Each of the vertebrae of the spine has a small shock absorber between them, this is known as the disc. The discs are made up of a firm outer ring and a gelatinous inner core; When the disc ruptures, either due to wear and tear on the body or some other injury, the internal substance spills out and causes the herniated disc.
The pain and the rest of the symptoms produced by the herniated disc do not come entirely from the spillage of the nucleus itself, but from the pressure that this soft substance exerts on the nerves and spinal cord when it comes out of the disc.
Herniated discs can occur in any segment of the spine, although among all of them, the most susceptible regions are usually the lumbar and cervical. Symptoms can range from mild to moderate and intensify over time until they become chronic; In situations like this, consultation evaluation should be a priority.
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The symptoms of a herniated disc can be completely different depending on the location of the herniation and the specific nerve it is affecting. Common symptoms of a cervical herniated disc and a lumbar herniated disc include: pain, weakness, and numbness on only one side of the body.
Occasionally, a herniated disc can be asymptomatic and go unnoticed for a considerable period of time.
Atypical or very severe pain.
Weakness that interferes with the proper functioning of the lower or upper extremities.
Appearance of cauda equina syndrome (compression of nerve roots).
Difficulty walking caused by radiating pain
Pain in the lower back that may extend to the buttocks, thigh, calf, and foot.
Tingling sensation or numbness radiating to the part of the body that supplies the affected nerve (or nerves).
Muscle weakness and difficulty lifting the leg.
Neck pain that goes down to the shoulder, arm, forearm, and hand.
Tingling sensation or numbness radiating to the part of the body where the affected nerve (or nerves) are connected.
Muscle weakness and difficulty lifting the arm.
In addition to the specific symptoms of herniated discs, there are neurological symptoms caused by nerve compression. Among them we can mention:
A herniated disc can lead to radiculopathy, which manifests as pain, numbness, or weakness along the path of a compressed nerve; as well as sciatica, which causes sharp pain in the lower back and radiates down one leg.
Patients may experience a decrease in muscle strength and sensation in the affected limbs due to nerve compression.
In extremely rare cases, herniated discs can cause urinary incontinence, requiring immediate medical attention.
The first step in diagnosing a herniated disc is the physical evaluation, where the specialist will examine the patient’s back for pain and tenderness points. In addition, the doctor may ask you to perform certain movements and specific positions to find the source of the pain.
Neurological tests are also frequently used to assess relevant aspects such as: reflexes, muscle strength, walking performance and the level of stimulus when receiving touches, vibrations and/or punctures.
If during the physical examination the doctor notices signs of a more complex nerve condition or other type of significant damage, he or she will probably need to undergo imaging tests (X-ray, CT scan, MRI, myelography, electromyography…) to rule out and/or confirm the existence of other pathologies causing back pain.
Statistics indicate that about 90% of cases of herniated discs resolve favorably with conservative treatments, while the remaining 10% require some type of surgery.
Initial conservative treatment includes:
The prescription of analgesic, anti-inflammatory, nerve soothing and/or muscle relaxant medications accompanied by a period of rest, may be enough to improve the condition of the patient with small hernias.
Physical therapy is an unavoidable step for people with herniated discs. The therapist will not only help you re-educate your way of walking, lifting heavy objects and carrying out different activities; He will also teach you some basic exercises to help strengthen the muscles that support the spine and increase the flexibility of your musculoskeletal system.
Small changes in routines can make a huge difference in favor of your health, so make sure to: Stop any physical activity that causes pain, maintain a balanced diet, lose weight (if you are an obese person) and perform low-impact exercises constantly.
In this outpatient procedure, the doctor injects a controlled dose of steroids into the back (around the disc) to decrease swelling and relieve pain for several months. It should be noted that this is not a definitive solution, so when the effect wears off, the symptoms may return.
Very few people need surgery to fix their disc problem. However, below we will mention the usual surgical procedures for these cases…
During a discectomy, surgeons cut and remove the portion corresponding to the herniated disc and leave the rest of the disc in place, this procedure is one of the most frequent in the surgical treatment of herniated disc.
When total removal of the disc occurs, a spinal fusion is essential to provide sufficient stability to the spine. In this surgery, special techniques are applied that allow the vertebrae to be joined and thus correct the intervertebral problem.
In consultations prior to surgery, the specialist will be in charge of dictating some recommendations to take into account both in the days prior to surgery and on the day of the intervention itself, for example: stop the intake of certain types of medications that can delay coagulation, avoid the consumption of food and drinks in the hours prior to surgery, arriving punctually to the health center, among others.
To estimate the price of a disc trade, we must exhaustively assess multiple factors; for this reason, we always recommend contacting our specialists to obtain a personalized quote that really fits the needs of the patient.
The first cause of a herniated disc in the spine is disc degeneration caused by the aging of the human body; The second reason is the performance of physically demanding work for many years. Other risk factors associated with the appearance of herniated discs include: being overweight, genetic predisposition, sedentary lifestyle and being an active/passive smoker.
In this segment, we are in charge of answering some of the most recurrent concerns among our readers…
Recovery time after lumbar discectomy (most common surgery) is about 1 to 2 months. Depending on the amount of physical effort demanded by the patient’s work activity, this time could be extended for a few more weeks.
Discectomy is a safe method that is performed regularly; however, as with any other operation, there may be common complications such as:
Infections.
Bleeding.
Cerebrospinal fluid leakage.
Involvement of a blood vessel, cervical nerve, or lumbar nerve during the procedure.
The location and length of the scar will depend on the type of surgery you underwent. A lumbar discectomy will leave a vertical scar of a few centimeters on the lower back; while in an anterior cervical discectomy with fusion, the incision is made horizontally in the front of the neck.
Herniated discs require surgery when the response to previous treatments has not improved symptoms after more than 6 months have been tried or when the herniation has been found to be seriously compromising a nerve root.
Most herniated disc repair surgeries (lumbar or cervical) last approximately 1 to 2 hours; although depending on the techniques and maneuvers used it could be extended for a few more minutes.
A lumbar herniated disc generates pain in the middle/lower back, the pain can be fixed at this point (small herniation) or radiate to the lower limb of the affected side, causing discomfort and/or weakness from the buttock to the foot.
After you leave the clinic and get home, make sure to:
Rest.
Keep wounds and bandage clean and dry.
Ask for support from a family member when bathing or when you need to perform movements that involve physical effort.
Take medications according to medical indications.
Avoid driving, long walks, heavy lifting, and climbing stairs until your doctor says it's okay.
Go to the consultation punctually to remove the stitches and assess your progress.
