Herniated Disc Lumbar
When a patient presents with lower back pain that seems to radiate down the leg, thigh, calf, ankle and foot, then the doctor will examine the history of the patient. This is usually followed by a physical examination, and if the doctor suspects herniated disc lumbar, then an MRI (magnetic resonance imaging) will tie in the suspicion of a herniated disc. Often various tests are done to ascertain what is exactly going on with herniated disc lumbar. For example, scientists look at the inflammatory cytokines that accompany pain caused by the sciatic nerve when there is lumbar disc herniation. You see, our bodies make many divergent kinds of cytokines. They are in actuality molecular messengers that send responses between the cells in our body.
Thus, they hypothesize that when we suffer from some kind of compression of lumbar nerve roots because of herniated disc lumbar a chemical is stimulated to produce the sciatic leg pain that radiates from even the bottom of our foot through our leg, and even into our buttock of the leg that is affected. Thus far, they have not been able to clearly define why this molecular messenger is produced. When they recently studied over 76 herniated disc lumbar patients, there were able to classify the herniation into sequestration, extrusion, and protrusion types. Thus from each of these they took macroscopically tiny amounts of tissues that were adjacent to the nerve root in question.
These tissues were then analyzed using both biochemical and immunohistochemical means, all looking for these inflammatory cytokines. Further analysis was done using in vitro studies to see if they could replicate the cytokines. Interestingly enough they found histiocytes, which are cells that are created to protect our bodies from infection.
They also found fibroblasts, or endothelial cells. These cells are used to maintain the structural reliability of various connective tissues. Further, they also found chondrocytes; these are cells that come from bone or cartilage stem cells. The firm conclusion was that within the herniated disc lumbar site prostaglandin E2 is being produced. Prostaglandin E2 is actually an enzyme that causes a chemical reaction in our bodies. It is thought that with further studies we will be able to deduce the role that inflammatory cytokines plays in being the cause of sciatic pain.
What follows after the tests reveal a herniated disc lumbar is most probably treatment that is considered extremely conservative. Ordinarily non-steroidal anti-inflammatory medication is involved as well as rest. Alternatively, using x-ray guidance, an epidural steroid injection may also be given. Physical therapy is then commonly introduced.
Should various conservative measures not prove advantageous, finally surgery for the herniated disc lumbar will be indicated. Frequently, a procedure called a microdiscectomy will be done. What this accomplishes is removal of a tiny piece of bone, which then releases the compressed nerve root, ending the herniated disc material from pinching the nerve root. This is performed as an outpatient surgery, leaves a tiny scar, as it is a minimally invasive surgical procedure and does not require overnight hospitalization.
If you're interested in more info you can read about herniated disc surgery here.