What is a Herniated Disc?
People who are suffering from leg pain, weakness of the lower extremity muscles or back pain are diagnosed with a herniated disc.
A herniated disc occurs when the cushion which sits in between the spinal vertebra is pressed outside its normal position.
The condition of herniated disc can cause pain weakness or numbness in an arm or leg.
It can also irritate the surrounding nerves.
It has been seen that many people develop no symptoms of a herniated disc.
Causes of a Herniated Disc
The most common reason that cause a herniated disc is disc degeneration (wear and tear of the disc).
The normal ageing process decreases the fluid in the vertebral disc that helps in maintaining proper flexibility.
Any injury to the spine can also cause a herniated disc that may cause cracks or small tears in the outer layer of the disc.
Inside the disc there is a jelly like material that can be pushed out from the cracks or tears in the capsule, causing the disc to break into fragments or bulge.
Injury to the disc can be due to the followings:
- Repeated activities that may stress the lower back such as prolonged exposure to vibration, poor lifting habits and sports related injuries.
- Increased pressure or a sudden heavy strain to the lower back. A sudden twisting movement can push the nucleus out of the outer layer of the disc.
Symptoms of a Herniated Disc
Herniated disc common symptoms include the followings:
Tingling and Numbness: A patient experiences some abnormal sensations of numbness, pin or needles and tingling.
Usually all these symptoms occur in the same area and can be similar to painful electric shock sensations.
Electric Shock Pain: Abnormal sensations are caused by the nerve pressure. This sensation is similar to an electric shock pain.
When there is a compression in the neck region then shock goes down to the arms and when compression is in the low back region then shock goes down to the legs.
Bladder or Bowel Problems: Bladder or bowel problems are an important indication of cauda equine syndrome.
This condition usually results from a herniated disc.
Muscle Weakness: It could be possible that signals from the brain may get disturbed due to nerve irritation that further causes muscle weakness.
Diagnosis of a Herniated Disc
The condition of a herniated disc is diagnosed when its symptoms are present.
With the help of neurological examinations, abnormal reflexes can be revealed.
A positive straight leg raising test is done in order to elicit the pain when a straight leg is raised while sitting or lying.
An abnormal sensation could also be there in the leg or foot.
In order to determine any signs of infection or inflammation, many blood tests are done.
The degeneration of the spine is indicated by plain film X-rays. Also, CT scan or MRI scan is performed for determining whether a disc is herniated.
The irritation in the nerves due to a disc herniation can be precisely determined by using an electromyogram (EMG).
Herniated Disc Treatment
A herniated disc treatment depends upon many factors that include the followings:
- Existence of worsening symptoms
- Symptoms experienced by a patient
- Patients’ activity level
- Age of a patient
The purpose of every treatment is to relieve the symptoms of a herniated disc and to provide a relief from its pain.
Discomfort and pain caused by cervical and lumbar herniated discs can be treated with the help of non-surgical treatments.
These treatments are provided for 4-6 weeks.
Patients who are still going through a high loss of function and severe pain, can consider surgery as an option.
If the pain caused by a herniated disc is mild to moderate, then nonsteroidal anti-inflammatory medication is given.
For directing the medication to the precise level of a disc herniation, an epidural steroid injection is given by using a spinal needle under X-ray guidance.
Physical therapy is also sometimes recommended.
Physical therapy also involves gentle massage, ultrasound, pelvic traction, ice and heat therapy, stretching exercises and electrical muscle stimulation.
Along with physical therapy, muscle relaxants and pain medication may also prove beneficial for a patient.
Types of Surgery for a Herniated Disc
Laminectomy: This procedure removes most of the lamina of a vertebra or the bony arch.
Artificial Disc Replacement: During this procedure, a diseased herniated disc is replaced with an artificial disc.
For treating pain connected with degenerative disc disease, Prodisc-L is used which is made up of plastic and metal.
The Charite artificial disc is yet another artificial disc having a plastic core in between 2 chrome plates which gets locked into the spine.
Discectomy: In this, there is complete, or part of an intervertebral disc is removed.
Spinal Fusion: During the spinal fusion procedure, a bone is grafted on the spine in order to create a hard union between 2 or more vertebrae.
Sometimes rods and screws are used for providing additional spinal support.
Endoscopic Procedure for Treating a Herniated Disc: An endoscopic herniated disc surgery is performed by making a small incision.
Both an endoscope and a camera are used, and a needle and a mechanical device is inserted into the back of a patient.
Then the diseased part of the disc is removed by the surgeon.
This procedure is done on an outpatient basis that also involves faster recovery.
Laser Therapy for a Herniated Disc
Percutaneous Laser Disc Decompression (PLDD) is used for treating neck or back pain which is caused by a herniated disc.
PLDD provides an instant relief without performing any surgery.
This minimally invasive procedure is done under local anesthesia and is performed on an outpatient basis.
A laser beam is used for vaporizing a small part of the disc in order to decompress it.
Cost of a Herniated Disc Surgery
Iran is known worldwide for its excellent medical health care facilities.
The surgery for a herniated disc replacement is very cost-effective in Iran that attracts many global patents.