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A herniated disk is a problem with the disk that sits between the bones that are in your spine. These cushions are known as disks and the bones are known as vertebrae. The spinal disk is soft with a jelly type of center and is enclosed in a rubbery exterior. When the jelly type of center known as the nucleus slips or ruptures this is known as a herniated disk. It can occur at any part of the spine but most commonly is found to occur in the lower back. It can then cause pain and numbness as well as weakness in the arm or leg. Some people don’t have any symptoms and others with mild symptoms may improve over time.
Symptoms
Herniated disks are common in the lower back (lumbar spine) and neck (cervical spine). They usually affect one side of the body.
- Arm or leg pain. This will be due to the herniated disk occurring in the lower back and may cause pain in the buttocks, thigh and calf as well as in the foot. If the herniated disk is in your neck, the most pain, which may be sharp, will be felt in your shoulder and arm.
- Numbness or tingling. For those who have a herniated disk that affected the nerves, they will have numbness and tingling in the part of the body that the nerves affected in.
- Weakness. The muscles that are controlled by the affected nerves will be weakened and therefore may decrease your strength while holding items or may cause you to stumble.
You can have a herniated disk without symptoms. You might not know you have it unless it shows up on a spinal image but if you have pain that radiates into your arm or leg, or you have neurological symptoms like numbness or weakness then you must seek immediate help.
Causes
Disk herniation usually occurs with age and is known as wear and tear also as disk degeneration. With the aging process, the disks are more sensitive and therefore can tear even with the slightest strain. They also become less flexible. Most people don’t know the cause of their herniated disks because some may have it due to age, or carrying heavy objects or those that have had any kind of trauma.
Diagnosis
Doctors will check your back pain and perform various physical tests in order to find out the source of the pain. And the doctor may also perform a neurological exam to check your muscle reflexes, muscle strength, walking ability, and sensation.
Usually for cases of herniated disk these tests are enough but if your doctor suspects another condition, the doctor may order the following tests:
Imaging tests
- X-rays. These X-rays can determine if there are other problems such as infections, tumors, problems with spinal alignment or a broken bone which can cause the back pain.
- Computerized tomography (CT) scan. These are like multiple x-rays from different directions combined together to see a clearer picture of the spinal column and other structures around it.
- Magnetic resonance imaging (MRI). This test will be used in order to find the herniated disk’s location and to see the affected nerves.
- Myelogram. This is a CT scan with dye that is injected prior to the scan in order to see the spinal cord or nerves compressed due to multiple herniated disks.
Nerve tests
Electromyograms and nerve conduction tests are used to determine how well electrical impulses are moving along nerve tissue in order to locate the nerve damage.
Nerve conduction study. This test is performed through placement of electrodes on the skin that help to determine the functioning in muscle and the nerves. This will show the response of the nerve signals while a small current goes through the nerves.
Electromyography (EMG). This test is used to see the electrical activity of the muscle when it is contracted as well as when at rest. The doctor will insert small needle electrodes into various muscles through the skin in order to determine this.
Treatment
Patients who are diagnosed with herniated disk often think that surgical treatment is the only option when consulting a specialist and in fact, herniated disk has various choices of treatment, depending on the condition and the level of severity.
- Medication: includes both oral and injection, for pain killer or muscle relaxant along with corticosteroid injection to reduce pain and inflammation.
- Physiotherapy: helps muscle relaxations and reduces pain. It also facilitates in strengthening muscles. However, patient must be under doctor’s and physiotherapist’s supervision and be consistent with the program to achieve the highest effects of the treatment.
- Surgery: If the above mentioned (Medication and/or Physiotherapy) treatment options did not improve the symptoms, doctor may advise surgical treatment. Currently, with the help of cutting-edge technology that results in highest level of accuracy, surgery becomes less alarming than many would think.
There are various surgical techniques to help relieving pressure on the nerves and spinal cords:- Diskectomy. To remove the herniated disk.
- Laminectomy (decompression therapy).To remove the lamina for expanding the spinal canal and relieving pressure on the spinal cords.
- Spinal fusion. To connect two or more vertebrae, making your spine more stable.
- Endoscopic surgery: a minimally invasive surgery using a microscope which results in a small wound and causes less damage to surrounding muscles. It also causes less blood loss, fewer complications and shorter recovery period.
Besides the technology mentioned above, there is another technology called intraoperative neuromonitoring which shows real-time nerve monitoring, thus it could reduce the risk of nerve damage during the critical surgical procedure.
Evidently herniated disk can be treated without operative procedures if you seek medical advice from an early stage of your symptoms. Nonetheless, if you have a severe condition and surgery becomes necessary, with the help of the state-of-the-art technology paired with an expert team of surgeons can result in a competent surgery that lowers the risk of injury, hospital admission and essentially facilitate the patient to have a better quality of life.
