Many patients with back pain, leg pain, or muscle weakness in the lower extremities are diagnosed with a herniated disc. With this disease, the nucleus pulposus, which is located between the spinal vertebra, is pushed out of its normal position, breaking the annulus fibrosus and squeezing the nerves.
Intervertebral discs
The nucleus pulposus is a soft pillow that sits between each vertebra in the spine. This "pillow" becomes more rigid with age, gradually loses its elasticity and becomes more vulnerable to injury. When the fibrous ring surrounding the nucleus pulposus ruptures, part of the nucleus is pushed out of its normal position - this is called a herniated disc. And when a herniated disc protrudes from the space between the vertebrae, it pinches the spinal nerves where they exit from the spinal canal, which leads to severe pain.
Symptoms of a herniated disc
A herniated disc can occur suddenly, such as in a fall or accident, or it can occur gradually with frequent spinal deformities. Often, people who have a herniated disc also have spinal stenosis, a problem that causes the space around the spinal cord and spinal nerves to narrow. When a herniated disc occurs, the space for the nerves is reduced, which leads to irritation.
When the spinal cord or spinal nerves are compressed, they cannot work properly. They start sending the wrong signals to the brain. Common symptoms of a herniated disc include:
- pain in the limbs, as if an electric shock;
- tingling and numbness in the hands and feet;
- muscle weakness;
- problems with the intestines and urination.
These symptoms are an important indicator for seeking medical attention.
Diagnostics of the herniated disc
The doctor will be able to diagnose a herniated disc after a thorough medical examination or, for a reliable result, send the patient for an MRI. The diagnosis of herniated disc and the treatment plan depend on the symptoms experienced by the patient, the results of the physical examination, and the results of imaging studies.
Hernia treatment
Most often, treatment of a herniated disc begins conservatively, that is, they usually recommend rest, special physical exercises, and also recommend avoiding those actions that provoked the appearance of a hernia.
Ice can significantly reduce pain symptoms and relieve muscle spasms. It must be applied to the areas affected by pain.
Non-steroidal anti-inflammatory drugs are usually prescribed to relieve pain associated with a herniated disc. By reducing inflammation, these drugs can relieve pressure on compressed nerves. NSAIDs should be used strictly under medical supervision.
Steroid medications can be very helpful in episodes of acute (sudden) disc herniation. Like NSAIDs, these powerful anti-inflammatory drugs reduce inflammation around compressed nerves, thereby relieving symptoms.
Other medications containing narcotic pain relievers are helpful for severe short-term pain. Unfortunately, these medicines can cause drowsiness and addiction. It is important to use them as little as possible.
Muscle relaxants are used to treat spasms of the back muscles. It often happens that the muscle spasm is worse than the pain from pinching the nerves.
Cortisone injections can be injected directly into the area of nerve compression. When using injections, the medication is delivered directly to the area of the herniated disc.
Treating a herniated disc usually starts with the simple steps outlined above. However, surgical treatment of a herniated disc may be recommended after trauma, with significant compression of the nerves. The operation is performed in order to remove the herniated disc and free up space around the compressed nerve. Depending on the size and location of the hernia and related problems (for example, spinal stenosis, spinal arthritis, etc.), the operation can be done in several ways: endoscopic, microscopic excision of the hernia, discectomy, etc.
