Disc Herniation

The human backbone or spine is made up of 26 bones, known as vertebrae. The spaces between the bones contain soft disks filled with jelly-like substance. These disks support the vertebrae and keep in place. A herniated disk is a disk that slips out of its usual place or gets ruptured. A herniated disk can disturb the adjoining nerves and result in severe pain or numbness in the arm or leg. In maximum cases, surgeries are not required.

What is Herniated Disc?

The spinal disc can rupture when it becomes less elastic. A spinal disc is a soft cushion that rests between each vertebrae of the spine. When the disc gets ruptured, a portion of it gets pushed out of its normal boundary. This condition is known as a ‘Herniated disc’. If the Herniated disc bulges out from between the vertebrae, the spinal nerves and spinal cord can get pressed.

Symptoms of Herniated Disc

When the spinal nerves and spinal discs get compressed, abnormal signals may get passed from the compressed nerves. In some cases, signals may not get passed at all. Some of the common symptoms of a herniated disc are:

Picture of Disc Herniation

Picture 1 – Disc Herniation

Muscle Weakness

Due to nerve irritation, signals from the brain get interrupted. This can lead to muscular weakness. Nerve irritation can be tested by conducting an examination of reflexes.

Electric Shock Pain

Pressure on the nerve can lead to abnormal sensations which can cause pains similar to electric shock. When the compression occurs in the neck, the shock passes down the arms. When the compression occurs in the lumbar or low back region, the shock goes down the legs.

Tingling and Numbness

Sometimes, patients experience sensations like tingling, pins, needles and numbness. These are felt in the same region where painful electric shocks are experienced.

Bowel or Bladder Problems

Patients may have urinating problems, abnormal bowel movements or a feeling of numbness around the genitals. This is a sign of Cauda Equina Syndrome – a condition which is regarded as a medical emergency and requires immediate treatment.

When a disc is herniated , it presses against the nerves.   The above symptoms are caused due to irritation of nerves from the pressure exerted by herniated disc.

Disc Herniation Causes

The problem can occur due to various causes, like:

Disc degeneration

Disk herniation is generally the result of gradual wear and tear of the disc, known as Disc degeneration. As the body grows old, the spinal discs lose some of their fluid content which helps maintain their flexibility. This increases its susceptibility to suffering a rupture even due to a minor strain or twist.

Trauma

A herniated disc may also be caused due to trauma, or injuries, suffered by the spine which may cause cracks in it or minor injuries in the outer layer of its discs. The jelly-like substance from between the discs may be forced out of the cracks or ruptures which might cause the disc to bulge, break open or get ruptured into fragments.

In some cases, using the back muscles (instead of the muscles of the leg and thigh) to lift and carry large and heavy objects may result in herniated disc. Twisting and turning during lifting may also result in this problem.

In rare cases, a person might experience this condition on getting hit or due to suffering a fall.

Injurious activities for the Spine

Other reasons, which can cause injury to the spine, may also give rise to this problem. These include activities that are done over and over again might stress the lower portion of the back. This might include poor lifting habits, or sports related injuries and prolonged exposure to vibration.

Sometimes, a sudden heavy pressure or twist or even a sneeze can force out some of the nucleus material inside through the outer layer of the disc (known as the annulus or capsule).

Disc herniation Treatment

The primary goal of the treatment of herniated disc is to relieve patients of the discomforting symptoms. To achieve this, patients should be diagnosed on the basis of factors like:

  • Activity level
  • Age
  • Symptoms experienced
  • Whether or not the symptoms have worsened
  • Source and severity of pain

Treatment usually begins after all such factors have been taken into consideration. Medical cure involves:

  • Application of ice and heat, which is very helpful in relieving the symptoms of disc herniation. It helps to relax the muscles of the back. It releases the muscle spasms and provides huge relief from pain.
  • Avoiding activities that aggravate the symptoms of herniation. This is a must. Doing this resolves the condition in time.
  • Physical therapies, such as lumbar stabilization exercises, do not affect the herniated discs. However, they help relax the lumbar muscles. Due to this reason, the discs do not experience great pressure. Strong and well balanced muscles help control the lumbar spine and reduce the risk or injury to the nerves or discs.
  • Non-inflammatory non-steroidal medications are often prescribed to patients to reduce the pain of disc herniation. These medications reduce the inflammation and release the pressure around the nerves.
  • Oral medications, which are also helpful in cases of chronic herniation. These are also powerful anti-inflammatory medications used to relieve the pressure around the nerves and reduce inflammation. Prednisone and Medrol are two commonly prescribed drugs.
  • Narcotic pain medications and muscle relaxers. Narcotic pain relievers are prescribed for short term pain management and in cases of severe pain. Muscle relaxers are used to treat spasms in spinal muscles.
  • Epidural Steroid Injections or injections of cortisone which are directly administered to the area of nerve compression. These relieve the compression around the nerves.

Surgical Treatments for Disc Herniation

Surgical treatment may be necessary if patients experience progressive weakness in the arms or legs due to nerve root pinching form the herniated disc. An early surgery stops neurological progression of the condition and creates a healing environment for the nerves to recover. In these cases, nerve loss can occur without surgical intervention. In some cases, the loss may be a permanent one. Symptoms like pain and sensory abnormalities might not require surgery.

Surgery Options

The surgery options available for disc herniation are:

Laminectomy

It is done to relieve the pressure on the spinal cord or nerve roots which is mostly caused by old age. It removes all the lamina on selected vertebrae and also eliminates the thickened tissue that is compressing the spinal canal or the opening in the vertebrae through which the spinal cord runs.

Laminotomy

This operation involves removal of the portion of the vertebrae which forms a protective arch over the spinal cord or lamina.

Discectomy

It is an operative procedure in which the herniated disc is removed, the one that presses itself against the nerve roots and the spinal cord. It is also used in cases of bulging discs and ruptured discs. It is the most effective surgery for those who suffer from severe disabling pain.

Percutaneous Discectomy

It is used for the surgery of bulging disc and also of those discs that have not ruptured into the spinal canal. The procedure involves inserting a special tool through a small incision made in the back. The herniated disc tissue is removed. This reduces the size of the herniated disc. However, this surgical technique is considered to be experimental and is less effective. Its use is declining.

Disc Herniation Prevention Tips

The following tips may help recurrence of a disc herniation if done as directed:

Image of Disc Herniation

Picture 2 – Disc Herniation Image

  • Hold an object close to the body when carrying it.
  • Reduce your smoking tendencies or stop smoking.
  • Bend your knees and hips when lifting something heavy and keeping the back straight.
  • Avoid wearing high heeled shoes.
  • Perform exercises that strengthen the back and abdominal muscles.
  • Maintain a healthy weight.
  • Maintain a good posture always like sitting straight, standing straight.

Disc Herniation may be extremely discomforting and even debilitating at times. However, it is a common back disorder that can be cured with enough rest and proper treatment in time.