Vertebral column pathologies are becomes more frequent in the human population due to lack of information, inadequate movements, and overload applied on vertebral area. These factors are the most common causes of the disc herniation disease. Herniated disc usually appears close to the lumbar and cervical area . This pathology affects a big percentage of the population, bothmale and female; besides is the higher cause of short-term disability associated to people under 45 years old as well as the most frequent cause of lumbar paint . This paper is focusing on the most important aspects of the disc herniation; primarily referred to its etiology, clinical manifestations, and available treatments as well as physiotherapy intervention for decrease the disease symptomsand its final treatment. Also, this paper cover the principals medical implications of the illness and how are affected, pathologically, the spinal medulla and the peripheral nerves using clinical data.
Figure 1 Intervertebral disc herniation. http://www.nucleusinc.com
Spinal disc are soft structures localized between two consecutives vertebras (Figure 1); its principal function is allow aharmonic column movements as well as both to provide physical support and to spread the forces during the movements. Due to ageing the amount of glucoproteins on the disc core decline , producing by this mean dehydration them increasing the friction force in the interactions. Thereby, the disc suffers degeneration in the mucosa, increment of the internal fibrous tissue, reduction in theinter-vertebral space and high sensibility to the traumatism. The augmentation, by the mechanical loads, in the pressure exerted over the core disc erodes the anular fibrous area, them causing a disc herniation.
Disc herniation is an anomalous condition or lesion created as consequence of the attrition in the inter-vertebral disc. This is made up by a core or nucleus pulpous surrounded by a fibrous ring. As a result of excessive load, the ring could be fissured allowing by this means the nucleus move out from the core (leakage), causing the herniation. Usually, this process takes three steps . First a fissure is formed; this fissure consists in a tear over the fibrous cover film of the disc like radial fissure, where the tear is perpendicular to the fiber orientation. Second, the fissureis bulged, deforming the fibrous cover film due momentum transfer between the gelatinous material from the nucleus and the wall itself. Finally, when the fibrous cover film breaks and some of the nucleus material leak out, a disc herniation is diagnosed.
Disc herniation etiology includes but not limited to: degeneration or joint ageing together with formation of osseous excrescence, thismechanism is not fully defined but have been reported some genes associated . Micro-traumatism caused by blows close to the vertebral disc. Repetitive mechanism flexion/extension of the back raising big loads, constant overload on the vertebral disc could cause a progressive deterioration. Constant rotational movements, for example people whom most of the time remains on sit-position doing change indirection, this is called shearing effect. People with overweight or high corporal volume; the risk is higher in patients whose weight is concentrate in the abdominal area. Atrophy in the muscles located on the lumbar zone.
In addition to the etiology mentioned in the previous paragraph, this illness leaves several “secondary” implications to the human body . Compression in the root of theperipheral nerves can produce an intense pain in the root adjacent area. Typically, acute spasms appear at the time of the root base pain; this pain can to produce muscle spasms with either reduction in the column movements or total lost of the movements associated to stiff neck. Due the compromise of the motor root, the patient experiments muscular weakness or diminution or absence of reflexes...
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