The spine is formed by the vertebrae bones, with intervertebral discs between them. The intervertebral disc helps in keeping the spine flexible and also acts as shock absorber. Any damage to the disc may results in bulging or extrusion of the disc; this condition is called herniated disc.
Herniated disc can occur in any part of the spine. However, it is more common in the lumbar spine but can also affect the cervical and the thoracic spine.
Advancing age, trauma, smoking, poor diet, and poor body mechanics can affect the flexibility and strength of the disc. Injury to the spine can cause minor cracks in the hard outer covering of the disc which result in the oozing of the gelatinous material from the disc, with bulging or defragmentation of the intervertebral disc.
When a herniated disc compresses the nerve roots, one may feel pain, numbness, and also weakness in the area having the compression of nerve. A herniated disc present in the lower back causes pain and numbness in the buttock and lower legs; condition is called as sciatica.
Back pain is the most common complaint in patients with a herniated disc. Compression of a nerve, by a herniated disc, can lead to weakness or numbness in the legs. Bladder or bowel dysfunction may indicate the presence of cauda equina syndrome.
The basic steps in the diagnosis of a herniated disc include:
- Medical and family history of the patient
- Physical examination
- Neurological examination
- Testing of reflexes to evaluates muscle weakness
- Diagnostic imaging techniques such as X-rays, CT scan, MRI scans are employed to confirm the damaged disc
Plain X-rays helps in identifying the collapsed disc space, whereas CT and MRI scan are more precise techniques that help to visualize the bone, disc and nerve structures.
The initial treatment of herniated disc usually involves various non-surgical options such as adequate rest, modification of activities, applying heat or ice to the affected area, physical therapy, medication such as anti inflammatory, muscle relaxant, narcotics, and steroid injections. Majority of the cases treated with non-surgical methods heal within a period of 1 to 6 months.
In rare cases where the non-surgical methods have been fund to be ineffective, doctor may recommend spinal surgery. Discectomy is one of the most common surgical procedures employed for the management of herniated disc. It involves removal of a segment of the herniated disc causing nerve compression.