The vertebral column (spine), together with sternum and ribs, constitutes the skeleton of the trunk of the body. The vertebral column makes up about two-fifths of the total height of the body and is composed of a series of bones called vertebrae.
The adult vertebral column typically contains 26 vertebrae. These are distributed as: 7 cervial vertebrae (in the neck region); 12 thorasic vertebrae (chest region); 5 lumbar vertebrae (supporting the lower back); 5 sacral vertebrae (fused together into one bone called sacrum); and usually 4 coccygeal vertebrae (fused into one or two bones called coccyx). Prior to the fusion of the sacral and coccygeal vertebrae, the total number of vertebrae is 33.
Between adjacent vertebrae from the first vertebra to the sacrum are fibrocartilaginous intervertebral discs. Each disc is composed of an outer fibrous ring consisting of fibrocartilage, called the annulus fibrosus and an inner soft, pulpy, highly elastic structure, called nucleus pulposus. The discs form strong joints, permit various movements of the vertebral column and absorb vertebral shock.
The intervertebral discs are subject to compressional forces while performing the function of shock absorbers. The discs between the fourth and fifth lumbar vertebrae and between the fifth lumbar vertebra and sacrum usually are subject to more forces than other discs. If the anterior and posterior ligaments of the discs become injured or weakened, the pressure developed in the nucleus pulposus may be great enough to rupture the surrounding fibro-cartilage. If this happens, the nucleus pulposus may protrude (herniate) posteriorly or into one of the adjacent vertebral bodies. This state is called herniated disc or slipped disc.
Most often the nucleus pulposus slips posteriorly towards the spinal cord and spinal nerve. This movement exerts pressure on the spinal nerves, causing considerable, sometimes very acute, pain. When intra-abdominal pressure is increased by coughing, sneezing or other movement, symptoms are aggravated, and cervical muscle spasm may often occur. Neurologic abnormalities may include decreased reflexes of the deep tendons of the biceps and triceps and decreased sensation and muscle atrophy or weakness in the forearm or hand.
Preksha — Yoga management
Initially the patients should be made immobilized without any delay on a hard bed. For fast recovery and healing complete bed rest is compulsory for a few days. Complete immobilization of spine is the safest and quickest route of healing and recovery. The duration of immobilization required depends upon the degree of injury. In the later stage preksha-yoga therapy should be applied, which promotes the recovery.
Shat kriyas – Jal neti
Yogic exercises – Of the spine (without any undue pressure)
Asanas – Mostly backward bending asanas — Makarasana; Sleeping in Advasana and Jyesti Asana — in the initial stage
In the later stage — Uttanpadasana, Pawanmuktasana, Shalbhasana, Bhujangasana and Suptavajrasana
Pranayam – Anulom-Vilom and Nadi shodhan
Kayotsarga – 45 minutes — thrice a day
Preksha – Perception of whole vertebral column
Anupreksha – Contemplation for correction of the injured disc
Dietary recommendations
• In the begining semiliquid diet should be taken
• Khicheri and vegetable soup should be taken in the meals. Thereafter rice, pulses, boiled vegetables and wholemeal bread may be taken as the condition improves
• Spices and non-vegetarion food items should not be taken.