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Posted by on Sep 15, 2010 in Portfolio | 0 comments

Herniated disc

Herniated disc

This time we talk about herniated disc syndrome at the lumbar area (HDS).

Most of patients are diagnosed when they already are suffering deliberating shooting pain down to the affected leg(s). The pain usually is felt at the gluteus, hamstring, and calf/shin. There is tingling, pins/needles or numbness like abnormal sensations at the back or lateral part of the foot. However, the first sign of HDS usually appeared many years before it is formally diagnosed with MRI. Conservative treatment is very cost-effective if started early and performed properly.

The first sign of HDS is string-tight calf muscles or hamstring without any reason. If the calf muscle is tight and achy without any history of injury, the likelihood that it is due to HDS is higher than 80% (my impression). Another early sign is achy gluteus in the night. At this time you may or may not have any low back pain, but proper physical examine can reveal bruising-like tenderness at the corner of the distal end of spine and the iliac superio-posterior process of iliac crest.

Another early sign of HDS of lumbar spine is low back pain of one side only at the abovementioned corner without lower limp symptoms. Detailed physical examine can reveal nervy tenderness behind the knee and at the calf muscle of the same side to the low back pain.

Low back injury and degeneration are the two causes mentioned in the textbook. However, why does the low back injure or degeneration occur at the first place? It is because of the bad posture established from very young age. Examine your posture in the mirror, if the lumbar curve (point to front) is excessive large (lordosis-protruding tummy and high bottom), be careful even you have no any symptom now!

To change your posture, you need have a strengthening program for the low part of abdomen muscles and efficient stretch for the hip flexer (iliopsoas). It is wise to start treatment for HDS when you have the symptom mentioned above, it is even wiser to correct your posture before you have any symptom.

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