Z a h r a Ay u H

LOW BACK PAIN 0 3 0 .1 4 .2 0 5

Koas Ilmu Penyakit
Saraf RSAL Mintohardjo
 THE INTERVERTEBRAL DISC

 An intervertebral disc acts

as a shock absorber

 Protect the nerves that run

down the middle of the
spine and intervertebral
discs
OVERVIEW

WHAT IS HERNIATED DISK?

 A herniated disk refers to a
problem with one of the
rubber y cushions (discs)
between the individual
bones (ver tebrae) that stack
up to make your spine.

 P ro l ap s e o f a n i nte r v e r te b r a l d i s c
t hro ug h a te ar i n t h e sur ro u ndi ng
a n n u l u s f i b ro s us
 A spinal disk i s a little like a
jelly donut, with a sof ter
center encased withi n a
tougher exteri or. Sometimes
called a slipped disk or a
ruptured di sk , a herniated
disk occur s when some of the
sof ter "jelly" pushes out
through a tear in the tougher
exterior.

  irritate nearby ner ves

FOUR STAGES TO A DISC HERNIATION
 The disc press on a
ner ve, symptoms may
include: pain that
travels through the
buttock and down a leg
to ankle or foot because
of pressure on the
sciatic ner ve.
 SYMPTOMS
 M o s t h er ni ated d i s k s o c c ur i n yo ur l ow er b ac k (l um b ar s p i n e ) , a l t ho ug h t hey c a n al s o
o c c ur i n yo u r n e c k ( c e r v i c al s p i n e ) .
 SYMPTOMS
 The most common signs and symptoms :
 Arm or leg pain.
 herniated disk is in your lower back most intense pain in your buttocks,
thigh and calf. If the herniated disk is in your neck  most intense in the
shoulder and arm.
 This pain may shoot into your arm or leg when you cough, sneeze or move your
spine into certain positions.
 Numbness or tingling.
 in the body part served by the affected nerves.
 Weakness.
 Muscles served by the affected nerves tend to weaken. This may cause you to
stumble, or impair your ability to lift or hold items.
 WHEN TO SEE A DOCTOR?
 Seek medical attention
if your neck or back
pain travels down your
arm or l eg, or if it's
accompanied by
numbness , ti ngling or
weakness.
 CAUSES

 Disk herniation is most often the result of a gradual, aging-

related wear and tear called disk degeneration.
 As you age, your spinal disks lose some of their water content. That
makes them less flexible and more prone to tearing or rupturing with
even a minor strain or twist.

 S o m et i m e s , us i ng yo ur b ac k  R a r ely, a t r aum at i c
m us c l e s i ns te ad o f yo ur l eg a n d ev e nt s uc h a s a f al l
t hi g h m us c l e s to l i f t l ar g e , h eav y o r a b l ow to t h e
o b j ec t s c a n l ea d to a h er ni ated b ac k c a n c au s e a
d i s k , a s c a n t w i st i ng a nd t ur nin g h e r n i a te d d i s k
while lifting.
 RISK FACTORS
Factors that increase your risk of a herniated disk may include:
 Weight.
 Excess body weight causes extra stress on the disks in your lower back.
 Occupation.
 People with physically demanding jobs have a greater risk of back problems.
Repetitive lifting, pulling, pushing, bending sideways and twisting also may increase
your risk of a herniated disk.
 Genetics.
 Some people inherit a predisposition to developing a herniated disk.
 COMPLICATIONS
 Rarely, disk herniation can compress the entire cauda equina.
Emergency surger y may be required to avoid permanent weakness or
paralysis.

Seek emergency medical attention if you have:

 Wor sening symptoms.
 Pain, numbness or weakness may increase to the point that you can't perform
your usual daily activities.
 Bladder or bowel dysfunction.
 People who have cauda equina syndrome may become incontinent or have
difficulty urinating even with a full bladder.
 Saddle anesthesia.
 This progressive loss of sensation affects the areas that would touch a saddle —
the inner thighs, back of legs and the area around the rectum.
 THERAPY
 Medications
 Surgery
 Physiotherapy
 PREVENTION
To help prevent a herniated disk:
 Exercise.
 Strengthening the trunk muscles helps stabilize and support the spine.
 Maintain good posture.
 Good posture reduces the pressure on your spine and disks. Keep your back
straight and aligned, particularly when sitting for long periods. Lift heavy
objects properly, making your legs — not your back — do most of the work.
 Maintain a healthy weight.
 Excess weight puts more pressure on the spine and disks, making them more
susceptible to herniation.
THANK YOU