Intervertebral disc herniation is the displacement of the cushion or disc that is situated between the vertebral bones. Intervertebral disks are the soft pad like cushioning between each vertebrae that acts as a shock absorber for the spine and all of its different parts.
When displacement or herniation of the disc occurs, the disc ruptures or bulge out between the vertebrae and begin to pinch the nerves in the spine and the spinal cord. The disc can impinge upon the spinal cord or nerve roots causing pain and dysfunction of the nervous system.
Intervertebral disc herniation may occur in the lumbar spine, cervical spine, and thoracic spine.
Lumbar Disc Herniation
A lumbar disc herniation is a common cause of low back pain, buttock pain, and leg pain.
Symptoms of Lumbar Disc Herniation:
- Tingling or numbness in one leg.
- Weakness in certain muscles and in one or both legs.
- Movements or activities such as bending, coughing, or sneezing may intensify the pain.
- Leg weakness or loss of leg function.
- Muscle spasms or cramping.
Thoracic Disc Herniation
A thoracic disc herniation causes mid back and rib/abdominal pain. It is located in the upper back. Thoracic herniated disc is not as common as a lumbar disc herniation or cervical disc herniation.
Symptoms Associated with the Thoracic Herniated Disc:
There are 3 areas where disc hernaition can take place and they are central, lateral, or centro-lateral. The symptoms for each are as follows:
- Central Disc Protrusion - When there is pressure from the thoracic herniated disc, pressure is put on the spinal cord which affects the nerve. This leads to upper back pain. Size of the herniated disc and the amount of the pressure on the spinal cord determines the extent of the symptoms.
- Herniated Lateral Disc - Protrusion of disc laterally. The gel-like material will put pressure on the nerve that is located at that level of the spine and will likely cause radiation chest wall or abdominal pain.
- Herniated Centro-lateral Disc - Usual symptoms associated with this type of herniation are upper back pain, radiating pain, or myelopathy, which is a functional disturbance or pathological change in the spinal cord.
Cervical Disc Herniation
A cervical disc herniation is a common cause of neck and arm/shoulder pain.
Symptoms of Cervical Disc Herniation:
- Numbness, tingling, and/or burning in the arm on the affected side.
- Movement or activities like as bending, coughing, or sneezing may cause worsening of the pain. Head movement to any one side may also aggravate the patient's symptoms.
- Arm weakness or loss of arm function.
Tests to Diagnose Intervertebral Disc Herniation
To diagnose a herniated disk, a physical exam by a specialist and a diagnostic study like an MRI or x-ray will be required to determine if it is a normal wear and tear of the disk or if there is something else causing the problem.
Treatments for Intervertebral Disc Herniation
Disc herniations can be successfully treated with medications, physical therapy, and steroid injections performed by a pain management specialist. If these treatments are not effective, surgery could be an option. Some disc herniations can be treated with minimally invasive surgery like Lumbar microdiscectomy, Endoscope assisted discectomy, Cervical "keyhole" foraminotomy with discectomy while others require traditional open surgical techniques like anterior cervical discectomy with microscope assistance and fusion.
To treat a herniated disk, doctors will often try non-surgical methods before considering surgery Non-surgical methods can include:
- Alternating between cold and warm compresses, preferably using ice.
- Non Steroidal Anti-inflammatories, corticosteroids, neuropathic pain meds does help.
- Muscles Relaxants like Soma and Skelaxin.
- Spinal Manipulation or Traction by a Chiropractor.
- TENS-Transcutaneous Electrical Nerve Stimulation.
- Massage Therapy
Watch 3D Video of Cervical Radiculopathy, Disc Bulge, Disc Herniation:
Prevention for Intervertebral Disc Herniation
Staying physically fit to reduce the load on the spine and keeping the back and stomach muscles equally strong can reduce the chances of back pain and herniations.