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HERNIATED DISC

    Herniated Disc at a Glance

    • Herniated discs are very common and often go undetected.
    • Some patients can experience serve and disabling pain.
    • They tend to occur in patients who are from 20 to 50 years old.
    • Eighty-five percent of the time, herniated disc symptoms disappear after a few days or weeks.
    • Most treatments focus on reducing pain.
    • Surgery is rarely needed unless severe pain is present or nerve damage is occurring.

     

    Herniated Disc Symptoms

    While most herniated discs cause few problems, some can lead to severe and disabling back pain. In addition, they may lead to numbness, weakness, balance or walking problems. Other symptoms may include deep muscle pain and muscle spasms.

    A herniated disc can cause a shooting pain and numbness in the buttock and down the leg. This is called sciatica and is the most common symptom when the problem is located in the low back. Pain may also occur in the lower back, although it is usually less intense than leg pain.

    Herniated discs in the neck or upper back can cause pain the neck, shoulders and upper arms.

    A rare, but serious condition known as “Cauda Equine Syndrome” can develop in the low back, affecting bowel and bladder function as well as leading to partial paralysis of the lower limbs if left untreated.

    Anatomy & Causes of Herniation

    The spine is formed of 24 vertebrae, or bone segments that are stacked on one another from the pelvis to the skull. These are further divided into several areas:

    • The neck, or cervical discs, has seven vertebrae.
    • The middle back, or thoracic spine, contains 12 vertebrae.
    • The lower back, or lumbar, has five vertebrae.
    • At the base of the spine is a bone mass called the sacrum, and at the end of the sacrum is the coccyx, or tail bone, which can be thought of as three to five additional vertebrae that nature has fused together.

     

    The spine protects nerve roots that exit at various points from the spinal column and travel to the limbs and other areas of the body. Between the vertebrae of the neck, middle back and lumbar are soft discs filled with a spongy substance. When healthy, these discs protect the spine and keep it flexible.

    A herniated disc occurs when the soft center ruptures though the outer wall of the disc structure. This happens when this outer wall (called the annulus) begins to thin, stretch, and come apart, due to aging, wear and tear, or injury. The condition can occur in the neck or middle back, but is most common in the low back, called the lumbar spine. This condition is also called slipped disc.

    Herniation has been linked to obesity, improper lifting, smoking, sudden pressure and repetitive strenuous activities.

    The type of herniation can vary. From least to most serious, the degrees of herniation are:

    • Bulge – A bulging disc occurs when a section of a disc weakens and expands beyond its normal dimensions. If the bulge does not impinge on the nerves within the spinal column, the sufferer may not even know he or she has a bulging disc.
    • Protruded or contained herniation is when disc tissue has expanded beyond a bulge into the disc’s outer portion, or what’s called the annulus.
    • Ruptured Disc refers to the action of the soft nucleus pulposis in the center of the disc as it bursts through (ruptures) the outer rings of the disc structure.
    • Extruded herniation is the next degree, in which the disc extrudes into the vertebral canal, or the open spaces housing the nerve roots.
    • Sequestered herniation is the term given for disc material expanded and separated completely from the rest of the disc, effectively becoming a free fragment.

     

    Learn about Herniated Disc treatment options.

    TREATMENTS FOR HERNIATED DISC

    To diagnosis and treat most back problems, a doctor will exam a patient for possible nerve involvement, ask about medical history and likely order medical images of the back such as a simple X-ray; an MRI, which provides a view of the tissue around the spine; or a CT scan, which uses a series of X-rays to provide a cross-section view of the spine and surrounding tissues

    If the diagnosis is disc herniation, a doctor has a variety of treatment options. Treatments are usually non-surgical, and usually focus on pain management. Surgery occurs only rarely.

    They may be as simple as prescribing a common over-the-counter pain medication or as involved as complex surgery.

    Most herniated disc treatments will include medication, physical therapy, and occasionally intervention pain blocks. Recovery can take several months. Surgery may be required if these measures fail.

    Non-Surgical Treatments

    Fortunately, most patients are helped with the least-invasive treatments. Sometimes, this may be non-prescription medicine and an exercise plan designed to improve strength and flexibility in the back, torso and limbs.

    Non-surgical treatment options include:

    Pain Management Treatments

    The most common approach to treating a herniated disc is addressing the pain caused by the condition. Strategies include a nerve block or various types of epidurals, a procedure where medicine is placed directly into the spinal canal to block pain.

    Pain Management options include:

    Surgical Treatment

    For the few herniated discs that require surgery, the standard operation is a microdiscectomy, an operation to remove the herniated part of a disc,

    A surgeon performs a microdiscectomy with a microscope or similar device, often as an outpatient procedure. Microdiscectomies have a very good success rate. However, in up to 10 percent of cases, disc herniations can recur.

    Other surgical options range from a percutaneous laser discectomy, in which the surgeon makes a small incision, inserts a tiny probe and operates with the aid of television version of x-rays, to nucleus replacement, a new form of surgery still under investigation in which a surgeon replaces the center part of the disc with an artificial implant.

    You can find more information on surgical options by clicking on the links below.

    Surgical options for herniated disc:

    • Microdiscectomy
    • Percutaneous Laser Discectomy
    • Percutaneous Nucleoplaty Coblation
    • Laminotomy
    • Laminectomy
    • Transforaminal Micro Discectomy
    • Nucleous Replacement Disc Stabilization Arthroplasty

     

    Non-Surgical Treatments

     Pain Management

    Surgical Treatments

    OTC Medicine
    Physical Therapy
    Spinal Manipulation
    Rx Medication
    Selective Nerve Block
    Caudal-Epidural
    Epidural
    Transforaminal Epidural
    Percutaneous Laser Discectomy
    Percutaneous Nucleoplaty Coblation
    Laminotomy
    Laminectomy
    Transforaminal Micro Discectomy
    Micro Discectomy
    Nucleous Replacement Disc Stabilization Arthroplasty

     

    Related Topics

    • Bulging Disc
    • Compressed Disc
    • Herniated Intervertebral Disc
    • Prolapsed Disc
    • Ruptured Disc
    • Slipped Disc

    Frequently asked Questions

    Are there any side effects after epidural injections?
    What pain medication is prescribed for a herniated disc?
    What is the standard surgery performed on a problematic herniated disc?
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