Herniated Discs
A herniated disc is a medical condition that involves the rubbery cushions, or discs, that sit between the spines of the vertebrae. These spinal discs consist of a soft, gel-like core known as the nucleus, enclosed in a sturdy, rubbery outer layer called the annulus. When a portion of the nucleus pushes through a tear or weak spot in the annulus, it results in a herniated disc, also referred to as a slipped or ruptured disc. While herniated discs may arise in any region of the spine, they are most commonly found in the lower back.
Symptoms
Herniated discs most commonly occur in the lower back, though they can also affect the neck. Symptoms vary depending on the disc’s position and if it compresses a nerve. In most cases, herniated discs impact only one region of the body.
- Arm or leg pain: For herniated discs involving the lower back, pain is typically experienced in the lower back, thigh, buttocks, calf, and occasionally in the foot. If it affects the neck, pain is usually concentrated in the shoulder and arm, often shooting into the arm or leg whenever you cough, sneeze, or move into a particular position. Most people describe this pain as burning or sharp.
- Numbness or tingling: Affected nerves can cause radiating tingling or numbness in the area they serve.
- Weakness: The muscles that the impaired nerves serve usually weaken, possibly causing stumbling or trouble holding or lifting things.
In some cases, a herniated disc may not cause any noticeable symptoms and could only be detected via spinal imaging.
Causes
The disc within the spine tends to be less flexible and highly susceptible to tears or ruptures with age, a condition known as disk degeneration.
Traumas like a fall or a blow may lead to a herniated disc, which can also aggravate the existing condition.
Lifting heavy items with back muscles rather than the legs can cause a herniated disc. In addition, turning or twisting can result in a herniated disc.
Risk Factors
Factors likely to increase the chances of developing a herniated disc are:
- Weight: Excessive body weight adds extra strain on the lower back discs.
- Occupation: Jobs involving repetitive pulling, lifting, bending, pushing, or twisting can heighten the risk.
- Genes: A genetic predisposition may make some individuals more prone to herniated discs.
- Smoking: Smoking may reduce the oxygen flow to the discs, accelerating their degeneration.
- Frequent driving: Sitting for longer periods, along with the vibrations the vehicle causes, can put excessive pressure on the spine.
- Sedentary lifestyle: Lack of routine exercise can increase the risk of herniated discs.
Complications
The cauda equine, a collection of long nerve roots that look like a horsetail, continues through the spinal canal after the end of the spinal cord just over the waist. In rare instances, the whole spinal canal, along with the cauda equine nerves, can be compressed by the herniated disc. This may require emergency surgery to prevent long-lasting weakness or paralysis.
Seek immediate medical care if you have the following:
- Worsening symptoms: Persistent numbness, pain, or weakness that interferes with everyday activities.
- Bladder or bowel dysfunction: Incontinence or trouble urinating even when the bladder is full can result from cauda equina syndrome.
- Saddle anesthesia: Gradual loss of sense in parts that the body would come into contact with a saddle, such as the backs of the legs, inner thighs, or area surrounding the rectum.
Diagnosis
At The Joint Pain Clinic, we diagnose herniated discs by performing a comprehensive physical examination, which includes assessing pain levels and muscle reflexes, strength, and sensation. If necessary, diagnostic tests may be ordered to confirm the diagnosis.
Our Treatment Options
Joint Pain Clinic offers the following treatment options:
Caudal epidural steroid injections (CESIs):
This treatment involves the use of ultrasound imaging to precisely implant a needle into the epidural space, whereby a combination of corticosteroids and anesthetics are administered. It is a widely used method to reduce pain and inflammation caused by herniated discs.
Physical therapy:
A physical therapist will create a personalized exercise program aimed at relieving pressure on the affected nerve, loosening tight muscles, and improving blood circulation. This approach promotes healing, enhances mobility, and strengthens the muscles supporting the spine.