What is a Disk Herniation?
A disc herniation happens when the inner, jelly-like, layer ruptures through a weakened spot in the outer, fibrous, layer. A herniated disc can cause inflammation and irritation of surrounding spinal nerves, leading to symptoms including back pain, weakness, and/or numbness in the lower or upper extremities.
While disc herniation can occur anywhere in the spine, they most commonly occur in the lower back (lumbar spine) and neck (cervical spine).
Normal aging causes the intervertebral discs to lose a portion of their water content, making them more susceptible to injury (disc degeneration)
Causes of Disk Herniation
Various risk factors have been identified that increase the risk of disc herniation, including:
- Physically demanding occupations that involve heavy and/or repetitive lifting, pushing, pulling and/or twisting
- Excess weight placing excess stress on the intervertebral discs
- Having a genetic predisposition
Symptoms of disc herniation vary widely, with some patients none, and others having debilitating symptoms, including:
- Pain in the neck, shoulder, and arm on the affected side
- Intensified pain with coughing, sneezing, and certain movements (extension, lateral bending, and/or rotation)
- Numbness or tingling in area that is supplied by the affected nerve
- Weakness of the muscles supplied by the affected nerve
First line disc herniation treatment typically includes pain and anti-inflammatory medication, as well as muscle relaxants. Short term narcotic therapy, and antidepressants, may be recommended in cases that don’t respond to first-line medication options. In persistent cases, epidural steroid injections or nerve blocks, may be recommended. In addition to traditional medicinal therapy, a trial of physical therapy or chiropractic may be recommended. Treatment may include the use of various modalities like ice and heat therapy, electrical stimulation, ultrasound, traction, and/or manual therapy. Patients will also be educated on proper lifting techniques and be provided with an exercise program to increase range of motion and strength in the affected area.
In cases that do not respond to conservative therapy, surgery may be necessary. Various surgical options exist depending on the location and extent of the disc herniation.