PATHOGENESIS
HNP or herniation of intervertebral discs, which are often referred to as the Lumbar Disc Syndrome or lumbosacral radiculopathies is a common cause of lower back pain acute, chronic or recurrent. Protrusion, rupture, shifting is a term used in the disc nucleus which is pushed out. If the nucleus under pressure, while the nucleus is between two endplate of the vertebral body is confronted and surrounded by the annulus fibrosus pressure causes the nucleus pushed out, called the nucleus pulposus hernia.
Disc herniation may occur in the midline, but more often occurs on one side. Complaints of pain can be unilateral, bilateral or bilateral but more weight to one side. The cause is often due to trauma flexion, and especially repeated trauma to the posterior longitudinal ligament and annulus fibrosus which has undergone a process of degeneration. Sciatica, which is characterized by pain radiating to the leg according to the distribution of the affected nerve dermatof, is a symptom that usually occurs and is found in 40% of patients with HNP.
ETIOLOGY
Herniated nucleus pulposus can be caused by the following:
• Degeneration of intervertebral discs
• minor trauma in older patients with degeneration
• severe trauma or fall
• Lifting or pulling heavy objects
RISK FACTORS
Risk factors that can not be changed:
1. Age: age of increasingly higher risk
2. Gender: men more than women
3. A history of previous back injury or HNP
Risk factors that can be changed:
1. Work and activities: prolonged sitting, lifting or pulling heavy items, often bending or twisting motion on the back, strenuous physical exercise, exposure to constant vibration as a driver.
2. Irregular exercise, start exercising after a long practice, practice
the weight in the long term.
3. Smoking. Nicotine and other toxins can interfere with the ability of
discs to absorb the necessary nutrients from the blood.
4. Excessive weight, especially extra weight in the stomach area can
cause strain on the lower back.
5. Long and repetitive cough
