The most common cause of sciatica and other back, hip
and leg pain is a herniated disc. This occurs when a
disc, the soft, cushion-like tissues that act as shock
absorbers to the vertebrae, either ruptures or is partially
pushed out of alignment. The term, 'slipped disc' has
been commonly used to describe a herniated disc. The
spinal nerves lie very close to the spine and so any
change in the alignment of the parts of the spinal column
can cause pressure or irritation to these major nerves.
Like many other tissues of the body, spinal discs lose
their elasticity as we age and this makes them much
more susceptible to damage and injury. Deterioration
of the spinal discs can start as early as 30 years of
age in about one third of the population and so disc
herniation becomes more common as we get older.
A herniated
disc occurs when a piece is pushed out , having ruptured
or bulged between the vertebrae. Because there is little
space around the spinal cord and spinal nerves, the
bulging or ruptured disc often impacts on the nerves,
causing irritation or compression to the nerve.
What are the Symptoms of a Herniated Disc?
The most common symptom of disc herniation is pain;
where the pain is felt depends on the location of the
affected disc in the spine. Other symptoms include muscle
cramps or spasms, difficulty moving the affected area,
muscle weakness, increased pain when trying to move,
loss of feeling in the area, pain in the skin surrounding
it, a pins and needles sensation down the limb.
These
symptoms do not represent a medical emergency but if
bladder or bowel problems occur, immediate medical advice
must be sought. The pain, sometimes called nerve pain
or neuralgia may be a dull ache, a burning sensation,
a sharp pain often likened to an electric shock or a
pain that radiates down the arm or leg.
What causes a Herniated Disc?
Sometimes the cause of a herniated disc cannot be determined
but it is usually due to either an accident or sudden
injury or it develops gradually as the result of repetitive
strain being placed on an area of the spine. Poor posture
when sitting, standing, carrying or lifting will place
undue strain on the spine which in time will cause a
disc herniation.
How is a Disc Herniation diagnosed?
Disc herniation can be diagnosed by a doctor through
a physical examination and collecting a medical history.
A firm diagnosis can be reached with muscle strength,
sensation and reflex tests although CT scan, x-ray,
ultrasound or MRI may also be used to locate the exact
cause and location of the problem.
Once a correct diagnosis
has been made the most appropriate treatment plan can
be established. The treatment will be based on certain
individual factors such as the age and general health
of the patient, the symptoms and their severity, how
active the patient's lifestyle is and whether the symptoms
have been getting worse over time.
What is the Treatment for a Herniated Disc?
Treatment usually starts conservatively with rest recommended
to allow the irritation and inflammation to subside.
Activities that aggravate the symptoms are usually curtailed
in the short term. Some disc herniations resolve themselves
given time and rest.
To get relief from the pain, the
application of heat packs and cold compresses are very
effective. Heat and cold, applied to the affected area,
relax the muscles, relieve spasms and reduce pain significantly.
After the initial intensity of the pain subsides, physical
therapy may be used to strengthen the muscles of the
torso to correct posture and support the spine more
strongly. This can lessen the likelihood of repeated
pain from the disc herniation.
Pain medication also helps with the pain associated
with a herniated disc, NSAIDS or non-steroidal anti-inflammatory
drugs reduce inflammation and pressure at the site of
the disc which is a contributor to the pain and muscle
relaxants reduce cramping and muscle spasms.
Oral steroid
drugs are powerful anti-inflammatory medications which
reduce inflammation and relieve symptoms. Some of these
have significant side effects so be sure to ask your
doctor about this. Cortisone injections into the site
of the herniated disc relieve the pressure on the compressed
nerve in severe cases; this type of treatment is faster
acting than oral medication.
If these conservative and moderate treatment measures
are not successful at controlling disc herniation symptoms
or the patient is experiencing on-going problems, surgery
may be considered. During surgery, bone may be removed
around the herniated disc to allow the nerves more space
or the part of the disc that is protruding outside the
vertebrae may be removed. In severe cases, especially
after trauma, the disc may be removed completely.
How can I Prevent further problems from a Disc Herniation?
To help prevent pain in the future, there are several
things you can do. To keep your back strong and healthy
you need to watch your posture when you lift heavy things,
when you sit or stand for long periods and when you
bend forward from the waist. Regularly do exercises
which strengthen the core muscles, maintain a healthy
weight, get regular exercise and don't smoke. With a
few lifestyle changes, you can protect your back and
avoid the pain from disc herniation.
