CONDITIONS EXPLAINEDHerniated Discs
CONDITIONS EXPLAINEDHerniated Discs
Herniated Discs are an extremely common condition affecting the cushioning discs that lie between each vertebra in the spinal column. The discs are composed of a fibrous outer coating, and a gel-like inner nucleus. With injury or degeneration, the soft nucleus can bulge out from its fibrous capsule and compress local structures, as well as releasing potent inflammatory mediators that further compound the pressure on surrounding structures. This often painful condition can impinge on the spinal cord and nerve roots traveling out from it, causing numbness, weakness, and pain in associated regions. Pain typically only affects one side of the body.
There are many causes for disc herniation, some of the most common including simple wear and tear, repetitive movements, improperly lifting, trauma, obesity, and genetic factors. In addition, the discs lose fluid over time becoming more rigid. This leads to greater susceptibility to injury as they become weaker and more brittle. Generally, care should be taken to avoid placing the brunt of a load onto the back. Injury can occur across a range of severities, and symptomatic presentation is different in most instances.
The symptoms of disc herniation vary between individuals, but the most common include:
- Pain ranging from a dull ache to sharp severity
- Numbness, burning, and tingling like the sensation of pins and needles
- Muscle Weakness, numbness, with the potential for altered reflexes and spasticity.
- Loss of bowel or bladder control in extreme cases – Requires immediate medical evaluation
Herniated Discs are an extremely common condition affecting the cushioning discs that lie between each vertebra in the spinal column. The discs are composed of a fibrous outer coating, and a gel-like inner nucleus. With injury or degeneration, the soft nucleus can bulge out from its fibrous capsule and compress local structures, as well as releasing potent inflammatory mediators that further compound the pressure on surrounding structures. This often painful condition can impinge on the spinal cord and nerve roots traveling out from it, causing numbness, weakness, and pain in associated regions. Pain typically only affects one side of the body.
There are many causes for disc herniation, some of the most common including simple wear and tear, repetitive movements, improperly lifting, trauma, obesity, and genetic factors. In addition, the discs lose fluid over time becoming more rigid. This leads to greater susceptibility to injury as they become weaker and more brittle. Generally, care should be taken to avoid placing the brunt of a load onto the back. Injury can occur across a range of severities, and symptomatic presentation is different in most instances.
The symptoms of disc herniation vary between individuals, but the most common include:
- Pain ranging from a dull ache to sharp severity
- Numbness, burning, and tingling like the sensation of pins and needles
- Muscle Weakness, numbness, with the potential for altered reflexes and spasticity.
- Loss of bowel or bladder control in extreme cases – Requires immediate medical evaluation
Patient Animation VideoHerniated Discs
Experiencing Symptoms of Herniated Discs?
Detection & Diagnosis
Physical examination can do much to identify the cause of back problems, and x-rays are routinely ordered examining the back. Unfortunately, x-rays do not provide good visualization of softer tissues such as the vertebral discs, and usually cannot definitely diagnose this condition. As such, more useful diagnostic modalities include:
OUTCOMESRelated
Treatments & Procedures
The goals of treatment in spinal deformity are a reduction of pain and restoration of function. The exact modalities will vary depending on the specific nature of a deformity. A combination of approaches may be necessary to achieve satisfactory results. These may include the use of specialized instrumentation, fusion procedures, as well as the adjustment or removal of spinal structures. Perhaps the most important prognostic factor for surgical success and patient recovery relates to the patient frailty index, which evaluates a patient’s physiological tolerance for the stresses of surgery. Even so, advances in technology and the developments of newer strategies is consistently improving outcomes as a whole.
Limiting painful motions, though not limiting motion entirely, is important to reduce aggravation of the affected site. Motion is important to keep blood flowing across the regenerating tissues that need it most, and too much limitation of movement can lead to maladaptive habits. Light and careful activity with the use of ice in the first few days followed by heat, such as with a heating pad is recommended. Electrical stimulation can also help, usually in the form of a TENS unit.
Specialized stretches and exercises can help stabilize the spinal column. Strengthening the spine can help compensate for vertebral instability. In addition, weight loss will reduce the pressure on the spine, and can alleviate compression of the nerve roots.
NSAIDs, Steroids, and Narcotics. NSAIDs such as aspirin, aleve, and ibuprofen can do a great deal to reduce pain and inflammation. In patients for whom this is inadequate, stronger narcotics may be prescribed. Steroids are an additional medication that can provide long term relief by reducing inflammation, and are typically injected at the site of stenosis.
Cervical stenosis may be treated with a short term neck brace to provide some measure of rest for the recovering structures, but long term use weakens local musculature and should be avoided. A back brace is not typically recommended for back problems, however.
If conservative options are unable to provide satisfactory relief for patients, surgical options may provide greater benefit. Laminotomy and artificial disc surgery are among the most commonly performed for disc herniation.
Anterior Lumbar Interbody Fusion
Anterior Lumbar Interbody Fusion (ALIF) is a procedure performed from the anterior to fuse vertebrae into a single structure. This technique is usually favored when..
Artificial Disc Replacement
Artificial disc replacement is a procedure with the goal of removing a painful intervertebral disc and replacing it with a prosthetic one. Spinal fusion is much more commonly performed..
Decompression (Laminectomy)
Decompression Lumbar Laminectomy is the most common surgical procedure performed for the correction of stenosis in the back. The surgeon will remove or trim the bony lamina and a thick ligament..
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