Lumbar Disc Herniation
Post Rehab Goals and Objectives:
- Improve Lower Extremity
- Improve Cardiovascular Capacity
- Improve Lumbar Functional Capacity
Description
About 80% of the population experience back pain at some point in there lives. 35% of lumbar disc herniations develop true sciatica. Not all lumbar disc herniations produce symptoms. 90% of those with sciatica improve with conservative management. About 90% of all disc herniations occur at the L4-5 and L5-S1 levels, so the L5-S1 nerve roots are the most involved. Many of these clients benefit from lumbar disectomy or laminectomy. The goal of these procedures is to return client to maximum functional status and reduce pain.
A significant number of back injuries are linked to the IV disc. The disk is composed of a central nucleus pulposus surrounded by an annulus fibrosus. The nucleus is composed of approximately 70-90% water in a young healthy disc but the water content decreases with aging. The annulus fibrosus consist of 10-20 concentric collagen fibre layers that surround the nucleus. The layers are arranged in alternating orientation of parallel fibers lying approximately 65 degrees from vertical.
A herniated disc occurs when all or some of the nucleus pulposus is forced through the torn annulus fibrous. When this occurs the extruded disc may impinge on the nerve root as it exits the spinal cord, resulting in pain and other signs of nerve root irritation. Herniations are usually seen in adults less than 45 years of age. Herniations may result from severe trauma, strain or may be related to intervertebral joint degeneration. 90% of disc herniations occur in the lumbar region. The symptoms of a lumbar disc herniation are unilateral and include pain, which radiates into the buttocks, leg and foot. The herniation, in the early stages, may cause sensory or motor loss in the area innervated by compressed spinal nerve root. In the later stages, weakness and muscle atrophy may occur. Herniations that fail to respond to conservative treatment may necessitate surgery. Laminectomy is the most common surgical procedure to reduce the herniation.
IV disc of the lumbar spine are susceptible to a variety of injuries, which may account for pain in the low back. The primary component to annular injury involving the disc is the natural aging process or degeneration.