What Is A Herniated Disc?
A herniated disc (also called a ruptured, slipped, or bulging disc) is a damaged “cushion” between two bones in the spine (vertebrae). This occurs when the nucleus pushes through the outer wall. This herniation can result in a large bulge that can press against nearby nerve roots. A herniated disc is a common injury that can affect any part of the spine. A herniated disc can cause severe pain and other problems in the arms or legs.
Why Are Vertebral Discs Important?
Vertebral discs are flexible, rubbery cushions that support the vertebral bones. They allow the spine to twist and bend. Each disc has a soft inner nucleus that is surrounded by a fibrous outer wall.
Causes of Herniated Discs
Herniated discs commonly result from age-related weakening of the spinal discs. This is called disc degeneration, and it can occur gradually over many years as a result of normal wear and tear on the spine. A herniated disc can also result from a traumatic injury, or from lifting a heavy object improperly.
Symptoms of A Bulging Disc
Symptoms of a herniated disc vary depending on the location of the disc and the severity of the rupture. Some herniated discs cause no symptoms, and a person with this type of injury may not realize the disc is damaged. But a herniated disc can also cause severe pain, numbness or tingling, and weakness. Most herniated discs occur in the lower back, where they can cause symptoms in the buttocks, legs and feet. Herniated discs also occur in the neck, where they can cause symptoms in the shoulders, arms and hands.
How are Herniated discs Diagnosed?
To make a diagnosis, the patient’s medical history is taken, and a determination made as to whether the pain has increased gradually or was precipitated by a traumatic injury. A comprehensive physical exam, which includes a check of reflexes, sensation/numbness, posture and muscle strength, helps in assessing the situation. Usually, the patient is examined sitting, standing and walking.
Also, imaging tests are usually administered to provide a more precise visualization of the spine. They are used to determine whether there is a disc injury and, if there is one, to delineate its size and location. Tests include X-rays, MRI or CT scans, electromyograms (which measure nerve impulses), and myelograms (in which contrast dye highlights the affected region).
Herniated Disc Treatment
Treatment options for herniated disc depend on the location and severity of the injury. A herniated disc may be treated with pain-relieving medications, muscle relaxers, and corticosteroid injections. A person with a herniated disc may benefit from physical therapy. When the condition does not respond to these measures, and the patient is still experiencing pain, surgery may be necessary. This is true in approximately 10 percent of herniated disc cases. The type of procedure performed depends on where the herniated disc is located, and the severity of the damage. There are several surgical options. All of these operations are performed in the hospital under general anesthesia:
- Spinal fusion