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Herniated Disk:
Description
A herniated disk is a disk that has bulged out from its proper place in your back. Disks are small, circular cushions between the bones of the spine (vertebrae). Normally, disks act as shock absorbers to cushion your vertebrae from each other as you move. A herniated disk may press on nearby nerves and cause severe pain.
Cause
When a disk is damaged, the soft rubbery center of the disk squeezes out through a weak point in the hard outer layer. A disk may be damaged by:
Symptoms
Symptoms may develop gradually or begin suddenly. Symptoms include:
A fall or accident
Repeated straining of your back
A sudden strenuous action such as lifting a heavy weight or twisting violently
May happen spontaneously without any specific injury
Localized back pain
Pain that increases with specific movements
Numbness, tingling, pain, or weakness in one or both legs
Changes in bladder or bowel movements
Examination
A review of your symptoms and pain history will be gathered. After an examination of the spine, movement and reflexes in your arms and legs may be tested. Your Physician may require one or more of the following tests:
X-rays of your spine
An MRI (Magnetic Resonance Imaging)
CT scan (computerized X-ray images of your spine)
Electromyography (tests of electrical activity in your muscles)
Myelography (injection of dye into the fluid around the spinal cord that can be seen on X-rays)
Diskography (injection into the disk and X-rays taken)
Treatment
In most cases, treatment without surgery will relieve your pain. An initial period of rest is advised to reduce muscle spasm and irritation to the area, and modifications should be made to your activity level and practice/game participation.
As your pain lessens a rehab protocol will be instituted to address muscle imbalances and weakness. Other modalities may be prescribed by your physician to help speed your recovery and lessen pain. Herniated disks can have very variable lengths of recovery, and some may even need surgical intervention. About 80% of these cases should see pain reduction within a few weeks, and most athletes are able to return after treatment.
Prevention
Correct posture when walking, sitting, and playing sports is always important. Proper technique when weightlifting can help prevent herniated disks. When lifting heavy objects, don't bend over at the waist, but rather kneel or squat down by the object, while keeping your spine in alignment. Use your leg muscles to do the lifting and avoid twisting. Don't lift heavy weights that your body is not prepared for and keep your spine stabilizing muscles strong and flexible by doing core exercises.
Recovery/Rehabilitation
The goal of rehabilitation is to return you to your sport as soon as is safely possible. If you return too soon you may worsen your injury, which could lead to permanent damage. Return to sport will be determined by how soon your symptoms resolve and your function returns to normal, not by how many days or weeks it has been since your injury. In general, the longer you have symptoms before your start treatment, the longer it will take to get better.
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