What are the most effective treatments for a herniated disc. How can you manage herniated disc pain at home. When should you seek medical attention for a slipped disc. What are the surgical options for severe herniated discs. How can you prevent future disc herniations.

Understanding Herniated Discs: Causes, Symptoms, and Diagnosis

A herniated disc, also known as a slipped or prolapsed disc, occurs when the soft cushion of tissue between the bones in your spine pushes out. This condition can cause significant pain and discomfort, especially if it presses on nearby nerves. But what exactly causes a herniated disc?

• Aging
• Excessive or improper exercise
• Incorrect lifting of heavy objects
• Vibration from driving or operating machinery
• Inactivity or being overweight

Recognizing the symptoms of a herniated disc is crucial for early intervention and effective treatment. Common signs include:

• Lower back pain
• Numbness or tingling in shoulders, back, arms, hands, legs, or feet
• Neck pain
• Difficulty bending or straightening the back
• Muscle weakness
• Pain in the buttocks, hips, or legs (sciatica)

How is a herniated disc diagnosed? General practitioners can often identify a slipped disc based on symptoms and a physical examination. They may ask you to perform simple movements to locate the affected area. In some cases, further tests like an MRI scan might be recommended for a more detailed assessment.

Conservative Treatment Approaches for Herniated Discs

For most people with herniated discs, conservative treatments can provide significant relief. These approaches focus on managing pain and promoting natural healing. What are some effective conservative treatments?

Rest and Activity Modification

While complete bed rest is no longer recommended, short periods of rest combined with gradual increases in activity can be beneficial. How should you approach activity with a herniated disc?

• Start with gentle exercises and gradually increase intensity
• Focus on low-impact activities that don’t exacerbate pain
• Listen to your body and avoid movements that cause sharp pain

Pain Management Medications

Over-the-counter and prescription medications can help manage pain associated with herniated discs. Which medications are commonly used?

• Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen
• Acetaminophen (paracetamol)
• Muscle relaxants
• Short-term use of stronger painkillers containing codeine (under medical supervision)

It’s important to alternate between different types of painkillers and take them regularly rather than waiting for severe pain to occur. This approach can help maintain mobility and facilitate recovery.

Physical Therapy and Exercise

Physical therapy plays a crucial role in herniated disc recovery. A skilled physiotherapist can design a personalized exercise program to strengthen the back muscles, improve flexibility, and promote proper posture. What types of exercises might be included in a physical therapy program for herniated discs?

• Core strengthening exercises
• Gentle stretching routines
• Low-impact aerobic activities
• Posture improvement exercises

Advanced Treatment Options for Persistent Herniated Disc Pain

When conservative treatments fail to provide adequate relief, more advanced interventions may be considered. What are some of these options?

Epidural Steroid Injections

Epidural steroid injections can provide targeted relief for herniated disc pain. How do these injections work?

The procedure involves injecting a corticosteroid medication directly into the space around the spinal cord (epidural space). This can help reduce inflammation and alleviate pain. While not a permanent solution, these injections can provide significant short-term relief and allow patients to engage more effectively in physical therapy.

Surgical Interventions

Surgery is typically considered a last resort for herniated disc treatment. When might surgery be recommended?

• Persistent pain that doesn’t respond to conservative treatments
• Progressive muscle weakness
• Numbness or loss of function in extremities
• Loss of bladder or bowel control

What are the common surgical procedures for herniated discs?

1. Microdiscectomy: Removal of the herniated portion of the disc
2. Laminectomy: Removal of a portion of the vertebral bone to relieve pressure on nerves
3. Artificial disc replacement: Replacing the damaged disc with an artificial one

Alternative and Complementary Therapies for Herniated Discs

Many individuals find relief through alternative and complementary therapies. While scientific evidence varies, some people report benefits from these approaches. What are some popular alternative treatments for herniated discs?

Chiropractic Care

Chiropractic adjustments aim to improve spinal alignment and reduce pressure on affected nerves. Some patients report significant pain relief and improved mobility following chiropractic treatment.

Acupuncture

This traditional Chinese medicine technique involves inserting thin needles into specific points on the body. Some studies suggest acupuncture may help reduce pain and improve function in people with herniated discs.

Massage Therapy

Gentle massage can help relax tense muscles, improve circulation, and promote overall relaxation. While it may not directly address the herniated disc, massage can be a valuable component of a comprehensive pain management strategy.

Lifestyle Modifications and Prevention Strategies for Herniated Discs

Preventing future disc herniations is crucial for long-term spinal health. What lifestyle changes can help protect your spine?

• Maintain a healthy weight to reduce stress on your spine
• Practice proper lifting techniques, using your legs instead of your back
• Incorporate regular, low-impact exercise into your routine
• Improve your posture, especially if you have a sedentary job
• Quit smoking, as it can contribute to disc degeneration
• Stay hydrated to maintain disc health

When to Seek Immediate Medical Attention for Herniated Disc Symptoms

While most herniated disc symptoms can be managed at home or with outpatient care, certain signs warrant immediate medical attention. When should you seek emergency care for a suspected herniated disc?

• Sudden, severe back pain following an accident or injury
• Loss of bowel or bladder control
• Progressive weakness or numbness in the legs
• Unexplained fever accompanying back pain
• Sudden weight loss in conjunction with back pain

These symptoms could indicate a more serious condition or complication related to your herniated disc. Prompt medical evaluation can help prevent potential long-term complications and ensure appropriate treatment.

The Role of Emerging Technologies in Herniated Disc Treatment

As medical science advances, new technologies are being developed to treat herniated discs more effectively and with less invasive methods. What are some promising innovations in herniated disc treatment?

Regenerative Medicine

Stem cell therapy and platelet-rich plasma (PRP) injections are being studied for their potential to promote disc healing and regeneration. While still in the experimental stages, early results show promise for certain patients.

Minimally Invasive Surgical Techniques

Endoscopic discectomy and percutaneous disc decompression are examples of minimally invasive procedures that aim to provide relief with smaller incisions and faster recovery times compared to traditional open surgery.

Artificial Disc Technology

Advancements in artificial disc design and materials are making disc replacement surgery an increasingly viable option for some patients, potentially offering better long-term outcomes than spinal fusion.

As research continues, these and other emerging technologies may offer new hope for individuals struggling with persistent herniated disc pain.

Slipped disc – NHS

A slipped disc is when a soft cushion of tissue between the bones in your spine pushes out. It’s painful if it presses on nerves. It usually gets better slowly with rest, gentle exercise and painkillers.

Check if it’s a slipped disc

A slipped disc (also called a prolapsed or herniated disc) can cause:

• lower back pain
• numbness or tingling in your shoulders, back, arms, hands, legs or feet
• neck pain
• problems bending or straightening your back
• muscle weakness
• pain in the buttocks, hips or legs if the disc is pressing on the sciatic nerve (sciatica)

Not all slipped discs cause symptoms. Many people will never know they have slipped a disc.

Other causes of back pain

Sometimes the pain may be a result of an injury such as a sprain or strain, but often there’s no obvious reason.

Back pain is rarely caused by anything serious.

How you can ease the pain from a slipped disc yourself

Keep active

If the pain is very bad, you may need to rest at first. But start gentle exercise as soon as you can – it’ll help you get better faster.

The type of exercise is not important, just gradually increase your activity level.

Take painkillers

Alternate painkillers such as ibuprofen and paracetamol. Paracetamol on its own is not recommended for back pain.

Take them regularly (up to the recommended daily amount) rather than just when the pain is particularly bad. This will help you to keep moving.

A pharmacist can help with a slipped disc

Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are not suitable for everyone. Speak to a pharmacist if you’re not sure.

Stronger painkillers containing codeine may help for pain that’s just started.

But these types of painkillers can cause addiction and should only be used for a few days.

Non-urgent advice: See a GP if you have back pain and:

• painkillers are not helping
• the pain is no better after a month
• a very high temperature or you feel hot and shivery
• unexplained weight loss
• a swelling in your back
• the pain is worse at night

Immediate action required: Call 999 or go to A&E if you have back pain and:

• numbness around your bottom or genitals
• cannot pee
• lose feeling in 1 or both legs
• cannot control when you pee or poo
• got it after a serious accident, such as a car accident

What happens at your appointment

Your GP will usually be able to tell if you have a slipped disc from your symptoms.

You may also have a physical examination. Your GP might ask you to raise your arms or do simple leg exercises to find out where the slipped disc is.

Treatment for a slipped disc from a GP

A GP might prescribe a stronger painkiller, a steroid injection or a muscle relaxant to use in the short term.

If your symptoms do not get better, a GP might recommend further tests, like an MRI scan.

They might also refer you to a physiotherapist. Physiotherapy from the NHS might not be available everywhere and waiting times can be long. You can also get it privately.

Surgery for a slipped disc

Surgery is not usually needed, but a GP might refer to you a specialist to discuss surgery if your symptoms:

• have not improved using other treatments
• include worsening muscle weakness, or numbness

Alternative treatments for a slipped disc

There’s some evidence that manual therapies, like osteopathy, can help ease lower back pain.

You’ll usually have to pay for this treatment privately.

What causes a slipped disc

They can happen because of:

• ageing
• exercising too hard
• lifting heavy objects the wrong way
• vibration from driving or operating machinery
• being inactive or overweight

To help prevent a slipped disc

Page last reviewed: 22 March 2021
Next review due: 22 March 2024

Herniated Disk Treatment, Remedies, & Medications

Written by WebMD Editorial Contributors

• Rest
• Medications
• Physical Therapy
• Injections
• Surgery
• Protect Your Spine
• More

A herniated disk can press on the nerves in your spine and cause pain, weakness, and numbness in your neck, back, arms, and legs. Sometimes these symptoms can be severe enough to disrupt your life.

Most of the time, though, the problems from your herniated disk should start to improve on their own within a few weeks. In the meantime, try one or more of these treatments to help you feel better.

Take it easy for a few days. Rest can relieve swelling and give your back time to heal. While your back hurts, avoid exercise and other activities where you have to bend or lift.

Your doctor might suggest that you rest in bed. Bed rest is fine for a short period of time, but don’t stay off your feet for longer than 1 or 2 days. You need to keep moving so your joints and muscles don’t stiffen up.

You can also use ice and heat to help relieve your pain. Just place an ice pack or warm wet towel on the area of your back that is sore. You can alternate hot and cold, or use whichever feels best.

Take an over-the-counter pain medicine like ibuprofen (Motrin, Advil) or naproxen (Aleve, Naprosyn). These medicines can help relieve your pain and bring down swelling.

Just don’t use these for more than 10 days without talking to your doctor. When used in large amounts or for a long time, nonsteroidal anti-inflammatory drugs (NSAIDs) can increase your risk for heart problems or bleeding.

Narcotics such as codeine or oxycodone-acetaminophen (Percocet) are also short-term options that your doctor may prescribe if over-the-counter meds don’t work.

Your doctor might also prescribe muscle relaxants to ease muscle spasms in your back. And nerve pain medicines, such as amitriptyline (Elavil, Vanatrip), duloxetine (Cymbalta), gabapentin (Neurontin), pregabalin (Lyrica), and tramadol (Ultram) are options to ease nerve-damage pain.

Some exercises can help improve the symptoms of a herniated disk. A physical therapist can teach you which ones strengthen the muscles that support your back. Physical therapy programs also include:

• Stretching exercises to keep your muscles flexible
• Aerobic exercises — such as walking or riding a stationary bicycle
• Massage
• Ice and heat
• Ultrasound therapy
• Electrical muscle stimulation

If rest, pain relievers, and physical therapy don’t help with your pain, your doctor can inject a steroid medicine into the space around your spinal nerve. This is called an epidural injection. The steroid can help bring down the swelling, help you move more easily, and ease pain from a herniated disk.

Your doctor will use an X-ray or CT scan to find the right spot to inject the medicine. You might need more than one steroid shot to relieve your pain.

Most people with a herniated disk don’t need surgery. Rest and other treatments should start to improve your symptoms within 4 to 6 weeks. But if your pain doesn’t improve, surgery might be an option.

Talk to your doctor about surgery if:

• You’re not getting relief from pain relievers, injections, and physical therapy.
• Your symptoms keep getting worse.
• You have trouble standing or walking.
• You can’t control your bowels or bladder.

Discectomy. During this procedure, your surgeon removes your damaged disk to relieve pressure on your nerves. They can perform the surgery in a couple of ways:

• Your surgeon performs open discectomy via a cut in your back or neck.
• Microdiscectomy is done through a much smaller incision. Your surgeon inserts a thin tube with a camera on one end to see and remove the damaged disk.

Lumbar laminotomy. Sometimes your surgeon will also need to remove a small piece of bone called the lamina from the vertebra. The lamina forms a protective cover over your spinal cord. Removing part or all of it helps the surgeon access your herniated disk. It also can relieve pressure on your nerves and eliminate leg pain and sciatica.

The lamina can be removed during the discectomy. Or, you might have it taken out in a separate surgery.

Spinal fusion. After a discectomy or laminotomy, your surgeon may fuse together the two vertebrae on either side of the disk to stabilize your spine. This is called spinal fusion. Fusing the two disks will stop the bones from moving and prevent you from having any more pain.

Artificial disk surgery. Only a few people are good candidates for artificial disk surgery because it only works on certain disks in your lower back. But if your doctor thinks this is an option, they will replace your damaged disk with one made of plastic or metal. The new disk will help keep your spine stable and let you move more easily.

Most herniated disks get better on their own or with treatment. But they can happen again.

To protect your spine and prevent another herniated disk, you should always sit and stand up straight. If you have to stand for a long period of time, rest one foot on a stool or box to take pressure off your back.

Be careful when you lift anything heavy. Squat from your knees to pick it up. Don’t bend from the waist. It puts too much pressure on your back.

Stay at a good weight for you. Extra pounds put more strain on your back.

Don’t smoke. It can cause hardening of the arteries, which can damage the disks in your spine.

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Why does the clutch slip? Causes and remedies.

– Ixora

CLUTCH KIT

Why does the car clutch slip – kitaec.

ua blog

In the article:

• How to determine the presence of slip
• Why slip occurs and how to deal with it

The link between the car engine and the gearbox is the clutch. Its task is to transmit torque from the flywheel mounted on the crankshaft to the gearbox input shaft. Further, through the transmission, the rotation is transmitted to the wheels.

This node is subject to very significant loads, especially in urban areas, where you have to shift gears and engage the clutch every now and then. Not surprisingly, over time, its parts wear out, and the clutch begins to act up. The most common problem that motorists have to face is slipping. As a rule, it occurs gradually, imperceptibly at first, but then more and more clearly affecting the behavior of the car.

To understand what it is and why it occurs, you need at least a general idea of ​​​​the device and the principle of operation of the clutch.

How the clutch works and works

The main elements of this assembly are the driven disk, the drive (pressure) disk, the diaphragm spring, the clutch with the release bearing, the release fork and the drive. Also, a massive flywheel mounted on the crankshaft shank is directly involved in the operation of the clutch, which, as you know, is driven directly by the engine using a crank mechanism.

The driven disk has heat-resistant and wear-resistant friction linings. For their manufacture, special mixtures of resins and rubber are used with the addition of pieces of copper or brass wire, fiberglass, ceramics and other materials. The pads are attached to the disc with rivets or glue. It is this part that is subjected to the greatest loads in the process of operation and, as a rule, the first to fail. The driven disk is most often one, but there may be two or more.

The diaphragm spring is usually structurally integral with the drive disc, and this part is often called the basket. The spring has petals that tightly press the driven disk to the flywheel. In some designs, instead of one diaphragm spring, there may be several helical springs arranged in a circle.

Due to the force of friction, the driven disk rotates with the flywheel. And since the disc is splined to the input shaft of the gearbox, the torque is transmitted from the crankshaft to the gearbox. When in gear, the input shaft transmits rotation to the secondary shaft, and through it to the transmission, which ultimately makes the wheels spin.

The release drive can be mechanical, hydraulic or pneumatic and is controlled by the clutch pedal. Hydraulics allow smoother control of engagement and disengagement of the clutch on passenger cars. And pneumatics is used only on trucks. When the pedal is not pressed, the clutch is engaged, the driven disk is firmly pressed against the flywheel by the pressure disk.

The depressed pedal acts on the drive, the main element of which in the mechanical version is a metal cable. When the cable is pulled, the clutch release fork turns on its axis and presses on the release bearing (disengagement clutch).

The bearing is mounted on the input shaft of the gearbox and can move along its axis. Under the influence of the release fork, the release bearing flexes the spring diaphragm in the center, causing its petals to loosen the pressure along the edges. As a result, the driven disk moves away from the flywheel and free space appears between them. The transmission of torque at the gearbox is stopped. Now you can shift gears without the risk of damaging the gears of the mechanism.

If the drive uses hydraulics, a pusher is connected to the pedal by means of an articulation, which presses on the piston of the clutch master cylinder. The main cylinder pumps the working fluid through the pipeline to the working cylinder, and the latter directly acts on the shutdown fork.

How to determine the presence of slip

When the clutch slips, this is primarily manifested by a serious loss of power, which is especially noticeable on an uphill slope. Accelerating dynamics also suffer. When driving in low gears, the car may twitch.

While the problem has not yet become apparent, it may seem that the power unit is not pulling. Gradually, however, symptoms begin to appear that directly indicate adhesion. One of them is the smell that occurs due to the intense friction of the friction layer of the clutch disc on the surface of the flywheel. The smell resembles burnt rubber and is felt in the cabin.

A common sign of slippage is difficult gear shifting and a crunch when shifting gears. It’s getting harder and harder to get moving.

In addition, clunking, grinding or other extraneous sounds indicate clutch problems, especially if they differ when the pedal is depressed and released. Vibration is sometimes observed, the pedal may be pressed hard or, conversely, fail, and its free play may increase.

It also happens that when the clutch pedal is pressed, the discs do not completely diverge, remaining in some contact. In this case, we speak of incomplete disengagement of the clutch. You can check this as follows. With the engine running at low speeds, depress the pedal all the way and try to engage first gear. The presence of problems will be indicated by difficult inclusion and extraneous sounds.

Why slip occurs and how to deal with it

Sooner or later, any clutch begins to slip. The inevitability of this problem is determined by the very principle of operation of this device. At the moment the fixed driven disk comes into contact with the surface of the rotating flywheel, a very significant friction occurs. As a result, the friction coating gradually wears out, wears out, and becomes thinner. At some point, the contact becomes not tight enough, and the driven disk begins to slip relative to the flywheel. This is what slippage is.

Although the clutch disc can rightly be attributed to consumables, you can still extend its life somewhat if you follow some rules. For example, the bad habit of some drivers, who, starting from a standstill, accelerate strongly and at the same time sharply release the clutch pedal, accelerates the wear of the clutch.

No less detrimental to the clutch fast driving in low gears. In both cases, the driven disk slips for a while and erases unnecessarily.

Another habit is to keep the clutch pedal depressed at a traffic light or in a traffic jam – although it does not spoil the disc, it contributes to the wear of the spring and release bearing. Getting rid of these bad habits will increase the life of the device and save money.

The correct way to start moving is to gently release the clutch pedal and only then gradually start to put pressure on the gas. And it is better to press the clutch, on the contrary, sharply.

Another possible cause of slipping could be grease getting on the clutch disc or flywheel. This sometimes happens if the crankshaft oil seal is worn out. In this case, you can wash the mating surfaces of the flywheel and the driven disk with a suitable agent, such as kerosene. After that, the friction linings should be lightly cleaned with fine sandpaper.

If the clutch has already begun to slip, but there is still some margin of the friction layer (more than 0.2 mm), you can try to adjust the pedal free play. The corresponding procedure is usually described in the vehicle repair and maintenance manual. Often this operation allows you to delay the repair of this unit.

If the pads are worn almost to the rivets, then you should not delay replacing the disc. When the level of the friction linings is equal to the rivets, they will begin to rub against the surface of the flywheel, scratching it. As a result, the flywheel may need to be replaced.

Wear on other parts of the clutch – release bearing, diaphragm spring, release fork – can also lead to slip. Their service life is comparable to the disk resource. Therefore, if one of the parts needs to be replaced, and the clutch as a whole has passed about 70 … 100 thousand kilometers without repair, then it is better to replace the entire assembly. This will save time, effort and finances. You can buy spare parts for clutch at reasonable prices in the Chinese online store.

And another culprit for slipping may be the clutch drive. The reasons may vary depending on the type of drive. This may be, for example, a damaged lever, a broken or jammed cable. If the drive is hydraulic, it is necessary to check the entire system for leakage of the working fluid or pump it, removing air from it.