Herniated Discs
Quick Reference
A herniated or “slipped” disc occurs when the soft, pliable cushioning between the vertebrae pushes out into the nerves of the spinal cord. Herniated discs are most commonly reported among the vertebrae of the neck or lower back, and are often accompanied by intense pain. Depending on the severity of pain or nerve impediment, treatment may range from anti-inflammatory drugs to more invasive procedures.
Detailed Description
Discs have both a firm outer ring made up of cartilage, called the annulus, and a more pliable gelatin center, called the nucleus. In a herniated disc, abnormal expansion of the nucleus pushes the annulus into the spinal cord, interfering with local nerves, and causing the resulting pain. This process can develop from a variety of circumstances, including bad posture, excess body weight, improper lifting techniques, a fall or accident, repeated strain of the back, or sudden pressure. In addition, discs are susceptible to general wear and tear, and become more vulnerable as their water content and associated flexibility decreases throughout the aging process.
The most common symptom associated with a herniated disc in the lower back is a sciatica, or sharp, shooting pain that extends from the buttocks down the back of the leg. However, symptoms such as weakness or numbness in one leg, a loss of bladder or bowel control, and an intense pain centered in the back may also indicate this condition. If the herniated disc occurs in the neck or upper vertebrae, it may be difficult to straighten the neck without substantial pain, and numbness or weakness may occur in one or both arms.
Treatment
The presence of a herniated disc can be confirmed through physical examination, usually with the aid of X-ray, CT, MRI, or similar scans. Depending on the type of pain experienced, muscle relaxers, analgesics, anti-inflammatory drugs, icing or heat may all be prescribed. For very severe pain, an epidural injection of a cortisone-containing drug may be administered to decrease nerve inflammation, or a small amount of chyopapain may be used locally to physically dissolve the disc protrusion. A laminectomy, or surgical procedure in which a portion of the vertebral bone is removed, is another option.
In addition to medication or surgical procedures, physical therapy may be advised to strengthen back muscles and joints and therefore decrease the likelihood of further problems. Utilizing chairs and mattresses with adequate back support, practicing proper lifting techniques, and maintaining a healthy body weight are also a part of normal treatment. After treatment has begun, any intense pain should decrease significantly after a few weeks, although some pain may continue months into the future.
Last updated: 17-Dec-02
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