39. Central disc herniation

Question 1

What is central disc herniation?

Answer 1

Uncommon => low back pain and saddle pain in the S1 and S2. May compress nerve roots of the cauda equina.

Question 2

Symptoms

Answer 2

Back pain during sitting and bending, position that increase P on anular fibers
Mus. weak.
Radiating
Sensation of heat or pins and needles
Numbness or tingling in the arms, hands, legs or feet
Incontinence (cauda quina syndrome)

Question 3

Causes

Answer 3

Trauma, poor lifting technique or sports injury, genetics, aging, degenerative disc disease

Question 4

Diagnosis

Answer 4

Medical history and physical exam. may disclose bowel or bladder dysfunction.

Question 5

Treatment

Answer 5

McKenzie exercise program. Emergency if cauda equina syndrome. Surgery to prevent loss of function.