What is a Herniated Disc?
A herniated disc, also called a prolapsed disc or slipped disc is a fairly common condition where the intervertebral discs i.e. the discs that lie in between the spinal bones rupture and the material that is within it starts to protrude out of the space. By doing so, it can compress the nerves that arise from within the spinal-cord, causing pain, numbness and a number of other neurological symptoms. A herniated disc can be seen in any part of the spine though the lumbar spine is the most common site affected.
Anatomy of the Intervertebral Disc
The spinal column is composed of 24 vertebral bones. These vertebral bones are subject to different kinds of twisting movements. In order to prevent them from rubbing against each other, between each of these vertebrae at soft gelatinous intervertebral discs that act as shock absorbers. The intervertebral discs have an outer hard shell and are filled with a soft gelatinous material that makes them fairly pliable. In the event that this hard outer shell ruptures, the gelatinous material can leak out and compress the nerves.
Causes of Herniated Discs
The change in the structure of the herniated discs is usually an age-related phenomenon. However, it appears that sudden movements such as lifting heavy weights or bending awkwardly can result in herniated discs.
There are a number of different risk factors that can contribute to the development of disc herniation. These include being obese, smoking, injury to the back and participating in activities that place a great deal of strain on the back (for example weightlifting).
Depending on the site where the disc has herniated, the symptoms can vary. Lumbar disc prolapse can cause shooting pains in the gluteal region (buttocks) and down the leg, sometimes called sciatica. Disc prolapse in the neck can cause pain and numbness down the arms. Disc prolapse in the lowest part of the spine can result in cauda equina syndrome; a condition characterized by low back pain and paralysis of one or both legs. This is a medical emergency.
Diagnosis is straightforward and can be achieved through clinical examination and radiological investigations. A simple x-ray is usually enough though in some cases. A CT scan or MRI scan may be required to assess things further.
The treatment options depend upon the site of disc herniation. In most cases, simple painkillers (such as paracetamol, codeine and non-steroidal anti-inflammatory drugs) and physical therapy is sufficient. If required, muscle relaxants may be offered to the patient. It is essential for patients to stay active even if they have slipped discs. Of course, activities that may make it worse such as weightlifting and strenuous activities should be avoided.
In the event that the symptoms are severe and disabling, surgical treatments may be required. These include nerve decompression through minimally invasive methods, discectomy i.e. removal of the disc and replacement of the disc with prosthetic materials. Sometimes, spinal fusion may need to be conducted.