What is a herniated disc?
Your spine consists of bones known as vertebrae, and between these bones are small rubbery discs that act as cushions. They have a soft jelly-like center or nucleus (Nucleus Pulposus) that is encased by a tougher rubbery ring (Annulus Fibrosus) (Fig. 1)
Sometimes the exterior of these rubbery discs can tear, and the soft inside slips out. This results in a herniated disc, also known as a slipped disc or ruptured disc (Fig. 2). This disc injury can irritate nearby nerves causing pain, numbness, or weakness in an arm or a leg. Many people with a herniated disc never experience symptoms and surgery is rarely required for treatment. Nonetheless, there are a range of options available to help those who suffer pain or discomfort from a herniated disc.
What causes a herniated disc? / Risk factors.
In most cases, a herniated disc happens because of wear and tear, something known as disc degeneration as you age. Your discs become less flexible and are more prone to tears and ruptures. Most people cannot identify the cause of their herniated disc. It can happen from using your back muscles instead of your leg muscles to lift heavy objects. Or from awkward twisting and turning. However, there are other factors outside of your age that can increase your risk of slipping a disc. Being overweight increases the strain on the discs in your lower back. Some people may be genetically predisposed to rupturing a disc. Working a physically demanding job, and smoking can decrease the oxygen supply to your disc, causing it to degenerate more rapidly.
Symptoms
It's possible to have a herniated disc without having any symptoms. This happens to a lot of people. They may first notice a herniated disc while undergoing tests for a different issue. Herniated discs can trigger a few common symptoms - back or neck pain radiating to the arm or leg pain (often described as a sharp or shooting pain) as well as numbness or tingling along the affected nerves in the extremities. Your exact symptoms depend on where the herniated disc is located (Fig. 3). Talking to a doctor about the pain that you're experiencing is always a first step.
How is a herniated disc diagnosed?
Your doctor will usually be able to tell if you have a herniated disc by conducting a physical exam and asking about your medical history. He/She may order one or more of the following tests; an X-ray, a CT or MRI scan. You might be referred for additional tests like a nerve conduction study or an EMG to help pinpoint the location of the nerve damage.
Conservative treatment
More often than not, treatment options will include watching your movement and taking pain medication that relieves symptoms for most people.
Over-the-counter NSAIDs are great options for mild-to-moderate pain.
If your pain is severe, your doctor might recommend a cortisone injection around the affected nerve or a caudal epidural injection for lower back pain. Physical therapy can also help manage pain with positions, stretches, and exercises designed to minimize the discomfort caused by a herniated disc.
Surgical treatment
Few people with a slipped disc need surgery, but when it's necessary, surgeons may perform what's known as a discectomy. This may be done in an open manner or in a minimally invasive manner. The protruding portion of the disc is removed (Fig. 4).
Sometimes in cases of spinal instability, a bone graft or a special cage is needed to fuse two or more vertebrae together with metal hardware.
In rare circumstances, a surgeon may implant an artificial disc to replace the herniated one.
If you think you have a herniated disc, talk to your doctor, back problems are very common, but thankfully, we can help most people find a way to manage their pain and return to normal activity in no time.
In case you have back pain and suspect that you have a herniated disc / disc herniation, do not hesitate to contact us for consultation:
Tel: +995 599820404
Email: contact@neurosurgeon.ge
