How Is Herniated Discs Treated

A herniated discs is also known as a slipped disk or ruptured disk; it is one of the most common causes of back and leg pain. Herniated disks usually happen in the lower part of the spine. The spine, or backbone, is made up of a series of individual bones called vertebrae that are stacked to form the spinal column. Between the vertebrae are flat, round cushioning pads called intervertebral disks, which act as shock absorbers. Each disk has a soft, gel-like center — called the nucleus pulposus — surrounded by a tough, fibrous outer layer called the annulus.

Causes

A slipped disk occurs when the soft internal section of an intervertebral disk protrudes through the outer layer.

The human backbone, or spine, consists of 26 bones called vertebrae. Between each vertebra lie rubbery, cushion-like pads called “disks.” These disks help keep the vertebrae in place and act as shock absorbers.

Spinal disks have a soft, jelly-like center and a tougher exterior.

A herniated disk occurs when some of the soft interior slips out through a crack in the wall of the disk. This most commonly occurs in the low back but can also occur in the vertebrae of the neck.

The escape of this “jelly” is thought to release chemicals that irritate nerves in the surrounding area and cause significant pain. The prolapsed disk may also put pressure on nerves and cause pain through compression.

The cause of a leaking disk is usually gradual wear and overuse as a result of repeated movement over time.

Spinal disks lose some of their water content as a person ages. This reduction in fluid makes the disks less supple and more prone to splitting.

It is not always possible to recall the exact point when a disk problem begins, but it often occurs when lifting objects without bending at the knee or after twisting while lifting a heavy item

How is a herniated disk treated?

Most herniated disks resolve on their own or with conservative treatment, which includes rest, anti-inflammatory medicine, and physical therapy. Some people find that ice packs or moist heat applied to the affected area provides some symptomatic relief of the pain and muscle spasms in the back. In cases that do not improve with conservative treatment, spinal injections or surgery might be needed.

Medicine: Nonsteroidal anti-inflammatory drugs (NSAIDs) help to relieve pain, inflammation, and stiffness, allowing for increased mobility and exercise.

Common over-the-counter NSAIDs include aspirin, ibuprofen (Motrin®, Advil®), and naproxen (Naprosyn®, Aleve®). You may take medicines with food to avoid stomach irritation.

Muscle relaxants and various analgesics might be prescribed to relieve the discomfort associated with severe pain or muscle spasms in the initial treatment periods.

Physical therapy: The goal of physical therapy is to improve core strength, flexibility and endurance to enable you to engage in your normal activities.

The exercises prescribed by your physical therapist can also help relieve pressure on your nerves, reducing the symptoms of pain and weakness. The exercise program often includes stretching exercises to improve flexibility of tight muscles and aerobic exercise — such as walking or using a stationary bike — to build endurance and improve circulation.

Other exercises might help to strengthen the muscles of your back, abdomen, and legs.

Spinal injections — An injection of a cortisone-like medicine into the lower back might help reduce swelling and inflammation of the nerve roots, allowing for increased mobility. These injections are referred to as epidurals or nerve blocks.

Surgery — Surgery might be needed for people who do not respond to conservative treatment, whose symptoms get progressively worse, or who experience progressive neurologic decline. Rarely, a large disk herniation might injure nerves to the bladder or bowel, which requires emergency surgery. The most common surgical options include microdiscectomy, laminectomy, or foraminotomy.

Microdiscectomy — Microdiscectomy is a procedure used to remove fragments of a herniated disk, often using an operating microscope.

Laminectomy — The part of the bone that curves around and covers the spinal cord (lamina) and the tissue that is causing pressure on the nerve or spinal cord are removed. This procedure is performed under general anesthesia. The hospital stay is one to two days. Complete recovery takes about six weeks.

Prevention

Tips for preventing a herniated disk include:

avoiding obesity or losing weight, if necessary

learning the correct techniques for lifting and handling

resting and seeking help if symptoms occur

Although it can sometimes be extremely painful, a herniated disk has many promising treatment options.