging or herniation as nucleus pulposus leaks out.
• Injuries due to accidents, sudden falls or jerks, heavy weight lifting in incorrect posture or any activity that causes too much pressure on the disc can cause spinal herniation.
• Combination of degeneration and injuries as in cases of weakened spine in which even a slight trauma can lead to herniation is common in third and fourth decades of life.
• Smoking, being overweight due to sedentary lifestyle or lack of fitness triggers spinal herniation.

STAGES OF HERNIATED DISC

Herniation of disc occurs in four stages and early detection can help to treat this condition better and on time.

The four stages are:

• Disc Degeneration: – Weakening of nucleus pulposus due to chemical changes related to ageing causes drying out of the disc and becoming less shock absorbable.
• Disc Prolapse: – This stage is the beginning of slight bulging or protrusion that can lead to crowding of the spinal cord and nerves that happens due to positional changes in the disc. This crowding depends on the site of bulging.
• Disc Extrusion: – Tough outer layer of disc known as annulus fibrosus having tire like wall starts weakening that leads to bulging or herniation as gel-like nucleus pulposus leaks out but it remains within the disc.
• Disc Sequestration: – Nucleus pulposus breaks through the disc and moves into the spinal canal.

SYMPTOMS OF HERNIATED DISC

In some patients, there is extreme pain that causes trouble in day to day activities but in some patients there is slight pain or no pain at all. In cases where there is slight compression on nerves the patient may experience low backache or no pain but if there is more compression on the nerve then the patient may feel weakness or numbness along with the course of the compressed nerve.

Symptoms of herniated disc depends on the position and size of bulge

• If there is herniation of Lumbar spine or Saccaral (lower back), the patient might suffer from Radiculopathy or Sciatica in which patient may experience burning, tingling and numbness radiating from buttocks to legs or foot. One side is usually affected. Patient describes pain as that of electric shocks that is aggravated on physical exertion.
• If the cervical spine is affected, the patient will suffer from cervical radiculopathy that will cause sharp or dull pain in neck and shoulder blades. This pain can be radiating to the arm or hands causing tingling sensation or numbness in fingers and shoulders.
• If thoracic spine is affected, then the herniated material can protrude in sideways (lateral) or central positions causing upper back pain in cases of central protrusion and abdominal pain and chest pain in cases of lateral disc protrusion. In cases of centro-lateral protrusion combination of symptoms of upper back pain, radiating pain, or myelopathy can be seen. Paralysis from the waist down can also occur due to a thoracic herniated disc.
• If Coccyx or tailbone is affected, pain might radiate to rectum, hips or thighs that make exercising difficult, sitting painful and disturbed sleep. Some patient may also suffer from vomiting and nausea, muscle

weakness, loss of sensation and digestive discomfort, including rectal pain.

DIAGNOSIS OF HERNIATED DISC

The following procedures can be opted for diagnosing Herniated disc

• X-ray: – It can show structure of joint and outline of vertebrae and help detect the cause of pain. It can also detect fractures, tumours or infections.
• CT/CAT Scan: – It can show shape and size of spinal canal and related structures.
• MRI: – Degeneration, enlargements and other structures can be viewed in 3D.
• Myelogram: – It can show pressure on the spinal cord due to any underlying abnormality.
• Electromyogram/Nerve conduction studies: – It can help in diagnosing nerve and muscle damage due to any past injuries.

TREATMENT OF HERNIATED DISC

Majority of the cases of herniated disc are curable without surgery and improve in 90% of the patients with time if following measures are followed: –

• Limiting physical activities for 2-3 days along with anti-inflammatory medicines can be used. Walking can be done if bearable.
• Physiotherapy
• Epidural steroid injection may provide short-term pain relief by reducing inflammation if injection of a cortisone-like medicine into the space around the nerve is given.
• MRI or Radiographic imaging is not suggested until the symptoms are present for more than six weeks. Spine specialists or neurosurgeons can be consulted if symptoms persist for more than 4 weeks.
• Surgical treatment: – Microdiscectomy can be performed and is the most common procedure opted in cases of single herniated disc.

AYURVEDIC APPROACH ON HERNIATED DISC

As far as Herniated discs are concerned, people have a misconception that once the disc has bulged it will remain the same for life time but that is not true as it is manageable by using Ayurvedic medicines. Ayurveda works by balancing all three doshas in the body and herniated disc is caused by imbalance of Vata dosha in the body. Various Ayurvedic herbal decoctions, capsules, oils and tablets are helpful in providing relief to patients with mild to moderate prolapse of disc. In chronic or severe cases therapies like Shodna – detoxification, Abhyanga – Medicated oil massages and Swedana – Sudation therapy can be done using Nasyam in case of neck problems and Vasthi in case of back pain related problems.

TREATMENT AT PLANET AYURVEDA FOR HERNIATED DISC

Planet Ayurveda has been providing 100% pure and chemical free and prepared following strict Ayurvedic principles from the last 20 years. All the medicines are GMP certified and are made from the best quality of herbs with ancient time tested formulas and enriched with wisdom from ages.

Disc care pack with the best quality herbs prepared by experts at Planet Ayurveda is available to treat herniated discs. It is 100% pure and chemical-free and prepared following strict Ayurvedic principles. It includes: –

Products List

1. Boswellia Curcumin
2. Aamvatantak Churna
3. Yograj Guggul
4. Hakam Churna
5. Maha Triphala Ghrit

Products Discretions

1. Boswellia Curcumin

It is a combination of extracts of Bosewellia serata and Curcuma longa which acts on osteoarthritic chondrocytes. Bosewellia serata and Curcuma longa have anti-oxidative, anti-inflammatory, and anti-catabolic activities, suggesting a protective effect of these extracts on cartilage. Curcumin extract from culinary turmeric is known to have effect on many inflammatory based musculoskeletal concerns including degeneration. Boswellia contains boswellic acid that helps in blocking inflammatory pathways like lipoxygenase and cyclooxygenase giving relief from aches and pains that stem from pinched nerves caused by inflammation.

Dose – 2 cap twice daily after meal with warm water

2. Aamvatantak Churna

Aamvatantak Churna is a combination of Ashwagandha or Withania somnifera, Haridra or Curcuma longa, Methika or Trigonella foenumgraecum, Surnajan or Colchicum luteum, Gorakhmundi or Sphaeranthus Indicus and Shunthi or Zingiber officinale. It helps to nourish and strengthen the joints and reduces pain, inflammation and tenderness of muscles and joints.

Dose – 1 tsp twice daily with warm water after meal

3. Yograj Guggul

Yograj Guggulu is a combination of Shuddha Guggulu or Commiphora mukul, Chitraka or Plumbago zeylanica, Pippali or Piper longum, Jeeraka or Cuminum cyminum, Devdaru or Cedrus deodara, Ela or Elettaria cardamomum, Amalaki or Emblica officinalis, Mustaka or Citrus rotundus, Haritaki or Terminalia chebula and Ardraka or Zingiber officinale etc. It is very helpful to maintain Vata balance and treats various types of diseases related to joints, bone marrow and muscles.

Dose – 2 tab twice daily after meal with warm water

4. Hakam Churna

Hakam Churna is a combination of chandershoor or Lepidium sativum, Kalaunji or Nigella sativa, Mehika or Trigonella foenumgraecum and ajwain or Trachyspermum ammi. It is used to treat gastric issues like upset stomach and indigestion as it is the root cause of all diseases and in long term can affect vata dosha which then localises in joints and muscles and causes intense pains and musculoskeletal disorders.

Dose – 1 tsp twice daily with warm water after meal

5. Maha Triphala Ghrit

A polyherbal medicine with ghee as basic ingredient is having pain-relieving properties, anti-inflammatory, and strong analgesic and is extensively used to provide relief from pain and inflammation in case of joint pain and arthritis.

Dose – 1 tsp twice daily with warm water after meal

CONTACT  PLANET AYURVEDA TO PROVIDE YOU WITH THE COSTING/ORDERING AND DELIVERY INFORMATION AT – COSTING.PLANETAYURVEDA@GMAIL.COM OR CALL AT +91-172-5214040

CONCLUSION

Intervertebral disc herniation and degeneration are common and serious problems and the current ways of dealing with these problems include surgeries or artificial implants. The current treatments for these conditions   attempt to cover up the symptoms instead of actually solving the problem; however, in Ayurveda these conditions are curable from early stages as body, mind and spirit are focused. Ayurveda balances all three doshas in the body along with Shodna – detoxification, Abhyanga – Medicated oil massages and Swedana – Sudation therapy. If these methods can be put together, it will result in a far superior form of treatment compared to the current spinal fusion and artificial disc methods being used. It will actually correct the problem, and the patient will live a normal, healthy life. In case of any query related to your doubts, you can always connect with our experts at Planet Ayurveda.