What is Hernia Nucleus Pulposus?
Hernia Nucleus Pulposus (HNP) is a condition when the cushion or disc between the vertebrae (spine) exits from its original position and clamps the nerve behind it. This condition is also called the term “pinched nerve”. HNP generally attacks the fourth or fifth lumbar vertebra (in the lower back) or cervical vertebrae (in the neck), especially in adult patients who have entered the age of twilight.
Causes of Hernia Nucleus Pulposus
Between the vertebrae is a cushion, with a chewy middle part like a jelly and an outer layer of strong veil. As the age or result of injury, there may be a decrease in strength and elasticity of this bearing, so that the inside of the cushion may protrude and compress the nerves. These conditions resulted in patients experiencing pain to decrease the ability of physical motion.In addition to age and injury factors, as for some things that can increase a person’s risk of hernia nucleus pulposus, such as:
- Genetics. Conditions derived from one family member who has a history of HNP.
- Obesity. Emphasis on the spine due to excess body weight.
- Smoke. Cigarette smoke can lower oxygen levels on the disc and increase the risk of abrasion on the spine.
- Lifting heavy loads. Someone who often lifts or pushes a heavy load repeatedly with the wrong posture, potentially experiencing HNP.
Symptoms of Hernia Nucleus Pulposus
Not all HNP sufferers experience certain symptoms and only know it when performing a scan test. However, most patients usually experience symptoms, which are:
- Pain in the leg or shoulder, with intensity that can increase when coughing, sneezing, or moving in a certain position.
- Weakening of muscle function thus reducing the ability of the patient in moving, bending, or moving goods.
- Some points of the body experience a tingling sensation or stiffness. Usually around the back, shoulders, hands, limbs, and legs.
These symptoms are sometimes felt also by people with mild back pain due to sprained or twisted. It is advisable to see a doctor if a person feels the above symptoms in order to know the cause.
Diagnosis of Hernia Nucleus Pulposus
Given that there are several other potential diseases that have symptoms similar to that of the nucleus pulposus hernia, the physician will evaluate the symptoms, perform physical tests (including measures of walking ability, muscle strength, reflexes, and sensory abilities), as well as a series of advanced tests to examine bone and nerve conditions. Among others are:
- Scanning tests, such as CT scans (to get an idea of the condition of the spinal column and surrounding structures), MRI (to ascertain where the HNP and the affected nerves are involved), myelogram (to see any pressure on the spinal cord and nerves Others), as well as X-rays (to ensure that symptoms experienced by patients are not caused by fractures, tumors, or infections).
- Blood tests, to check if there is inflammation or infection.
- Neurological examination. This test aims to see the location of the nerve damage accurately. The usual method is the examination of nerve conduction and electromyogram (EMG).
Treatment of Hernia Nucleus Pulposus
Treatment of HNP will be adjusted to the severity of symptoms experienced by the patient. Some of the ways doctors usually advise are through medication, therapy, or surgery.
Here are some types of medicines that doctors may recommend:
- Pain relief medicine. If the patient’s condition is mild, pain medications such as ibuprofen, paracetamol, and naproxen may be used. Although these drugs are sold freely, patients are advised to consult with a doctor first so that the dose can be adjusted.
- Opioid medicine. If the patient has severe pain or pain not subside after taking the above pain medication, opioid-type drugs, such as codein or oxycodone-paracetamol combination may be given. However, this type of drug can only be consumed in the short term.
- Tranquilizers muscle. This drug will be prescribed for patients with muscle spasms.
- Anticonvulsant drugs. Although this drug is commonly used to control seizures, anticonvulsants can also be used as a pinched nerve pain reliever.
- Injections of corticosteroids. Stretoid antiinflammatory injections are generally given directly at the problematic nerve point.
- Oral corticosteroid drugs. In certain cases, doctors may administer oral corticosteroid drugs, such as prednisone or methylprednisolone, to relieve inflammation and swelling.
In general, HNP may improve over days or weeks. However, if the patient’s symptoms do not subside, suggestions for physical therapy, such as muscle stretching and certain body position exercises, will be given. There are also several types of light exercise that can be done at home, such as a leisurely stroll and yoga. Or other therapies, such as acupuncture, massage, and chiropratic care.
Only a small proportion of hernia nucleus pulposus cases require surgical treatment for recovery. Doctors will usually advise patients to perform surgery if:
- Symptoms do not subside after 6 weeks of treatment.
- Muscles weaken and stiff.
- Difficulty standing or walking.
- Can not control urine.
The surgery performed is a disectomy, namely the cutting and removal of part or all of the pads that clamp a nerve. When the overall cushioning is removed, the spine may be supported by metal fitting or artificial disc installation in place of the pads.
Although surgery is the best option for recovery, keep in mind that patients still need to maintain the condition and change the activity pattern to avoid side effects or postoperative complications. To optimize recovery, doctors will usually recommend therapy and rehabilitation programs.
Patients can also relieve symptoms of HNP at home if conditions are not severe, such as:
- Compressing with ice water to relieve pain and inflammation, followed by warm water compresses to provide comfort.
- Avoiding rest for too long, because it can cause muscles and joints become stiff and weak. It is advisable to take a leisurely walk or do light work, while accompanied by enough rest time to speed up the recovery process. Avoid severe activity because of potential exacerbation of symptoms.
Complications of Hernia Nucleus Pulposus
Although rare, HNP can suppress the cauda equina located in the lower back and lead to serious complications, such as:
- The discharge of fluid from the bladder, where the patient will have difficulty removing urine or faeces, to sexual sterility.
- Decreased ability to move, because this condition can aggravate symptoms, such as severe pain, weakened muscle, or stiff.
- Sadel anesthesia, in which the patient loses the ability to feel or sensation in points such as the inner thigh, back legs, and around the rectum.
It is advisable for HNP sufferers to immediately see a doctor or visit the nearest hospital if they have symptoms that lead to complications for immediate treatment.
Prevention of Hernia Nucleus Pulposus
The Hernia Nucleus Pulposus (HNP) can be prevented through the following steps:
- Exercise regularly. Choose the type of exercise that can strengthen muscles, joints and bones, especially the spine.
- Maintain posture. Make sure you sit with upright posture and weigh heavy weights with your legs instead of your back. This is done to maintain the natural posture of the back and prevent suppression of the spine.
- Avoid smoking. Nicotine substances contained in cigarettes can weaken the bearing tissue or spinal disc.
- Maintain ideal weight. Obesity can overload the spine for prolonged periods of time, resulting in faster bone removal.
- Avoid injury. Adjust the activity with your body strength, and avoid sudden movements that can result in injury to the spine or surrounding areas.