A herniated disc is a common spinal injury that can cause severe discomfort and limit mobility.
A herniated disc is a condition in which the intervertebral disc, which is the cushion between the spine’s vertebrae, ruptures or bulges out of its normal position. The herniated disc can cause pressure on the surrounding nerves, resulting in pain, numbness, and weakness in the affected area. It occurs when the soft cushion-like discs between the vertebrae of the spine slip or rupture, putting pressure on the nerves and causing pain. This condition can be caused by aging, genetics, or injury, and can affect people of all ages. According to Devillé et al. (2000), the causes of a herniated disc are multifactorial, including both genetic and environmental factors. Some of the common causes include age-related degeneration of the disc, which results in the disc becoming less flexible and more susceptible to injury. Additionally, trauma, such as a sudden impact or a fall, can also cause a herniated disc.
The vertebral column (also called the spinal column) is made up of 33 bones known as vertebra. Each vertebra is separated from the adjacent vertebrae by intervertebral discs, a spongy but strong connective tissue. The intervertebral discs, along with ligaments and facet joints, connect the individual vertebrae to help maintain the spine’s normal alignment and curvature while also permitting movement. In the center of the spinal column there is an open channel called the spinal canal. The spinal cord and spinal nerves are located in the spinal canal, where they are surrounded by spinal fluid. On each side of the spine, small openings between each vertebrae called the foramen, allow nerve roots to enter and exit the spina canal.
The spinal disc is a soft cushion that sits between each vertebra of the spine. This spinal disc becomes more rigid with age. As the spinal disc becomes less elastic, it can rupture. When the disc ruptures, a portion of the spinal disc pushes outside its normal boundary, and this is called a herniated disc. A herniated disc occurs when the fibrous portion of the disc ruptures or tears, and the jelly-like core squeezes out. When the herniated disc compresses a nerve, the result can be a pinched nerve. A pinched nerve may cause pain, numbness, tingling, or weakness in the arms or legs. The substance that makes up the disc’s jelly-like core can also inflame and irritate the nerve, causing additional pain.
Is a bulging disc also known as a herniated disc?
A bulging disc occurs when the outer wall of the disc weakens but doesn’t rupture, and “bulges” outward. A herniated disc may actually begin as a bulging disc whose outer wall is then ruptured by a great amount of pressure.
Where can disc herniations occur in the spine?
Disc herniations can occur in the cervical, thoracic, or lumbar spine. The location of the pain depends on the location of the herniated disc. If the herniation occurs in the neck, it can cause pain to radiate through the shoulder and the arm. If the disc herniation happens in the mid-back the pain or numbness can travel around the rib cage, from the back and also to the front of the chest or upper abdomen. If it occurs in the lower back, the pain can radiate down into the hip and through the entire leg. Other symptoms include weakness or muscle fatigue, and this is caused by affected nerve pressure associated with the muscles. So often symptoms of muscle fatigue will cause an individual to stumble when walking. An individual can suffer from a herniated disc without knowing it. This could be due to a minor herniation or lack of pressure being applied to the nerves in the spine. The only way to determine this is through x-ray imaging.
Treatment options for herniated discs vary depending on the severity of the individual’s condition and level of pain. Over the counter pain medication and narcotics is the simplest approach. Cortisone or steroid injections can be injected directly into the area of the spine where the herniated disc is leaking and around the nearby nerves. This is used to reduce swelling and inflammation long enough to allow the disc to heal. Spinal manipulation through chiropractic care is another moderately effective way to treat herniated discs. Discectomy is a procedure where the surgeon removes the protruding portion of the disc surgically. The final and most permanent solution to treating a herniated disc is through spinal fusion, where the disc may need to be completely removed and metal hardware is inserted to provide proper spinal stability. While this option provides spinal stability, the individual will lose a significant range of motion and mobility.
Biologics have shown to be successful non-invasive treatment options when it comes to disc related conditions. Stem cells and platelet rich plasma (PRP) are harvested through an individual’s own blood or bone marrow. The platelets are separated during a process called centrifugation and the extract is injected into the damaged disc. The goal is for growth factor proteins to repair the tear and allow for regeneration of the disc.
A herniated disc is a common condition that can cause severe pain and discomfort in the back, legs, and arms.
It occurs when the soft tissue between the vertebrae bulges out and puts pressure on the nerves. This condition can affect anyone, but it is more common among people who engage in activities that put a lot of strain on their back. The treatment procedure for herniated discs ranges from conservative therapy to surgery, depending on the severity of the condition. Poor posture and repetitive stress on the spine, such as lifting heavy weights or sitting for extended periods, can also increase the risk of developing a herniated disc. Furthermore, smoking has been found to be a risk factor for the development of a herniated disc. Smoking causes a decrease in oxygen supply to the disc, which can lead to disc degeneration and herniation. Overall, a herniated disc is a complex condition with multiple contributing factors, and understanding the causes can help with prevention and treatment. While complications such as nerve damage and infection can occur, most people recover within a few weeks to several months with proper treatment and care. It is important to seek medical attention if you experience any symptoms of a herniated disc to prevent further damage and ensure a swift recovery.
Research
- WLJM Devillé., DAWM van der Windt.”The test of Lasegue: systematic review of the accuracy in diagnosing herniated discs.” https://journals.lww.com/spinejournal/Fulltext/2000/05010/The_Test_of_Las_gue__Systematic_Review_of_the.16.aspx
- MP Scaparra., JR O’Hanley.”Optimizing system resilience: a facility protection model with recovery time.” https://www.sciencedirect.com/science/article/pii/S0377221711008940
- “Paediatric hip fractures: a systematic review of incidence, treatment options and complications..” http://www.actaorthopaedica.be/assets/1737/02-Bimmel_et_al.pdf