Herniated Disc

Marissa and Nikki

What is a herniated disk?

The bones that form your spine in your back are cushioned together by small, spongy discs that act as shock absorbers for your spine while keeping it flexible. When a disc gets damaged, it may break open or bulge creating a Herniated Disc or "slipped" or "ruptured" disk. Most happen in the lumbar spine, following second most likely, cervical spine and lastly, the least likely, in the thoracic spine.


What causes a herniated disk?

  • Wear & tear of the disk due to age because discs tend to dry out and are not as flexible.
  • Injury to the spine causing tiny tears or cracks in the hard outer layer of the disc.


Symptoms...

  • If disc is not pressing on a nerve, there may be a lower back ache or no symptoms at all.
  • If disc IS pressing on a nerve, you may experience pain, numbness, or weakness in the area of your body to which the area travels.
  • With herniation in the lower (lumbar) back, Sciatica may develop, which is pain that travels through the buttock and down a leg to the ankle or foot because of pressure on the sciatic nerve. Low back may accompany the leg pain.
  • Leg pain usually occurs in one leg, start suddenly or gradually, may be persistent or intermittent, may get worse when sneezing, coughing, or straining to pass stool.
  • Nerve related symptoms include tingling or numbness in one leg, weakness in certain muscles, pain in the front of thigh, weakness of bladder and/or bowel control, severe deep muscle pain, and muscle spasms.


What increases your risk?

  1. Advancing Age, teens and young adults rarely develop herniated discs.
  2. Being a male
  3. History of back injury, previous herniated disc, or back surgery
  4. Not exercising regularly
  5. Smoking
  6. Being overweight


When should you call a doctor?

  • If you have pain, numbness, or tingling in one leg that gets worse with sitting, standing, or walking.
  • A fall from a height or serious injury as a car crash.
  • Low back pain with paralysis, confusion or shock
  • Sudden loss of bowel or bladder control
  • New vomiting or fever accompanied with low back pain for more than 48 hours
  • Work-related back injury and non-improving symptoms after 48 hours,


Exams & Tests to confirm Herniated Disk...

Medical History and Physical Exam; diagnosis based on features pointing to irritation of one or more spinal nerves and to the loss of strength, sensation, or reflexes that are normally associated with the nerve.

Imaging tests help to confirm HD like as MRI is generally preferred over a CT scan for diagnosing a suspected HD in the lower back (lumbar spine).


How is it treated?

Symptoms from a herniated disc usually get better in a few weeks or months.

  • Rest if you have severe pain. Otherwise, stay active. Staying in bed for more than 1 or 2 days can weaken your muscles and make the problem worse. Walking and other light activity may help.
  • Try using a heating pad on a low or medium setting for 15 to 20 minutes every 2 or 3 hours. Try a warm shower in place of one session with the heating pad. You can also buy single-use heat wraps that last up to 8 hours. You can also try an ice pack for 10 to 15 minutes every 2 to 3 hours.
  • Do the exercises that your doctor or physical therapist suggests. These will help keep your back muscles strong and prevent another injury.
  • Ask your doctor about medicine to treat your symptoms. Medicine won't cure a herniated disc, but it may help with pain and swelling.

Goals of treatment are to:
  • Relieve pain, weakness, or numbness in the leg and lower back caused by pressure on a spinal nerve root or the spinal cord.
  • Promote a return to normal work, recreation, and other activities.
  • Prevent reinjury to your back and reduce the risk of disability from back pain.

Because inflammation usually fades over time, about 50% of people with a herniated disc in the low back recover within 1 month. And within 6 months, most people recover. Only 10% of people with herniated disc problems that cause noticeable symptoms eventually have surgery.

Often a Herniated Disc heals on its own because the jellylike material inside the disc is broken down and absorbed by the body, a process called resorption. Which is why nonsurgical treatment is typically recommended before surgery is considered.


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Nonsurgical Treatment..

Usually includes:

  • Education
  • Rest
  • Pain Relief like : nonprescription and prescription pain relievers, such as Tylenol or NSAIDS, muscle relaxants, corticosteroids, opioids, and anti-depressants.
  • Exercise



Surgical Treament..

Surgery is eventually the treatment for about 10% of people who have a herniated disc.

Surgery can be a good choice for people who have nerve damage that is getting worse, or severe weakness or numbness, or if pain is not improved after at least 4 weeks of nonsurgical treatment.

The most common and effective surgery for herniated disc is discectomy, in which, disc material is removed through an incision, done mostly to relieve pain and other symptoms in the leg.

It is not recommended if the herniated disc only causes back pain. Discectomy can relieve leg symptoms such as pain and numbness, but it does not relieve back pain


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