Central Disc Protrusion: Causes, Symptoms, Treatment
What is Central Disc Protrusion?
There are many types of bulging or herniated discs. Central disc protrusion is one such type which affects the spinal cord and may potentially result in problems with nervous system, such as muscle weakness and radiating pain.
The difference between a central disc protrusion and other standard bulging or herniated disc is that in central disc protrusion, the disc herniates or expands posteriorly or backwards into the middle of the spinal canal where the spinal nerve roots and spinal cord is present; whereas, in other disc herniation, the disc expands to either sides or forwards. In central disc protrusion, if there is compression of any of the nerve roots, then it produces serious symptoms in the patient.(1)
Causes of Central Disc Protrusion
There are various causes for central disc protrusion, some which can be avoided and some which are unavoidable, such as injuries or traumas. Some of the common causes of central disc protrusion(2) are:
- Aging of the spine.
- Degenerative disc disease
- Trauma/Injury to the spine.
- Incorrect or wrong lifting techniques.
The common cause of central disc protrusion is natural deterioration/degeneration of the spine. As a person ages, so does his/her spine and our spine endures different sort of strains over the years, such as twisting, bending and spinal compression due to weight gain. This leads to gradual squeezing of the spinal discs. The spinal discs are responsible for supporting the spinal vertebrae, cushioning them and acting as a shock absorber by allowing them to move or bend without impacting or compressing each other. If there is increased pressure on the discs and vertebrae, then it forces the disc to flatten and herniate/protrude outwards, which in the case of a central disc protrusion, there is herniation of disc backwards into the spinal canal.
Symptoms of Central Disc Protrusion
As mentioned before, compression of the nerve root due to central disc protrusion produces symptoms such as:
- Radiating pain along the nerve path.
- Muscle weakness.
- Tingling or numbness is felt in the hands, arms, feet or legs.
- Sensation of heat or tingling sensation, which feels like pins and needles.
- Incontinence in severe cases.
Treatment for Central Disc Protrusion
Treatment for central disc protrusion is required if the patient is experiencing debilitating symptoms, such as chronic pain and decreased mobility due to nerve compression from the herniated disc. Conservative treatment for central disc protrusion is started first to help alleviate the patient's symptoms as the body and the spine naturally heals itself. Over-the counter pain medications are prescribed to relieve pain associated with central disc protrusion and some mild stretching exercises are recommended to relieve the compression on the nerve. This type of conservative approach is effective in many patients suffering from central disc protrusion; however, it often takes many months before any type of relief is achieved.(3)
If the patient's symptoms persist even after many months, then minimally invasive spine surgery, such as decompression surgery, may be required where a part of the disc, which is causing compression of the nerve root and producing the symptoms, is removed. In some patients with central disc protrusion, it may be necessary to remove the entire disc and replace it with bone grafts and artificial disc in a surgery which is known as stabilization surgery.
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