A herniated disc, also known as a prolapsed, ruptured or slipped disc happens when the inner fluid leaks out through a rip or tear in the disc’s outer layer of cartilage. Your spine is made up of 36 bones. Together they are called the vertebrae. In between each vertebra is a soft disc filled with a jelly-like substance. These discs separate the vertebrae, cushioning the bones and keeping them in place. As you age, the discs break down, losing water and their ability to function as good shock absorbers. Since the spinal column contains the spinal cord and other nerve roots, a disc herniation will put pressure on the spinal nerves. These nerves are very sensitive to even the slightest pressure. Although the inner gel-like fluid of the disc is soft, when it’s leaked into the spinal column can result in pain, numbness, and weakness in one or both legs.
There are two types of disc herniations: disc protrusions and disc extrusions. Protrusions happen when the amount of disc material that is outside its normal disc space doesn’t equal the amount remaining between the vertebrae. Extrusions are the reverse; the amount of displaced material is greater than of the parent disc.
What Causes a Herniated Disc?
The most frequent “cause” of a herniated disc is the inevitable degeneration of intervertebral discs. As we age, the water content in our discs decreases, making them less flexible and more prone to tear or rupture.
- Improper lifting, whether it’s twisting and turning while lifting or using your back muscles to lift heavy objects, can cause a herniated disc.
- Smoking dehydrates all the cartilage of the body; excessive body weight puts excess pressure on the spine, and repetitive strenuous activities wear down the spinal discs.
- Rarely traumatic events like falls or accidents can cause a herniated disc.
Symptoms of a Herniated Disc
When the disc herniation is in the lower back, the most frequent symptom of a herniated disc is sciatica— a shooting pain extending from the buttocks and down the back of one leg. The pain is created by the disc’s leaked fluid putting pressure on the spinal nerve. Other symptoms are a weakness in one leg, a tingling in one leg or buttock, a loss of bladder or bowel control, and a burning pain centered in the neck.
When there is pressure on a nerve in the neck, it causes pain in the muscles between your neck and shoulder (trapezius muscles) and possibly shooting down the arm. Headaches in the back of the head, weakness in one arm, loss of bladder/bowel control, and burning pain in the shoulders, neck, or arm.
Treating a Herniated Disc
To diagnose your herniated disc, your doctor will ask you about your complete medical history. A physical exam will help them determine which nerve roots are under duress (and with what severity). They will check your spine and neck motion, muscle strength, painful areas, sensory changes, reflex changes, motor skills, and certain red flags that could indicate something other than a spinal problem. Diagnostic imaging tests such as X-Rays and MRI’s provide useful images for the physician to diagnose effectively.
Nonsurgical treatments are effective in more than 90% of patients who suffer from symptoms caused by a herniated disc. There are manageable steps you can take that help you resolve your neck or back pain gradually. Rest and over-the-counter pain medicines are sometimes all that is needed. Muscle relaxers, anti-inflammatories, and analgesics are also helpful. A cold compress or some ice can be applied several times per day, but not for longer than 20 minutes. After spasms settle down, you may apply a gentle around of heat to the area. Physical activity needs to be slower and more controlled, especially when bending and lifting. Taking short walks and avoiding sitting for long periods also help to fend off symptoms. The back and abdominal muscles can better support your spine if they are continually strengthened and maintained. Learn how to stand properly, sit and lift. Make sure you are getting regular exercise. If nonsurgical treatments fail, epidural injections may lessen nerve irritation and help you participate more efficiently in physical therapy.
If a disk fragment lodges in the spinal canal and presses on a nerve that causes significant loss of function, surgical options such as microdiskectomy or laminectomy can help, depending on the size and position of the disk herniation.
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