الانزلاق الغضروفي

Definition

A herniated disc is when the soft inner part of an intervertebral disc bulges out and presses on a nerve root.

Commonest sites

Lumbar at L4–L5 and L5–S1, then cervical.

Causes

Age-related disc wear, poor lifting technique, sudden twisting and obesity.

Symptoms

• Low back pain radiating down the leg (sciatica)
• Numbness and tingling along the nerve
• Muscle weakness and reflex changes
• Worse with coughing, sneezing and long sitting

Examination

Positive straight leg raise test.

Diagnosis

MRI when there are red flags or no improvement.

Treatment

• Most improve within 6 weeks with conservative care
• Analgesia and NSAIDs, physiotherapy, gentle activity rather than bed rest
• Epidural injections
• Surgery for progressive weakness or persistent pain

Nursing care

• Teach safe lifting: bend the knees, keep the back straight
• Strengthen abdominal and back muscles

Exam point

Urinary retention or incontinence with saddle numbness means cauda equina syndrome, needing urgent MRI and surgery.