Physiology and Medications of the Lumbar Disc Disease

Lumbar Disc Disease, as the name implies, is a disease attacking the lumbar area of the spinal column that is characterized by general pain, weakness, and numbness in any section of the lumbar area---five segments in the lower extremities of the spinal column and the disc connecting them or the intervertebral disc. Lumbar Disc Disease is often used interchangeably with the following associated medical terms— sciatica, lumbosacral radiculopathy (or simply radiculopathy), LBP (Lower Back Pain), (LRS)lumbosacral radicular syndrome, and herniated disc.

Technically speaking though LRS or radiculopathy would be descriptive of the more specific leg pain or the sciatica. Physiology of the disease involves the “rupture”, “herniated”, or “bulged” condition of the intervertebral disc caused by disc compression through dehydration in the affected discoid area and accompanied by bulging out of nucleus pulposus and degeneration of the annulus fibrosis. Further disc degeneration can lead to herniated condition whereby the nucleus pulposus ruptures from the outer ring region and effecting weight or press on the sensitive nerves sublocated between disc spaces or the lumbar epidural spaces.

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Due to the “weight” or the “press”, the affected person experiences pain in the aforementioned region. The impingement on the nerve roots or the sinuvertebral nerves caused neurological symptoms in the regions that are supplied by the affected nerves. Disc herniation usually attacks between the fifth and the fourth lumbar bodies (L4-5) and the fifth lumbar body and the immediate sacral region (L5-S1). Size of the disc herniation is irrelevant to the severity of the symptoms of the radiculopathy.

Inflammation from the disc hernia may also have resulted from increased activity of the phospholipase A2, nitric oxide, prostaglandin E, leukotriene B4 and thromboxane B2 in the disc region as caused by the hernia initiating nociceptive and inflammatory responses. Such disease is a common ailment in the elderly or the aging individuals. It occurs on four per cent of the US population with ages from 40 to 60 for both male and female gender.

Specific symptoms of the disease are dependent on the lumbar disc press on the specific nerve ends and may include any or a combination of the following: (1) intermittent or continuous back pain, (2) back muscle spasm, (3) sciatica, (4) muscle weakness/numbness in the lower extremities, (5) decreased joint reflexes, and (6) possible bladder malfunction. Symptoms may persist for more than a month. The disease is diagnosed through medical history examination, physical examination, x-ray diffraction, magnetic resonance imaging (MRI), Computed tomography (CT) scanning, Discography, Myelogram and Electrodiagnosis (e.

g. Needle electromyography). Neurological and musculoskeletal system’s possible dysfunctions are observed thoroughly to detect sensory or motor deficits. As of recent, lumbar disc disease treatment would include conservative therapy (non-operative) --- physical therapy (e. g. L5 reflex assessment), stress reduction programs, lumbosacral back support, weight management and medications for alleviating the painful symptoms---and operative therapy or the surgery or removal of the affected lumbar region, otherwise known as lumbar disketomy.

In a study for the assessing the efficacy of surgery for lumbar disc disease conducted by Weinstein and colleagues in 2006, it was found out that both operative and non-operative therapy for curing the disease demonstrated substantial improvement in their “conditions,” however, the authors, did not indicate which therapy is more effective downplaying it to “statistical insignificance. ” Bibliography Herniated Nucleus Pulposus (Slipped Disk) (2006). Retrieved January 10, 2008 from http://health. nytimes. com/health/guides/disease/herniated-nucleus-pulposus-slipped-disk/overview. html

Lumbar Disc Disease (Herniated Disc). Retrieved January 10, 2008 from http://www. ohsu. edu/health/health-topics/topic. cfm? id =8838. Malanga, G. (2007) Lumbosacral Radiculopathy. Retrieved January 10, 2008 from http://www. emedicine. com/SPORTS/topic66. htm Weinstein, J. et al. (2006). Surgical vs Nonoperative Treatment for Lumbar Disk Herniation. JAMA,. 2006, 296:2441-2450. Retrieved January 10, 2008 from http://jama. ama-assn. org/cgi/content/full/296/20/2441 What You Need to Know About Sciatica. (2007) Retrieved January 10, 2008 from http://www. spine-health. com/topics/cd/d_sciatica/sciatica. html

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