What is a Herniated Disc?
A spinal disc herniation, informally and misleadingly called a “slipped disc”, is a medical condition affecting the spine, in which a tear in the outer, fibrous ring (annulus fibrosus) of an intervertebral disc allows the soft, central portion (nucleus pulposus) to leak out.
The spine is composed of 23 vertebral discs. 6 are in the neck (cervical region), 12 are in the middle back (thoracic region), and 5 are in the lower back (lumbar region). These discs act as shock absorbers for the spine which endures tremendous pressure on a daily basis. As described above, a herniated disc occurs when one of these discs tears and the center of the disc leaks out.
Tears are almost always postero-lateral (located toward the back) in nature owing to the presence of the slightly weaker posterior longitudinal ligament in the spinal canal. This tear in the disc ring may result in the release of inflammatory chemical mediators which may directly cause severe pain, even in the absence of nerve root compression. This is the rationale for the use of anti-inflammatory treatments for pain associated with disc herniation, protrusion, bulge, or disc tear.
A herniated disc is normally a further development of a previously existing disc protrusion, a condition in which the outermost layers of the annulus fibrosus are still intact, but can bulge when the disc is under pressure. This can occur in the cervical, thoracic and lumbar spine and are most commonly caused by aging or acute injury.
What are the Symptoms of a Herniated Disc?
The most common symptom of a herniated disc is pain. For others, a herniated disc may cause no symptoms. For the patients who do feel pain, the top complaints are numbness, weakness, muscle spasms, tingling, pins and needles, burning, stiffness, and sharp, radiating or dull pain. The symptoms of a herniated disc correlate to the location of the injury. For example, a slipped disc in the cervical spine may cause pain in the neck and arms, whereas a herniation in the lower spine causes lower back discomfort or pain in the lower extremities.
Herniated Disc Symptoms Include:
Tingling or Numbness
What Causes a Herniated Disc?
Herniated Discs are most often caused by the natural aging process and usually occur in middle-aged people. The vertebral discs in the spine are made-up almost entirely of water. Gradually as we age, normal wear-and-tear from movement, posture and other daily activities causes the discs to lose water making them less resilient. This weakening in the disc can lead to tear or rupture.
A traumatic event, such as car accident or sports injury, is another common source of a slipped disc. Heavy lifting and repetitive motion are also frequent causes. Other typical causes of pinched nerves are:
Degenerative Disc Disease
- Poor Posture
Poor Health or Obesity
Improper Lifting and Twisting
Repetitive Motion or Overuse
Where can a herniated disc be located?
How is a herniated disc diagnosed?
After a complete medical history review and clinical examination, patients suffering from symptoms associated with a herniated disc are often sent for imaging. An MRI, CT scan and X-ray are the most common imaging tests used to diagnose a slipped disc.
How is a herniated disc treated?
Treatment for a herniated disc depends on the pain associated with the problem. Many people who suffer from slipped discs experience mild to no side-effects at all. Patients who do experience pain or discomfort are often prescribed conservative care and rest. Rest take the pressure off the spine and helps the disc to heal naturally. Conservative care treatments for herniated discs are as follows:
- Heat and Ice
- Physical Therapy
- Chiropractic Care
- Epidural Steroid Injections
OTC Medication such as ibuprofen to reduce inflammation
Muscle Relaxants to calm muscle spasms
Narcotics or Opioids short term as they can be habit forming and lose effectiveness over time as patient develops tolerance.
Surgery for Herniated Disc
If conservative care such as physical therapy, injections, medication or exercise are not reducing the symptoms and relieving the pain associated with a slipped disc, surgery may be an option. Most herniated discs can be fixed with a minimally invasive procedure. Common surgical procedures to relieve a herniated disc are:
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