Disc Herniation

What is Disc Herniation?

Disc herniation occurs when one of the spinal discs – which sit between each vertebra of the spine – ruptures and a portion of the disc bulges out between the vertebrae. When this happens, the spinal nerves and spinal cord can become pinched. If enough of the herniated disc is pushed out of place, then these can be compressed, causing back and leg pain, and neck and arm pain. Even a slight increase in pressure can be enough to produce back and leg pain (in the case of lumbar discs), and neck and arm pain (in the case of cervical discs).

What is the spinal disc?

The spinal disc acts as a cushion between vertebrae to absorb shocks. It is composed of two main parts: the annulus, which is the tough outer layer composed of connective tissue, and the nucleus pulposus, which sits at the center of the disc and is made up of a gel-like material. With age, the spinal disc loses its elasticity and becomes more rigid, making it more likely to rupture and cause disc herniation.

Symptoms

The most common symptom of disc herniation is pain in the corresponding area of the disc lesion, with or without pain in other parts of the body. When the disc herniation occurs in the cervical spine, pain can travel down the arms, hands and fingers. If the herniation happens in the lumbar spine, pain can travel down the legs and feet. Individuals with herniated discs can also feel sensations such as numbness and pins-an-needles in the arms, fingers, legs, and feet. In more severe cases, individuals can also experience loss of strength and urinary incontinence.

Please note: If you have been diagnosed as having lumbar spine disc herniation and suddenly develop urinary dysfunctions, such as incontinence or difficulty initiating urination, you should seek immediate medical attention, as this characterizes a condition called cauda equina syndrome that requires urgent care.

Causes

Many variables have been associated with the development of disc herniations, but the most common factors are:

• Bad posture (especially prolonged sitting, as is often seen in office workers);
• Work or sports-related repetitive trauma (activities that require repetitive lifting);
• Sedentary lifestyles and excess body weight;
• Genetics;
• Cigarette smoke.

Diagnosis

The diagnosis is done by means of a subjective and physical examination and can include such exams as X-rays, MRIs, and scans. For a reliable diagnosis of disc herniation to be made, the patient’s physical exam findings and symptoms need to match the MRI or other test findings. Only then can an effective treatment plan for the patient be prescribed, whether that entails treating a pinched nerve from a herniated disc, disc pain from a degenerative disc disease or some other condition.

Treatment

The treatment of pain and impairment arising from spinal disc problems will involve medication, such as anti-inflammatories, painkillers and muscle relaxants, as well as physiotherapy.

The physiotherapy treatment will involve:

• Physical modalities (heat, cold, electrotherapy);
• Manual therapy ( joint mobilizations, soft-tissue massage and other methods);
• Exercises (range of motion, strengthening, stabilization);
• Manual traction;
• Education.

Research has shown that back and neck pain are recurrent in nature; therefore, individuals suffering from this type of pain should take an active part in their rehabilitation, by understanding their problem (with education provided by the physiotherapist) and adhering to an exercise and postural hygiene program.

Remember: the faster you get treatment, the better your chances of success!

Contact our physiotherapists if you need more information.