The term Spondylosis is used to signify deteriorating changes in the intervertebral discs. Cervical spondylosis is a condition that happens due to degeneration of the discs in the cervical region and such changes in the lumbar region cause lumbar spondylosis. IVDP is defined as intervertebral disc prolapse which occurs due to improper postures, trauma, and degeneration.
The frequency of these conditions is growing at an alarming rate particularly among people working with computers and those who are having sedentary jobs. Individuals with cervical spondylosis will have pain and numbness in the neck and arm in variable intensities. Low back pain is the common appearance of lumbar spondylosis. IVDP causes stiffness and pain in the low back region that radiates pain and numbness in the leg. These conditions, if continued causes severe disability to such an extent that the individual will have to change his profession many times.
A prolapsed intervertebral disc is also identified as a slipped disc. Here, there would be a bulging out of the inner part of the disc. This is a condition that affects the spine in which there is a tear in the outer fibrous ring of an intervertebral disc allowing the soft central portion to bulge.
The intervertebral discs are present between the vertebral bodies of the spine. The discs would be rubber or jelly-like and they act like cushions to the spine when it bends. The discs consist of gelatinous inner nucleus pulposus and strong outer annulus fibrosus.
Stages of Disc prolapse Disc Dehydration
This is the stage where the outer layer of the disc weakens and the fibers around the disc become loose. This leads to flattening of the disc with loss of height and increase of diameter. This is called a bulge.
Disc Prolapse
This is a condition where the outer layer called the annulus fibrosis cracks and the soft interior of the disc starts protruding through the outer layer. When this happens, the prolapsed part of the disc tends to touch on the adjoining nerves and it’s at this point that you start experiencing pain and other associated symptoms.
Disc Extrusion
At this point, some part of the protruded nucleus pulposus starts to push out through the outer part of the disc and gets detached.
Disc Sequestration
In this stage, the free fragment of the nucleus pulposus (the innermost part of the disc) manages to get within the spinal canal.
Who gets slipped disc?
Doctors have pinned age as a factor in many of the cases. In addition, smokers are also more likely to get slipped discs because smoking makes the discs lose their natural flexibility. Furthermore, overweight people are also more likely to suffer from a slipped disc because their discs have to support extra weight than they can handle.
We can classify this under two major divisions
- CERVICAL RADICULOPATHY
Cervical radiculopathy is a disease process marked by nerve compression from herniated disk material or arthritic bone spurs. This impingement typically produces neck and radiating arm pain or numbness, sensory deficits, or motor dysfunction in the neckand upper extremities.
Cervical radiculopathy occurs with pathologies that cause symptoms on the nerve roots. Those can be compression, irritation, traction, and a lesion on the nerve root caused by either a herniated disc, foraminal narrowing, or degenerative spondylitic change (Osteoarthritic changed or degeneration) leading to stenosis of the intervertebral foramen.
Most of the time cervical radiculopathy appears unilaterally; however, it is possible for bilateral symptoms to be present if severe bony spurs are present at one level, impinging/irritating the nerve root on both sides. If peripheral radiation of pain, weakness, or pins and needle are present, the location of the pain will follow back to the concerned affected nerve root.
Characteristics/Clinical Presentation Typical Dermatomal Pattern of the Upper Limb
Typical symptoms of cervical radiculopathy are:
- Irradiating arm pain corresponding to a dermatomal pattern,
- Neck pain, paraesthesia,
- Muscle weakness in a myotomal pattern,
- Reflex impairment/loss,
- Headaches, scapular pain,
- Sensory and motor dysfunction in upper extremities and neck
Upper limb movements that are affected:
- C1/C2- Neck flexion/extension
- C3- Neck lateral flexion
- C4- Shoulder elevation
- C5- Shoulder abduction
- C6- Elbow flexion/wrist extension
- C7- Elbow extension/wrist flexion
- C8- Thumb extension
- T1- Finger abduction
- LUMBAGO-SCIATICA
Sciatica and Disc Prolapse – Sciatica is a pain in the leg caused by compression and/or irritation of one of five nerve roots that are branches of the sciatic nerve. The pain is felt in the lower back, buttock, and/or various parts of the leg and foot. In addition to pain, there may be numbness, muscular weakness, and difficulty in moving or controlling the leg. Typically, the symptoms are only felt on one side of the body.
Causes of sciatica – Sciatica is generally caused by the compression of a lumbar spine nerve root L4 or L5 or sacral nerve roots S1, S2, or S3, or far less commonly, by compression of the sciatic nerve itself. Sciatica may also be experienced in late pregnancy, primarily resulting from the uterus pressing on the sciatic nerve, and, secondarily, from the muscular tension and/or vertebral compression consequent to carrying the extra weight of the fetus, and the postural changes inherent to pregnancy.
Characteristics/Clinical Presentation
Causes of Slip discs
- Aging
- Smoking
- Obesity
- Physically demanding jobs such as lifting heavyweights
Symptoms of Slipped Discs
The symptoms are based on the location of the disc affected.
Symptoms of Slipped Disc in the Neck
- Pain in the neck, shoulders, arms in one side of the neck
- Numbness in part of the hand
- Pain that goes all the way to the hands
- Worsening of pain at night
- Muscle weakness in the hands
- A sensation of aching, burning in the affected area
Symptoms of Slipped Disc in the back
- Pain and numbness on one side of the back.
- Pain that goes all the way to the legs
- Worsening of pain at night
- Worsening of pain while standing or sitting
- Pain while walking for short distances
- Muscle weakness
- A sensation of aching, burning in the affected area
Treatment for Slipped Disc
A slipped disc treatment is mainly targeted at relieving the symptoms associated and prevention further recurrence.
Treatment for Slipped Disc in Contemporary Medicine (Allopathic Treatment)
To relieve the symptoms of this problem, conventional treatment comprises of using pain killers or traction. These treatments are not always successful and the user might need to undergo invasive procedures like epidural injections to help avoid further complications. If it is not responding to any interventions, spinal surgery can be done to remove the protruding disc, or to increase the space for the emerging nerve with or without fusion of the vertebrae is recommended.
Ayurvedic Treatment for Slip Disc:
Ayurveda offers a very tangible alternative that works in almost any case of a prolapsed or slipped disc. Ayurvedic medications comprising of herbal decoctions, tablets, capsules and oils for external application are very effective in providing relief in patients with mild to moderate problems. Persons with chronic problems and those with the severe intensity of symptoms would require Ayurvedic therapies like Abhyanga (Medicated Oil applications and massages), Swedana (Sudation therapy), Shodana therapies (detoxification) using Vasthi in the case of back pain related problems, and Nasyam in the case of neck related problems. These therapies are used to heal the nerves affected by the herniated disc and to relieve the muscular spasm as well.
Detoxification, that helps in reducing inflammation (Pittahara), healing of the damaged disc (mamsa bhagna), to reduce pain (vedanahara), and to strengthen the region (Rasayana).
Other modalities also include
- External therapies & internal medications
- Panchakarma,
- Advice of lifestyles and food changes
- Panchakarma Basti, Virechana, and Nasya
- External PPS, Abhyanga, Kashaya Seka, SSPS, Lepa, kati basti
- Internal Reducing inflammation (Pittahara)
- Healing of the damaged disc (mamsa bhagna)
- Reducing the pain (vedanahara)
- Strengthening the region (Rasayana)
Now a days many Ayurveda hospitals integrate physiotherapy and yoga thereby helps to provide a comprehensive healing for patients suffering from disc prolapse.
The treatment given by Ayurveda protocol provides a unique advantage to patients. These treatments help the patients avoid surgery, are safe and effective for the patient, and are natural and holistic. In addition, through these treatments, a patient can avoid the chance of a recurrence of the condition.
Importance of yoga
Yoga is not an exercise. Yoga is an approach to a perfect body and a perfect mind, and it relates to the five koshas of the human body. The first being for the attainment of bliss i.e, Samadhi, other four Kosas are Annamayakosa, Manomayakosa, Pranamayakosa and Vijnanamayakosa.
Annamayakosa – meant the Physique and yoga therapy for this kosa are (1) Food regulation or Naturopathy, where intake of only raw vegetable, juice, mixed vegetable juice along with the juice of karuka (Cynodon dactylon) grass which is good for nervous system are advised; and (2) Yogasana with correct body postures while sitting/resting are advised.
Manomayakosa – According to manomayakosha, (1) Mind plays an important role in the occurrence of the diseases which the modern medicine terms psychosomatic diseases. It is estimated about 85% of modern diseases are psychic. In this case, patients are advised to practice savasana and yoganidra in order to achieve relaxation leading to lessening the muscular spasm in the spinal column of the patient. (2) Meditation is the solution for all psychosomatic diseases. The right meditation for this is cittavrittinirodha for attainment of dhyana; and (3) Autosuggestion, a powerful technique of treatment by mental visualization. Therefore, three suggestions are relaxation, meditation, and autosuggestion.
Pranamayakosa – is stimulation of prana by practicing pranayama and certain other techniques of Yoga through which all the diseases will be cured. Reiki practice, pranic healing, etc, based on the prana force inside the body are different techniques to stimulate prana. The lumbar region which is directly connected with manipuarkacakra, and the cervical area connected with visuddhicakra are stimulated with certain techniques to cure diseases like IVDP and degeneration of spine.
Vijnanamayakosa – Practice of right sitting and lying postures to support muscles around the spine are necessary for the health of the spine. Lakhubhujangsana, Sarpasana, Makarasana, Dhanurasana, kandharasana, marjarasana, vyaghrasana and salabhasana are recommended.
Disc prolapse has got better treatment options in Ayurveda, which alleviates the need for surgery and improves the quality of life. Our experience of over 1000 years and time tested medication makes us the best at offering the services required to effectively heal. The treatment offered is time-tested, safe and effective. The treatment is natural and holistic which retards the chances of recurrence. Let the patients walk out with renewed confidence in life.
