Herniated disc

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Overview

A herniated disc in the spine is a condition during which a nucleus pulposus is displaced from intervertebral space. It is a common cause of back pain. The patients who experience pain related to a herniated disc often remember an inciting event that caused their pain. Unlike mechanical back pain, herniated disc pain is often burning or stinging, and may radiate into the lower extremity. Furthermore, in more severe cases, there can be associated with weakness or sensation changes. In the spine, a disc or a nucleus pulposus is localized between vertebral bodies. It supports the spine by acting as a shock-absorbing cushion. In some instances, a herniated disc injury can compress the nerve or the spinal cord that causes pain consistent with nerve compression or spinal cord dysfunction, also known as myelopathy. Herniated discs can be very painful. Unfortunately, there are limited effective conservative treatment modalities with significant effectiveness. Within a few weeks, most cases of painful disc herniation heal. In many instances, the herniation of the disc does not cause that patient any pain. Herniated discs are often seen on MRIs of asymptomatic patients. Imaging is not indicated in a patient with signs and symptoms of a stable herniated disc until six weeks of persistent symptoms. MRI is the imaging modality of choice. Most cases of herniated disc heal conservatively, but refractory cases may require interventional procedures or surgical repair. Epidural corticosteroid injections are effective pain relievers for disc herniation in the short term, while discectomy is more effective than conservative management until one year following surgery . Providers need to remain aware of treating the patient with a herniated disc and monitor for severe or rapidly progressing neurological changes; this would be an indication for urgent neurosurgical referral. 

Symptoms

Arm or leg pain. If your herniated disk is in your lower back, besides pain in your lower back, you'll typically feel pain in your buttocks, thigh and calf. ...

Numbness or tingling. People who have a herniated disk often have radiating numbness or tingling in the body part served by the affected nerves.

Weakness.

Causes

Disk herniation is most often the result of a gradual, aging-related wear and tear called disk degeneration. As people age, the disks become less flexible and more prone to tearing or rupturing with even a minor strain or twist. Most people can't pinpoint the cause of their herniated disk.

Risk factors

Weight. Excess body weight causes extra stress on the disks in the lower back.

Occupation. People with physically demanding jobs have a greater risk of back problems. ...

Genetics. ...

Smoking. ...

Frequent driving. ...

Being sedentary.

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Complications

Complications of a herniated disc include the development of chronic back pain. Furthermore, untreated cases of disc herniation, albeit rare, can lead to lasting nerve damage in severe nerve root compression.

The most serious complication from a herniated disc is the development of the cauda equina syndrome. This results when a very large fragment of disc material is ruptured into the spinal canal in the area where the nerves that control the bowels and bladder travel before they leave the spine.

Prevention

Using proper lifting techniques. Don't bend at the waist. ...

Maintaining a healthy weight. Excess weight puts pressure on the lower back.

Practicing good posture. ...

Stretching. ...

Avoiding wearing high-heeled shoes. ...

Exercising regularly. ...

Stopping smoking.