Herniated Disc

Herniated Disc
A herniated disc is a disc that pushes into the spinal canal. It may also be called a ruptured disc or slipped disc. As a disc degenerates (breaks down with time), it can herniate (the inner core pushes out) into the spinal canal. This occurs when a tear in the outer, fibrous ring (annulus fibrosus) of an intervertebral disc allows the soft, central portion (nucleus pulposus) to bulge out. This tear in the disc may result in the release of inflammatory chemical chemicals which may directly cause severe pain, even in the nerves are not directly compressed. This is called “chemical radiculitis”.

Causes of a Herniated Disc
The discs in your spine act like cushions, or shock absorbers. With age, the discs start to dry out and become flatter. If a disc becomes too weak, the outer part (annulus) may tear. The inside (nucleus pulposus) part of the disc pushes through the tear and can press on the nerves beside it. Herniated discs most frequently occur in the lumbar (lower back) area, but can also occur in the cervical (neck) and thoracic (mid-back) spine.

Symptoms of a Herniated Disc
Symptoms of a herniated disc vary from person to person. Pain usually occurs at the level of the herniated disc, but can also be referred to other areas. If the herniated disc puts pressure on one of the nerves in the spine, it may cause pain to radiate to the legs (from the back) or the arms (from the neck). When the disc herniates, it can also release chemicals that can be very irritating to the surrounding tissues and cause pain to radiate into the arms or legs. This is called “chemical radiculitis”. Pain from lumbar herniated discs commonly spreads into the buttock, down the thigh and into the calf. This is commonly referred to as sciatica.

Other symptoms can include weakness, numbness, tingling, loss of reflexes or muscle tone, foot drop, and loss of bowel and bladder control. Pain usually worsens with activity, coughing, sitting, bending forward and straining to have a bowel movement.

Treatment of a Herniated Disc
Treatment of a herniated disc usually begins with a period of conservative treatment that may include medications, physical therapy, home exercise and lifestyle modification. Patients who do not improve with these conservative measures may respond to epidural steroid or nerve root injections. In certain cases, patients respond to disc decompression with devices such as the DRX 9000. IDET can be helpful for selected patients. Patients with herniated discs may also have facet related pain, which responds to diagnostic blocks and radiofrequency.

Patients with severe symptoms that do not respond to other treatment, or those that have symptoms that show nerve damage is becoming progressively worse (i.e. loss of bowel or bladder control, muscle wasting, progressive weakness) may be candidates for surgery. Surgical procedures include laminectomy, discectomy or fusion. Unfortunately, surgery is not recommended or effective for all patients, and carries its own risks.

Adapted from Wikipedia by the Pain Relief Centers

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