The average onset of the condition is at 40 years of age and it is the vertebrae in the lumbar spine that are most often affected. The cervical vertebrae are less frequently affected and the thoracic vertebrae only very rarely. The ratio is about 100 to 10 to 1.
A slipped or herniated disc is the most common reason for spinal column operations. Yet only a small proportion of herniated disc cases have to be treated surgically. Conservative therapy and patience usually lead to success.
With kybun you can integrate back training into your everyday life without expending additional time.
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- A slipped disc (herniated disc, disc prolapse) is a spinal column condition in which part of the intervertebral disc protrudes into the spinal canal – the space that holds the spinal cord. Unlike an intervertebral protrusion, the fibrous cartilage ring on the intervertebral disc (Anulus fibrosus) is partly or entirely torn with a prolapse, while the posterior longitudinal ligament (Ligamentum longitudinale posterius) can remain intact (known as a subligamentous herniated disc).
Excessive strain after previous damage to the intervertebral disc is often the cause. However, a herniated disc can also occur with no eternal cause. The symptoms of a herniated disc are severe pain that often radiates to the extremities, frequently with a feeling of numbness in the area supplied by the pinched nerve root, and occasionally also signs of paralysis. Conservative treatment is usually possible. Severe cases require surgical treatment.
- In medical terminology, nerve root compression syndrome describes the mechanical irritation of a nerve root in the area of the spinal column. The main symptoms are characteristic back pain (e.g. lumbosciatica) which radiates to the dermatome of the affected nerve root, a positive Lasègue’s sign with lumbar nerve root compression, possible flaccid paresis and weakened monosynaptic reflexes (proprioceptive muscle reflexes).
It is usually caused by sudden changes to the configuration of the spinal column, e.g. by a herniated disc (disc prolapse) or a more highly defined protruded disc (disc protrusion).
Herniated discs can have a range of causes, including genetic weakness, one-sided strain and a weakness of the paravertebral musculature, that is the muscles located next to the vertebra. It has, to date, not been possible to prove that damage to the intervertebral disc was caused exclusively by an accident or injury. Arguments to the contrary are only accepted by the professional unions and courts of social justice in very rare cases. The general opinion is that healthy intervertebral disc tissue, if at all, should tear away from the vertebral body together with a piece of bone. A herniated disc is also a common occurrence during pregnancy. The upright human gait is another factor that increases the risk of herniated intervertebral discs. Many people older than 90 years of age who led active working lives have never experienced problems with the spinal column or intervertebral discs. On the other hand, some people suffer a herniated disc even as children.
Possible causes for the rapid increase in herniated discs today include a lack of exercise and malpositions, especially among office workers. Some studies have shown that the risk of intervertebral disc changes is elevated in case of obesity according to the body mass index.
Herniated discs typically cause back pain that may or may not radiate to the legs (ischialgia) or arms (brachialgia). Depending on the severity of the symptoms, a feeling of numbness or a muscle failure in the area supplied by the pinched nerve root may also occur.
A herniated disc can lead to a positive Lasègue’s sign and Kernig’s sign. In extreme cases, transverse spinal cord syndrome may develop, which can lead e.g. to urinary or anal incontinence and saddle block anaesthesia.
If mobility is retained, returning to normal activities as quickly as possible is recommended. Bed rest is not advisable since it has not been proven to have any therapeutic effect.
Effective pain medication therapy should be carried out early on if mobility is lacking.
In patients suffering from back pain radiating to the legs, what is known as back training (physiotherapy instruction for everyday movements) can be helpful in case of chronic complaints.
Heat therapy, massages with movement therapy, electrotherapy and connective tissue massages can alleviate the complaints.
Both conservative treatment (e.g. physiotherapy, chiropractic) and the removal of the intervertebral disc section that is impinging the nerve root by means of an operation (which is less common) can successfully relieve pressure on the nerve root. What are known as minimally invasive procedures and microsurgery methods such as percutaneous laser disc decompression should be mentioned in this context as well. Even more rarely, neighbouring vertebral bodies are stiffened by adding metal material (spinal fusion/spondylodesis).
Periradicular therapy (PRT) is a procedure in which cortisone is injected at the affected nerve root under CT or X-ray monitoring.
After a herniated disc, strengthening the core, stabilising back musculature is of particular importance. This helps regain the lost stability and security, alleviates pain and can avert an impending operation.
Strengthening the back musculature and stabilising the spine
- The kybun shoe has a soft, elastic sole that does not limit foot movement but provides the freedom for unrestricted movement in all directions. Walking on the soft, elastic surface and the associated instability in the kybun shoe trains the musculature and straightens the body.
- The core, stabilising musculature of the spinal column is strengthened, which in turn serves to pull on the intervertebral discs. This relieves and simultaneously stabilises the back. The irritated nerve is relieved and can gradually regenerate. The feeling of numbness (toes going to sleep) should decrease over time.
- Activating the core, stabilising musculature also stimulates deep circulation and therefore promotes healing after an injury.
More upright posture and prevention of wear
- Sitting for long periods of time, especially with a poor posture, puts one-sided strain on muscles and the spine. Underused muscles get weaker and shorten over time. On the other hand, muscles under excessive one-sided strain respond by tensing up. This leads to neck, hip and back pain, and subsequently to further malpositions. This vicious circle can later lead to a herniated disc.
- Standing on the soft, elastic, springy mat of the kybun mat or walking in the kybun shoe relaxes, stretches and trains the muscles and helps the body assume a natural, upright posture. This releases tension and imbalances. The standing and posture muscles are strengthened in a targeted manner. Back pain can be relieved by switching between tensing and relaxing the muscles.
- A more upright posture puts the load on the intervertebral discs with proper axial alignment so they remain healthy.
Specific initial reactions with intervertebral disc problems/herniated discs:
If you are not yet accustomed to the kybun shoe/kybun mat and suffer from intervertebral disc problems in addition, the radiating pain may worsen slightly at first. In this case, it is important for this initial reaction to disappear again as quickly as possible since neurological pain is very unpleasant and we do not want to further stress the affected nerve. In this case, please observe the ‘Application tips’ below and seek advice from your kybun dealer if your condition does not change within a few days.
Click here for the general initial reactions experienced by kybun mat and kybun shoe beginners: Initial reactions
For information about the special kybun shoe exercises or the basic kybun mat exercises, please click here: kybun exercises
The following adaptations to the standard implementation of interval walking are important in case of a herniated disc :
- Focus on slow exercises
- Objective: Developing the core, stabilising musculature so that further improper strain on the already damaged intervertebral discs is prevented
- Keep performing fast exercises every now and again in order to avoid overexertion
If you experience back pain in the kybun shoe or on the kybun mat, or if your familiar back pain gets worse (e.g. radiating pain), this may be due to various reasons (e.g. tense muscles, movements that are unfamiliar for the back, increased pressure on the intervertebral disc).
We advise you to perform the kybun exercises regularly every now and again. They loosen the muscles and straighten the body. Strain on the back and especially the intervertebral discs is relieved. The radiating pain should decrease after just a few hours or days.
Choose a kybun shoe with the slightly wider second generation sole. It provides you with greater midfoot stability. Ask your kybun dealer to show you the various models.
If you feel unstable wearing the kybun shoe or are looking for an additional training device to use at home, the kybun mat is the ideal alternative. You can strengthen the foot, leg and back musculature at home on the soft, elastic springy mat. You can hold on to a fixed object if you feel unstable. The kybun mat is also available in a choice of different thicknesses (the thicker, the more intensive the training). Ask your local kybun dealer for advice.
If you get very fatigued in spite of the kybun exercises, or if you feel pain or in case of lateral/medial rolling of the ankle joint on the kybun sole, we advise you to take a short kybun shoe/kybun mat break until the symptoms go away.
Be sure to maintain an upright posture, avoid taking excessively long steps and keep your gaze forward (do not look at the floor). You should walk straight on the kybun shoe sole and correct any lateral/medial rolling of the ankle joint!
If the radiating pain or the feeling of numbness does not go away, seek advice from your kybun dealer.
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