UNIVERSIDAD UTE

FACULTAD CIENCIAS DE LA SALUD “EUGENIO ESPEJO”

MEDICINA
INGLÉS MÉDICO II

Names: Ismael Albornoz, Mateo López, Karen Matailo, Gabriela Maya and Martín Romero
Semester: 8th C

Spinal Disc Herniation

Definition
● The spine (spinal column) consists of back bones (vertebrae). There are
shock-absorbing disks between each of the vertebrae. The disks have a tough, outer
layer of fibrocartilage and a soft, jelly-like interior called the nucleus pulposus.
● A herniated disk occurs when the tough covering of a disk in the spine tears or
ruptures.
● The soft, jelly-like interior of the disk may then bulge out through the covering.
● A disk may herniate because of a sudden, traumatic injury or repeated minor injuries.
Being overweight or lifting heavy objects, particularly lifting incorrectly, increases the
risk.
Etiology

● Aging, injury and being overweight can cause a herniated disc. When a herniated
disc causes pain, it can be mild or debilitating.
● Sudden compression of a disc between the vertebrae above and below it can cause
a tear in the annulus fibrosus, causing pain.

Risk Factors

● Load weights improperly.

● Overweight.
● Repetitive activities that overload the spine.
● Sedentary lifestyle.

Classification

There are four stages:

1. disc protrusion
2. prolapsed disc
3. disc extrusion
4. sequestered disc.

Stages 1 and 2 are referred to as incomplete, where 3 and 4 are complete herniations. Pain
resulting from herniation may be combined with a radiculopathy, which means neurological
deficit.
Signs and symptoms:

Signs and symptoms depend on the location of the disc and whether the disc is pressing on
a nerve. Usually, herniated discs affect one side of the body.

The patient may present:

● Pain in arms or legs.

● Shoulder and arm pain.
● Numbness or tingling.
● Weakness.

Epidemiology

The prevalence of herniated disc is in the range of 1-3% of back pain. Currently available
epidemiological studies indicate that in industrialised countries about 20% of the adult
population suffers from some form of chronic pain. The most affected sex is male,
predominates between 40-50 years, and the most affected anatomical region is the lumbar
spine, preferably between the 4th and 5th lumbar vertebrae.

Diagnosis

There are multiple imaging studies used in the diagnosis of herniated disc. Among them, the
most used in recent years are: myelography, computerised axial tomography and magnetic
resonance. Magnetic resonance imaging has had a greater impact in the diagnosis of spinal
conditions, since it makes it possible to investigate the characteristics of the intervertebral
disc. When a herniated disc is asymptomatic, the clinician must carefully correlate symptoms
with MRI abnormalities before considering invasive procedures.

Treatment

We have pharmacological and non pharmacological treatment. Non pharmacological

treatment tries to modify activities in daily life to avoid movement that causes pain.

Pharmacological treatment include:

- Acetaminophen, ibuprofen or naproxen sodium if pain is mild to moderate.

- Neuropathic drugs affect nerve impulses to decrease pain. We can use gabapentin,
pregabalin and duloxetine.
- Muscle relaxers if there are muscle spasms.
- Opioids if pain is severe. We can use codeine and oxycodone-acetaminophen.

Doctors may suggest physical therapy to minimise pain.

Surgery is done if conservative treatments fail to improve symptoms in six weeks.

 Sciatica Pain

Definition
● Sciatica is the name given to pain caused by irritation of the sciatic nerve. Anything
that irritates this nerve can cause pain, ranging from mild to severe.
● Sciatica is a condition that can lead to pain in the back and legs. It occurs when pain
travels along the path of the sciatic nerve. This nerve starts in the lower spine, and
travels through the hip and buttock and down the back of the leg to the foot.
● There are a range of different causes of sciatica. In most cases, the condition gets
better over time, either on its own or with treatment.
Etiology

● Sciatica is caused by compression of the nerve root, usually by a herniated

intervertebral disc, bone irregularities. or, less commonly, an intraspinal tumours or
intraspinal abscess. Compression can occur within the spinal canal or intervertebral
foramen.

Risk Factors

● Age: Most people who suffer from sciatica are between the ages of 30 and 50.
● Weight: Extra kilos can put too much pressure on the spine, which means that obese
people and pregnant women are more prone to developing a herniated disc.
● Diabetes: can cause nerve damage.
● sedentary lifestyle

Classification

It is classified according to time into:

● Acute sciatica: the pain reaches below the knee and lasts approximately 6 weeks.
● Chronic sciatica: Lasts more than 6 weeks and extends beyond the knee or ankle
and foot

Signs and symptoms:

The symptoms of sciatica include:

● Moderate to severe pain in lower back, buttock and down your leg.
● Numbness or weakness in your lower back, buttock, leg or feet.
● Pain that worsens with movement; loss of movement.
● “Pins and needles” feeling in your legs, toes or feet.
● Loss of bowel and bladder control (due to cauda equina).

Epidemiology

The prevalence of sciatica is 2% of the population and it is estimated that up to 80% of the
population has suffered from low back pain at some point in their lives. It occurs in people
between 45-60 years, decreasing by 50% from the age of 60.
Diagnosis

● Clinical evaluation. Sometimes MRI, electrodiagnostic studies, or both

Sciatica is suspected based on the characteristics of the pain. In that case, strength,
reflexes, and sensation should be tested. Electrodiagnostic studies can confirm the presence
and degree of nerve root compression and exclude conditions that may mimic sciatica, such
as peroneal nerve palsy, multiple mononeuropathy, or polyneuropathy.

Treatment

As medications we can use anti-inflammatories, corticosteroids and opioids. Doctors may

suggest physical therapy, useful to correct posture and strengthen the core. Surgery should
be done just when sciatica causes severe weakness or loss of bowel or bladder control.