The spine is usually made up of a set of bones called vertebrae. In between these bones, there exist a jelly-like substance called disc. With age, these disks began to lose their water content and hence split. This causes the jelly-like center of disc to bulge out of the disc. As a result, acute back pain and sciatica occurs. This condition is known as disc prolapse/ herniated disc. The rupture may occur to any of the disc. Usually the disc in the lumbar part of the spine is prolapsed. The damaged disc may either affect a single nerve root or whole of the spinal cord. The causes of herniated disc include aging, heavy lifting, long hour sitting, obesity, and smoking.
The common symptoms of prolapsed disc include:
- Back Pain
Severe pain in the lower back portion is the common symptoms of prolapsed disc. The condition is worsen with sneezing, coughing or movement of back. Often lying down in flat position gives temporary pain relief.
- Pain in nerve root
In severe cases, the pain in the back drops down inside the buttock towards the back of the leg. It occurs when a spinal cord nerve is trapped by a herniated disc. Sciatic nerve is most usually affected. Sometimes, the nerve near the spine is also irritated, causing weakness or numbness in the buttock and leg. The actual area and type of symptom depends on the nerve affected.
- Cauda equina syndrome
Cauda equina syndrome is a very rare symptom but if occurred needs immediate care. The pressing of nerves at the bottom of the spinal causes this condition. As a result, acute pain is felt in the back. In addition to pain, the person experiences other disorders such as numbness in the saddle region, loss of bowel and bladder control, and weakened legs. Urgent treatment is needed otherwise permanent damage may occur to the nerves.
- Abnormal sensation
Abnormal sensations may be felt in different parts of the body such as buttock, arms, and legs. The sensations include pins and needles, tingling or numbness.
Non-surgical treatments are more commonly used to treat herniated disc condition. Only severe cases which fail to respond to these treatments are corrected through surgical surgery.
- Non-surgical treatment:
The various steps involved in non-surgical treatment are given below:
- Rest and activity
Longer hours of bed rest is not recommended for lowering pain. Gentle activities which do not cause straining or stretching are advised. They enhance the recovery process.
Medications are usually prescribed to relieve pain. They may be in the form of injection or tablets. The medications may be non-steroidal anti-inflammatory medications, paracetamol, or muscle relaxant medicines.
To strengthen the muscles and maintain movement, physical therapies along with specific exercises are greatly beneficial.
- Alternate treatments
The alternative treatment includes chiropractic, acupuncture and osteopathy. They are helpful to treat pain.
- Surgical treatment:
Very few people require surgery to treat herniated disk condition. The surgery mainly aims to remove the damaged part of the disc. The patient is kept under anesthesia to create a numb feeling. The commonly used surgical treatments are:
- Disectomy (Open disectomy)
For bulged or ruptured disc, disectomy procedure is mainly chosen. In this surgery, the damaged part or whole of the disc is removed. For this, initially an incision is created on the spine. A special tool is then inserted to remove herniated disc. This method is considered as an effective method of surgical treatment.
This procedure tends to reduce the pressure on the spinal cord or spinal nerves. In laminectomy, the lamina on the selected vertebrae is removed. In addition, the thickened tissues that narrows the spinal cord are also cleared out. This method is, sometimes, done along with disectomy.
- Prosthetic intervertebral disc replacement
In this technique, the damaged disc is replaced with an artificial disc. The damaged disc is partially or fully removed through an incision in the spine. The remaining space is then filled with a replacement disc.
After-surgery, the patient is advised to give complete rest to the operated part. It is essential to regularly clean the wound. This avoids any infection in that part. Stress and strain should be completely avoided. The recovery is over in 2-3 months.
The risks involved in the treatment of herniated disc are:
- Increased swelling
- Instability in disc