Every year, more than 3 million Americans suffer from herniated discs. In Vietnam, according to a survey by the Hanoi Pain Relief Association in 2019, an estimated 12.75% of people have symptoms of low back pain (equivalent to 12.7 million people), of which 80% (about 9.6 million people) have herniated discs. Therefore, herniated discs are increasingly becoming a nightmare for the elderly.

1. What is a herniated disc?

Injury or a weakened disc can cause the disc to slip out of place. This condition is called a herniated disc. A herniated disc puts pressure on the spinal cord and nerves in the spinal canal, leading to pain and loss of sensation in the area.

Image of normal disc and herniated disc (Source: Internet)

Based on the severity, disc herniation is usually classified into four stages. With each stage, the severity of pain and the risk of nerve compression also increase. Below are the stages of disc herniation classified by Arseni et al. (1974):

Stage I: Early stage of disc degeneration

At this time, the annulus fibrosus and nucleus pulposus begin to have some small tears and become weaker than normal. The nucleus pulposus inside will press into this defect. At this stage, abnormalities can only be detected through disc imaging. There are no abnormalities on conventional films and clinical examination. Therefore, regular health check-ups are the best way to detect disc abnormalities.

Stage II: Disc herniation

The nucleus pulposus continues to press on the defect of the annulus fibrosus and bulges to one side. This creates a bulge and begins to compress the neural structures. At this time, various types of lesions have been detected on imaging methods. Clinically, this may be a period of localized low back pain.

Stage III: Herniated disc

At this stage, the annulus fibrosus is completely torn. At the same time, the nucleus pulposus escapes to form a herniated disc. Through the disc imaging, it can be seen that the herniated nucleus pulposus has or has not ruptured the posterior longitudinal ligament. At this time, the symptoms will become clear and severe, and can be divided into 3 levels:

+ Nerve root irritation

+ Root compression, partial nerve conduction

+ Loss of nerve conduction.

Stage IV: Disc – Spinal joint degeneration

The nucleus pulposus is deformed, fibrotic, the annulus fibrosus is broken, and there are severe cracks in many directions, leading to spinal stenosis and spinal joint damage due to severe reduction in the height of the vertebral cavity. Due to the lack of intervertebral discs, friction between the bones creates bone spurs. Clinically, it is often chronic recurrent low back pain. At the same time, accompanied by symptoms caused by compression that are easily severe

At this time, the pain almost never stops. The patient may have more pain when coughing, sneezing, or exercising vigorously. The disease can lead to many dangerous complications such as muscle atrophy, muscle disorders causing loss of control when urinating and defecating, loss of hot and cold sensation, and even loss of mobility.

Simulation of the 4 stages of disc herniation (Source: Internet)).

2. Causes of disc herniation

– Due to aging: over time, due to the effects of age, the disc gradually ages due to natural bone and joint degeneration. As age increases, the level of disc permeability decreases, leading to changes in the structure of the disc and spine, the fibrous ring begins to lose elasticity and weaken, causing mucus to accumulate, leading to the formation of a hernia. As the disc wears down, microscopic cracks or tears can form on the outer surface, creating an escape route for the gel-like interior.

– Due to trauma: Trauma is the second most common cause of disc herniation. The disc ruptures in a high-impact trauma, such as a car accident or fall. In particular, if the injury is not completely treated, the rate of herniation is much higher.

– Regularly working in the wrong posture, overworking, lifting heavy objects in the wrong posture or sitting, bending, turning in the wrong posture causes the spine to curve, worsening and changing the position of the disc and the outer fibrous capsule, causing disc herniation.

– Being overweight or obese causes increased weight, creating pressure on the disc and spine.

– Sedentary lifestyle: People who sit in one position for a long time or do little exercise make their musculoskeletal system less flexible and are very susceptible to disc herniation.

– In addition, if someone in the family has a disease of the spine or disc, the rate of disc herniation is also higher than normal.

3. Preventive measures for herniated disc

Here are some preventive measures to prevent herniated discs from becoming a concern in the elderly:

• Exercise: Regular exercise can strengthen the muscles around the spine, reducing the risk of disc herniation. Focus on core strengthening exercises, such as yoga, cycling, walking, etc. to increase joint flexibility.
• Maintain good posture to reduce pressure on the spine and discs. Keep your back straight when sitting for long periods of time. Use proper lifting techniques. When lifting heavy objects, use your legs instead of your back. Keep the object close to your body and avoid twisting your spine when lifting.
• Do not carry or lift heavy objects beyond your capacity. Choose the right posture when carrying and handling heavy objects
• Establish a scientific, healthy diet, stay away from harmful stimulants to improve the strength of the discs and the flexibility of bones and joints
• Maintain a healthy weight: Excess weight puts more pressure on the spine and discs, making them more susceptible to herniation.
• Regular health check-ups every 6 months to early detect and treat bone and joint diseases in general and disc diseases in particular.

4. Nutrition for people with herniated disc

Nutrition plays a significant role in the prevention and treatment of disc herniation. Therefore, the elderly should have a scientific, healthy diet, rich in nutrients that are good for bones and joints through the addition of foods rich in calcium, omega 3, vegetable protein, and fiber. Calcium is abundant in seafood, milk and dairy products. Omega 3 is abundant in fish oil and vegetable oils. Vegetable protein is high in beans. Fiber is found in fruits and green vegetables.

Elderly people need a nutritious meal with all the above groups of nutrients and limit foods rich in trans fat, salt, foods high in purines, and caffeine. In addition, patients can supplement with products and functional foods containing glucosamine. As mentioned in the article, Glucosamine – A powerful assistant for people with bone and joint diseases, glucosamine plays a role in protecting joints from damage or degeneration of cartilage, maintaining the flexibility and elasticity of joints as well as in protecting and regenerating damaged cartilage tissue due to aging, arthritis or trauma. 

In order to provide a good nutritional product for bones and joints, the Nutricare Medical Nutrition Institute –USA  (NMNI-USA) and Nutricare company have launched the Nutricare Bone products with added Glucosamine from the US to help increase the production of synovial fluid and cartilage cells to lubricate cartilage, increasing the flexibility and elasticity of joints. Nutricare Bone has an exceptionally high content (1800mg); Vitamin D3 increases calcium absorption in the intestines and Vitamin K2 allows the transport and increases the density of calcium attached to the skeleton, maximizing the body’s calcium utilization efficiency, supporting strong bones. Nutricare Bone also provides 50 essential nutrients including vegetable protein, Whey protein from the US to increase muscle mass for adults. According to the recommendations of NMNI-USA and Nutricare experts, daily use of 2-3 glasses of Nutricare Bone provides the body with essential nutrients for stronger bones.

Nutrition plays a significant role in preventing and treating herniated disc disease (Source: internet)

Above is an overview of the common herniated disc disease in the elderly. Hopefully, the article has provided you with useful information to effectively prevent herniated disc disease so as to maket it no longer a concern for the elderly.