Lumbar disc disease
Encyclopedia
Lumbar disc disease is the drying out of the spongy interior matrix of an intervertebral disc
in the spine
. Many physicians and patients use the term lumbar disc disease to encompass several different causes of back pain
or sciatica
. In this article, the term is used to describe a lumbar herniated disc. It is thought that lumbar disc disease causes about one-third of all back pain.
, loss of muscle strength
and loss of touch
sensation may occur if this herniation
causes the compression of the most proximal part of the nerve closely neighbouring the intervertebral disc material. Pain is in the distribution of the nerve compressed, usually down the back of the leg, side of the calf and inside of the foot (sciatica
). Most commonly, the nerve root between the fourth and fifth lumbar
vertebrae or between the fifth lumbar vertebra and first sacral segment are impinged.
In symptom
atic cases the diagnosis
should be confirmed by an MRI
scan. However, in cases with slight symptoms, a faster and cheaper CT scan (although it is inferior to MRI scan) may be recommended. While a CT scan can show the bony structures in more detail, an MRI scan can better portray soft tissue.
that will remove the compressing disc material, a microdiscectomy or discectomy
may be recommended to treat a lumbar disc herniation.
intermediate-layer protein (CILP) were 1.6 times more likely to have the disease than persons without the variation. CILP is a normal component of disc tissue. The gene variation causes a version of CILP that disrupts normal building and maintenance of cartilage.
Under normal circumstances, CILP slows the activity of another protein
, TGFβ1. TGFβ1 regenerates the cartilage matrix tissue. The variant CILP inhibits TGFβ1 to an abnormal degree, allowing for degeneration of the disc matrix. (Seki, et al., 2005)
Intervertebral disc
Intervertebral discs lie between adjacent vertebrae in the spine. Each disc forms a cartilaginous joint to allow slight movement of the vertebrae, and acts as a ligament to hold the vertebrae together.-Structure:...
in the spine
Vertebral column
In human anatomy, the vertebral column is a column usually consisting of 24 articulating vertebrae, and 9 fused vertebrae in the sacrum and the coccyx. It is situated in the dorsal aspect of the torso, separated by intervertebral discs...
. Many physicians and patients use the term lumbar disc disease to encompass several different causes of back pain
Back pain
Back pain is pain felt in the back that usually originates from the muscles, nerves, bones, joints or other structures in the spine.The pain can often be divided into neck pain, upper back pain, lower back pain or tailbone pain...
or sciatica
Sciatica
Sciatica is a set of symptoms including pain that may be caused by general compression or irritation of one of five spinal nerve roots that give rise to each sciatic nerve, or by compression or irritation of the left or right or both sciatic nerves. The pain is felt in the lower back, buttock, or...
. In this article, the term is used to describe a lumbar herniated disc. It is thought that lumbar disc disease causes about one-third of all back pain.
Symptoms
PainPain
Pain is an unpleasant sensation often caused by intense or damaging stimuli such as stubbing a toe, burning a finger, putting iodine on a cut, and bumping the "funny bone."...
, loss of muscle strength
Physical strength
Physical strength is the ability of a person or animal to exert force on physical objects using muscles. Increasing physical strength is the goal of strength training.-Overview:...
and loss of touch
Somatosensory system
The somatosensory system is a diverse sensory system composed of the receptors and processing centres to produce the sensory modalities such as touch, temperature, proprioception , and nociception . The sensory receptors cover the skin and epithelia, skeletal muscles, bones and joints, internal...
sensation may occur if this herniation
Spinal disc herniation
A spinal disc herniation , informally and misleadingly called a "slipped disc", is a medical condition affecting the spine due to trauma, lifting injuries, or idiopathic, in which a tear in the outer, fibrous ring of an intervertebral disc allows the soft, central portion A spinal disc herniation...
causes the compression of the most proximal part of the nerve closely neighbouring the intervertebral disc material. Pain is in the distribution of the nerve compressed, usually down the back of the leg, side of the calf and inside of the foot (sciatica
Sciatica
Sciatica is a set of symptoms including pain that may be caused by general compression or irritation of one of five spinal nerve roots that give rise to each sciatic nerve, or by compression or irritation of the left or right or both sciatic nerves. The pain is felt in the lower back, buttock, or...
). Most commonly, the nerve root between the fourth and fifth lumbar
Lumbar
In tetrapod anatomy, lumbar is an adjective that means of or pertaining to the abdominal segment of the torso, between the diaphragm and the sacrum ...
vertebrae or between the fifth lumbar vertebra and first sacral segment are impinged.
In symptom
Symptom
A symptom is a departure from normal function or feeling which is noticed by a patient, indicating the presence of disease or abnormality...
atic cases the diagnosis
Medical diagnosis
Medical diagnosis refers both to the process of attempting to determine or identify a possible disease or disorder , and to the opinion reached by this process...
should be confirmed by an MRI
Magnetic resonance imaging
Magnetic resonance imaging , nuclear magnetic resonance imaging , or magnetic resonance tomography is a medical imaging technique used in radiology to visualize detailed internal structures...
scan. However, in cases with slight symptoms, a faster and cheaper CT scan (although it is inferior to MRI scan) may be recommended. While a CT scan can show the bony structures in more detail, an MRI scan can better portray soft tissue.
Treatment
Initial treatment in lumbar disc disease is one or two days of bedrest (although growing number of studies shows that it makes little difference) and pain relieving medications. In cases with ongoing pain despite conservative treatments, a surgical operationSurgery
Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...
that will remove the compressing disc material, a microdiscectomy or discectomy
Discectomy
A Discectomy is the surgical removal of herniated disc material that presses on a nerve root or the spinal cord. The procedure involves removing the central portion of an intervertebral disc, the nucleus pulposus, which causes pain by stressing the spinal cord or radiating nerves...
may be recommended to treat a lumbar disc herniation.
Genetics
An inheritable gene variation may cause increased susceptibility. People with a variation in a gene that encodes the cartilageCartilage
Cartilage is a flexible connective tissue found in many areas in the bodies of humans and other animals, including the joints between bones, the rib cage, the ear, the nose, the elbow, the knee, the ankle, the bronchial tubes and the intervertebral discs...
intermediate-layer protein (CILP) were 1.6 times more likely to have the disease than persons without the variation. CILP is a normal component of disc tissue. The gene variation causes a version of CILP that disrupts normal building and maintenance of cartilage.
Under normal circumstances, CILP slows the activity of another protein
Protein
Proteins are biochemical compounds consisting of one or more polypeptides typically folded into a globular or fibrous form, facilitating a biological function. A polypeptide is a single linear polymer chain of amino acids bonded together by peptide bonds between the carboxyl and amino groups of...
, TGFβ1. TGFβ1 regenerates the cartilage matrix tissue. The variant CILP inhibits TGFβ1 to an abnormal degree, allowing for degeneration of the disc matrix. (Seki, et al., 2005)
See also
- Degenerative disc diseaseDegenerative disc diseaseDegeneration of the intervertebral disc, often called "degenerative disc disease" of the spine, is a condition that can be painful and can greatly affect the quality of one's life...
- SciaticaSciaticaSciatica is a set of symptoms including pain that may be caused by general compression or irritation of one of five spinal nerve roots that give rise to each sciatic nerve, or by compression or irritation of the left or right or both sciatic nerves. The pain is felt in the lower back, buttock, or...
- Spinal disc herniationSpinal disc herniationA spinal disc herniation , informally and misleadingly called a "slipped disc", is a medical condition affecting the spine due to trauma, lifting injuries, or idiopathic, in which a tear in the outer, fibrous ring of an intervertebral disc allows the soft, central portion A spinal disc herniation...
- Lumbar spinal stenosis