Your spine is made up of a complex network of muscles, connective tissues, nerves, bones, and cartilage. The vertebrae of each bone in the spine and neck are cushioned by small, durable cartilage disks that help cushion the bone and help with flexibility. These cartilage discs are round with a tough outer layer or ring called an annulus.
The term “Herniated Disc” refers to a slipped, bulging, or ruptured cartilage disk where the center or nucleus is pushed outside the annulus ring. This can cause excess pressure on the spinal canal, which can lead to excessive pain and discomfort.
A herniated disc can affect any part of the spinal column, though they are more common in the lower back lumbar region. Herniated cervical discs in the neck are also relatively common.
What Causes A Herniated Disc?
A herniated disc is often related to a severe strain or injury. Though it is possible for the cartilage discs to degenerate due to age or other underlying medical conditions. As this degeneration progresses it becomes easier for a disc to herniate or potentially rupture. Some genetic conditions can make certain individuals more prone to chronic herniated disc issues.
What Are The Symptoms Of A Herniated Disc?
The pain and discomfort of a herniated disc can vary depending on the pressure it places on the spine, surrounding nerves, and other tissues. This includes:
- A back or neckache
- Numbness in the area or extremities
- Weakness in the surrounding muscles
- Weakness in the extremities
What Is Sciatica?
Sciatica is a condition that occurs when a herniated disc in the lower back applies excessive pressure to the sciatic nerve. Typical symptoms include pain, a burning sensation, as well as tingling and numbness that radiates from the buttocks or leg. In a severe case, the discomfort can extend all the way down to the foot.
Sciatica tends to affect only one side of the lower body or a single leg. The discomfort can be more acute when standing, walking, or straightening the leg.
Herniated Disc In The Cervical Spine
The cervical spine refers to the vertebrae and nerves in the neck. When one of these discs becomes herniated it can cause a radiating pain in the shoulder blades that can extend down to the arm. In a severe case, numbness and tingling can extend all the way down to the fingertips.
When Should I Seek Medical Care For A Herniated Disc?
You should consider going to an urgent care clinic if you are experiencing significant symptoms of weakness, and numbness in your legs or arms, or if you experience numbness in the lower body that causes a loss of control over urine or stools. Especially, if symptoms are associated with a recent injury or infection.
How Is A Herniated Disc Diagnosed?
The specific diagnostics needed to evaluate a herniated disc can vary depending on your symptoms. Your physician will likely start with a basic evaluation of any pre-existing conditions that might exacerbate symptoms as well as performing a basic physical exam.
If warranted your physician might recommend or refer you to one of the following diagnostic methods.
This is one of the fastest diagnostic tools and might be able to provide keen insight into the severity of the herniated disc within an hour. It’s a typical first step in developing a treatment plan or determining if you need to be referred to a different diagnostic specialist.
Magnetic resonance imaging usually needs to be performed by a specialist. However, it can reveal soft tissue and connective tissue problems with significant detail.
CT or CAT Scan
This is a special type of radiography where sophisticated computer software effectively reads an X-ray to determine the characteristics affecting the spinal cord, vertebrae, cartilage discs, and other structures.
This is another special type of X-ray imaging diagnostic. It involves injecting the spinal canal with a special contrast material. The injected fluid will then fill into voids and other spaces to reveal structures that might be affecting the spinal canal, like herniated discs, tumors, and bone spurs.
EMG With NCS
An electromyogram and nerve conduction study will effectively measure the electrical impulses of the nerve roots. It is more often called for to determine how much the peripheral nerves and muscle tissue are being affected. This diagnostic can also help to assess nerve damage as well as complications in the surrounding tissues from a previous physical trauma.
How Is A Herniated Disc Treated?
A lot of minor to moderate herniated discs don’t require surgical intervention. With most, the symptoms will improve with time. Though your physician might prescribe pain medication to help manage symptoms. This might include routine exercise or perhaps refer you to a specialist like a chiropractor or physical therapist.
For a mildly herniated disc your physician might recommend limiting your activity for the next two or three days, and periodically taking over the counter anti-inflammatory medication. Periodic walking when tolerable can also help gradually improve your range of motion.
For a more moderate herniated disc, your physician might prescribe you special pain killers or more advanced anti-inflammatory medication. A cortisone injection might also be warranted in some cases where chronic inflammation is affecting the pressure or integrity of the joint.
An epidural injection might be called for to treat more significant discomfort from a herniated disc. This treatment process is typically guided by an X-ray, and follow up care might include the use of pain medication in conjunction with physical therapy.
Physical Therapy For A Herniated Disc
Physical therapy is sometimes used to help treat a herniated disc. This might include clinical exercises and continuing exercises at home on your own. This might include things like pelvic traction, massage therapy, ice & heat therapy, ultrasound treatments, electrical-muscle stimulation, or stretching exercises.
When Is Surgery Needed To Treat A Herniated Disc?
If physical therapy and other conservative treatments fail to improve symptoms, your physician might advocate surgical intervention.
Symptoms That Indicate The Need For Surgery
- When radiating pain significantly limits mobility and quality of life
- Leg or arm weakness and numbness worsens
- The Loss of normal bowel and bladder functions
- Difficulty walking or standing
- Medication and physical therapy don’t improve symptoms
What Is Lumbar Laminotomy Surgery?
Lumbar laminotomy is a surgical intervention designed to relieve leg pain or symptoms of sciatica caused by a herniated disc. It calls for making a minimally invasive incision in the lower back near the herniated disc. A portion of the disc is then removed. In some of these cases, a discectomy and spinal fusion may need to be performed to properly stabilize the vertebrae.
What Is Cervical Spine Surgery?
Cervical spine surgery is sometimes used to treat a herniated disc in the neck. Here again, a small incision is made in the posterior of the neck. A portion of the lamina might then need to be removed to alleviate pressure. In a severe case, a cervical plate may need to be installed to properly stabilize the neck. This is often preferable to a cervical spinal fusion.