Identifying and Treating a Herniated Disc
Many patients with leg pain, back pain, or
weak lower extremity muscles are diagnosed with a herniated disc. When a
disc herniation occurs, the cushion that lies between the spinal
vertebra is pushed out of its regular position. A herniated disc
wouldn't really be an issue if it weren't for the spinal nerves that are
extremely close to the edge of these cushioning discs.
Spinal Discs
The spinal disc is the soft cushion that
sits between each vertebra of the spine.
This disc becomes more rigid with age. In young individuals, the disc is
soft and elastic, but much like many other of the body's structures, it
gradually loses its elasticity and becomes more vulnerable to injury.
In fact, even in individuals in their 20s, MRIs frequently show early
evidence of disc deterioration.
As the spinal disc loses its elasticity, it can rupture. When a rupture
occurs, a part of the spinal disc pushes away from its normal boundary,
causing a herniated disc. When a herniated disc bulges out from between
the vertebrae, the spinal cord and the spinal nerves may become pinched.
If a herniated disc is pushed far enough, these structures may become
compressed, and that's where the pain begins.
Symptoms of a Herniated Disc
There a quite a number of reasons behind
why someone might develop a herniated disc. It may occur gradually with
repetitive straining of the spine, or it might occur suddenly in an
event such as an accident or a fall.
People who experience a herniated disc often already have spinal
stenosis, a problem that causes narrowing of the space around the spinal
nerves and spinal cord. A herniated disc would then further reduce the
amount of space remaining, leading to irritation of the nerve.
Some of the most common symptoms of a herniated disc include electric
shock pain, coupled with sensations of tingling and numbness. If these
sensations are felt in your arms, then this indicates a compression in
the neck region. If you feel electric shocks going down through your
legs, then you've probably got a compression in your lower back.
If you've got a herniated disc, then you might also experience muscle
weakness, due to the interruption of certain brain signals. Bowel or
bladder problems are other common symptoms of a herniated disc, and
these shouldn't be ignored since they may be a sign of cauda equina
syndrome. If you're finding it hard to have bowel movements, urinate, or
if you experience numbness around your genitals, then visit your doctor
immediately!
Diagnosis and Treatment of a Herniated Disc
Typically, your doctor will be able to
diagnose a herniated disc through a thorough physical examination, by
testing reflexes, sensation, and muscle strength. An MRI is also
commonly used to make the diagnosis more accurate.
While people diagnosed with a herniated disc sometimes have to undergo
surgery, it is usually considered as a last resort, especially in less
severe cases. There are many different treatments an individual can try
out first, and the most effective include:
• Rest & Activity Modification
The first treatment is to rest and to avoid carrying out any activities
that might aggravate your symptoms. Many disc herniations will resolve
if given enough time.
• Ice & Heat Applications
These can be extremely helpful in relieving a disc herniation's most
painful symptoms. By helping to relax the back's muscles, ice and heat
applications can relieve muscle spasms and provide efficient pain
relief.
• Anti-Inflammatory Medications
Nonsteroidal anti-inflammatory medications (NSAIDs) are often
prescribed, and help to relieve some of the pain. By reducing
inflammation, these medications can reduce some of the pressure on the
compressed nerves. NSAIDs should only be used under a doctor's
supervision.
• Oral Steroid Medications
These can be very helpful in episodes of an acute (sudden) disc
herniation. Some of these medications include Prednisone and Medrol.
Like NSAIDs, these powerful anti-inflammatory medications can relieve
your symptoms by reducing inflammation around the compressed nerves.
• Other Medications
Other medications used include muscle relaxers and narcotic pain
medications. Narcotic pain medications are useful for severe, short-term
pain management. Be warned though, these medications can be addictive
and can make you drowsy. It is important to use these for only short
stretches of time. Muscle relaxers are used to treat the spinal muscle
spasms often seen with disc herniations. Such muscle spasms are often
worse than the pain from the disc pressing on the nerves, so muscle
relaxers provide some welcome relief.
• Epidural Steroid Injections
Cortisone injections can be administered directly to the area of nerve
compression. Like oral anti-inflammatory medications, the idea is to
relieve the compression on the nerves. When an injection is used, the
medication is delivered directly to the affected area, rather than
traveling throughout your entire body, as is the case with oral
medication.