herniated disc

Herniated Disc – What You Should Know? | Orthopaedics

What is a herniated disc?

A herniated disc is a common condition that is painful and debilitating and refers to a problem with the rubber pads (discs) that lie between the individual bones (vertebrae) that make up the spine. However, some people do not feel pain, especially if the disc is not pressing on any nerves.

A spinal disc has a soft, jelly-like nucleus, which is located in a hard, rubbery exterior (ring). Sometimes called a slipped disc or ruptured disc, a herniated disc forms when part of the nucleus is pushed outward by a tear in the annulus.

A herniated disc, which occurs anywhere in the spine, irritates a nearby nerve. Depending on where the herniated disc is located, it can lead to pain, numbness, or weakness in the arm or leg. Most people do not have symptoms of a herniated disc. Surgery is usually not required to alleviate the problem.

Symptoms of a herniated disc

Most herniated discs occur in the lower back, although they also occur in the neck. Signs and symptoms depend on where the disc is located and whether the disc is pressed against the nerve. They usually affect one side of the body.

  • Pain and numbness, usually on one side of the body
  • Pain that spreads to your arms or legs
  • It intensifies at night or with some movements
  • Worse after standing or sitting
  • Pain when running short distances
  • Unexplained muscle weakness
  • Tingling, pain, or burning sensation in the affected area
  • Arm or leg pain: If the herniated disc is in your lower back, you will usually experience more pain in your buttocks, thighs, and calves. You may also feel pain somewhere in your foot. If your herniated disc is in your neck, you will generally experience a lot of pain in your shoulder and arm. This pain can burn in your arm or leg when you cough, sneeze or position yourself. The pain is often described as sharp or burning.
  • Numbness or tingling: People with a herniated disc often have numbness or tingling in the part of the body affected by the affected nerve.
  • Weakness: The muscles that supply the affected nerves weaken. It affects your ability to make mistakes or to lift or hold objects.

You may have a herniated disc without symptoms. You may not know you have it if it is not shown in the column image.

What causes a herniated disc?

As we age, the spinal discs gradually lose fluid volume. This process begins around age 30 and develops slowly over time. As discs dry, microscopic cracks or tears form on the outer surface, making them brittle, weak, and more prone to injury. The most common causes of a herniated disc are:

  • Wear: Discs dry out and are not as flexible as before.
  • Repetitive movements: Work, lifestyle, and certain sports activities that put pressure on the spine, especially the lower back, can further weaken an already vulnerable area.
  • Lifting incorrectly: Do not lift when bending at the waist. The proper lift is to lift with your legs and a straight back.
  • Injury: A high-impact injury can cause the disc to swell, tear, or break.
  • Ob requirement: Being overweight puts unnecessary pressure on your spine.
  • Genetics: People with disc degeneration often have certain genes. More research is needed to investigate the role of these genes; they may be the target of biological treatment in the future.
  • A slippery disc is formed when the smooth inner section of the intervertebral disc protrudes through the outer layer.
  • The human spine, or vertebrae, consists of 26 bones called vertebrae. The cushion-shaped rubber pads between each vertebra are called “discs.” These discs help support the vertebrae and act as shock absorbers.
  • Spinal discs have a soft, gelatinous centre and a hard outer surface.
  • Herniated disc forms when a soft inner part slides through cracks in the wall of the disc. It usually occurs in the lumbar area, but also the vertebrae of the neck.
  • Avoiding this “jelly” releases chemicals that irritate the nerves in the surrounding areas and cause significant pain. The enlarged disc puts pressure on the nerves and causes compression pain.

The cause of a leaking disc is usually regular wear and tear and heavy use as a result of repeated movements over time.

Risk factors for herniated disc

Herniated discs can occur at any age, but they are most common in men between the ages of 20 and 50.

Factors that increase the probability:

  • Weight: Being overweight puts extra pressure on your lower back.
  • Genetics: A person can have a reversal of herniated discs.
  • Occupation: People with physically demanding jobs or hobbies suffer from herniated discs such as pushing, pulling, or twisting. Any repetitive activity that distorts the spine can cause them.
  • Unsafe lifting technique: People should always use the strength of their legs, not their back when lifting heavy objects. Incorrect technique can lead to a herniated disc.
  • Frequent driving: Sitting for a long time and vibrations and movements of the car can damage the discs and the structure of the spine.
  • A sedentary lifestyle: Lack of exercise can lead to a herniated disc.
  • Smoking: Reduces the supply of oxygen to the discs and causes the shredding of tissues.

Herniated disc diagnosis

They can also check:

  • Your knee and ankle reactions.
  • Strength of your leg
  • How you walk on your heels and toes
  • Can you feel the light touching or vibrating?

If your doctor wants to rule out other sources of your pain or identify specific nerves that are exacerbated, they may perform more tests, including:

  • X-rays: Although a standard X-ray may not show if you have a herniated disc, it can show your doctor what your spine looks like and rule out whether your pain is caused by something like a fracture or tumor.
  • Myelogram: This test uses an X-ray to determine the colour and pressure in your cerebrospinal fluid.
  • Computed tomography: A computed tomography (or CT) scan takes several X-rays from different angles and combines them to create images of your spinal cord and the structures around it.
  • Magnetic resonance: MRI uses radio waves, magnetic fields, and computers to create detailed 3D images of the spine and surrounding areas. MRI scans can detect the location of a herniated disc, look inside it, and even determine which nerves are affected.
  • Electromyogram (EMG): Your doctor can use these tests to find out if any nerves are damaged or contracted. The EMG test uses a device to detect small numbers of electrical muscle cells when they are stimulated by nerves connected to them. The needle electrode placed on the muscle records its electrical activity and looks for what it shouldn’t be.
  • Nerve conduction studies (NCS) are often done in the same way as EMG: In this test, the nerves are stimulated with small electrical impulses by the electrode at one stage of the body, while the other electrodes detect impulses at a different time. The time it takes for electrical impulses to travel between the electrodes will tell your doctor if there is nerve damage.

Herniated disc treatment

Herniated discs can cause severe pain, but proper treatment can relieve symptoms. A person can largely resolve symptoms by avoiding pain-inducing movements and following the rules of exercise and pain relievers recommended by a doctor.

Treatment options include medications, treatment, and surgery.

Drugs

  • Over-the-counter (OTC): Ibuprofen or naproxen-based medications can help with mild to moderate pain.
  • Medicines for nerve pain: Medicines that treat nerve pain include gabapentin, pregabalin, duloxetine, and amitriptyline.
  • Medications: If over-the-counter medications do not reduce discomfort, a doctor may prescribe a combination of codeine, oxycodone, and acetaminophen, or another type of medication. Side effects include nausea, vomiting, confusion, and constipation.
  • Cortisone injections: These are injected directly into the hernia area to help reduce inflammation and pain.
  • Epidural injections: A doctor injects steroids, sedatives, and anti-inflammatories into the epidural area around the spinal cord. Helps reduce pain and inflammation in and around the nerve roots of the spine.
  • Muscle relaxants: Help reduce muscle pain. Common side effects of dizziness and nausea.

Physical therapy

Physical therapists can help you find positions and exercises that reduce herniated disc pain.

Therapists may also recommend:

  • Treat with heat or ice
  • Ultrasound, which uses sound waves to stimulate the affected area and improve blood flow
  • Traction, which can reduce stress on the affected nerve.
  • To improve support, short-term braces for the neck or lower back.
  • Electrotherapy, because electrical impulses reduce pain in some people.

Surgery

  • If symptoms do not improve with other treatments, cramps persist, or bladder control or movement deteriorates further, the treating physician may recommend surgery.
  • In most cases, the surgeon removes only the protruding part of the disc. This is an open discectomy.
  • The surgeon usually performs an open discectomy using a laparoscopic technique, opening a small hole in the front or back of the spine.
  • This technique eliminates the need to remove small parts of the vertebrae or move the spinal nerves and spinal cord to access the disc.

Artificial disc replacement

Surgeons in Europe have been performing disc replacement procedures since the 1980s, but they are not yet available in the United States.

There are two kinds. The first is to restore the entire disk. The second is the dismantling of the disc nucleus, which is just the soft nucleus of the disc called the nucleus.

Synthetic discs are made of metal, biopolymer, or both. A biopolymer is a material similar to plastic.

Complications of a herniated disc

Above your waist, your spine ends. Continuing down the spinal canal is a group of long nerve roots that resemble a horsetail (each equine).

In rare cases, a herniated disc can narrow the entire spinal canal, including all of the equine nerves. In rare cases, emergency surgery may be necessary to prevent permanent weakness or paralysis.

Seek emergency medical help if you have:

  • Exacerbating symptoms: Pain, numbness, or weakness can increase to the point of interfering with your daily activities.
  • Dysfunction of the bladder or bowel: Each equine syndrome can cause incontinence or difficulty urinating, even with a full bladder.
  • Saddle anaesthesia: This progressive loss of sensation affects the areas that touch the saddle: the inner thighs, the back of the legs, and the area around the rectum.

Prevention of a herniated disc

To help prevent a herniated disc, do the following:

  • Exercise: Strengthening the trunk muscles stabilizes and supports the spine.
  • Maintain good posture: This will reduce pressure on your spine and discs. Keep your back straight and aligned, especially when sitting for long periods of time. Lift heavy objects correctly, your legs, not your back, do a lot of work.
  • Keep a healthy weight: Excess weight puts more pressure on the spine and discs, making them more prone to herniation.
  • Give up smoking: Avoid using tobacco products.

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