Invertebral disks are the soft padlike cushioning between each vertebra that acts as a shock absorber for the spine and all of its different parts. Herniated disks are disks that rupture or bulge out between the vertebrae and begin to pinch the nerves in the spine and the spinal cord. It is possible for disks in the upper part of the spine to herniate, but it is most common in the lower, or lumbar, region. Sometimes called ruptured or slipped disk or pinched nerve, most doctors are referring to the same thing; the bulging disk between the vertebrae that is causing a person pain.
As people get older the soft, cushiony disks between the spine can lose their elasticity. As elasticity dissipates, the disk can tear or rupture. The disk can then bulge and put pressure on the nerves and cause tingling, numbness or other sensations. Sometimes, muscles spasms can occur because the affected area is trying to protect itself from further injury. Herniated disks can happen due to traumatic experience, like an accident or a fall, or from extreme overexertion, like lifting a very heavy weight. Herniations can also happen over time after normal wear and tear. There are also cases where a condition called Spinal Stenosis is narrowing the patient’s spinal canal and the herniated disk further aggravates and irritates the nerve.
Some symptoms of a herniated disk are tingling or numbness in the “saddle” region (any part of you that would touch while sitting in a saddle); electric shock type pains, which are unusual pains in the back and legs; weakening of the muscles; bowel or bladder problems. Bowel and bladder control issues can be very serious and the sign of an emergency, so a health care provider should be consulted immediately.
In diagnosing a herniate disk, the doctor will usually perform a physical exam and may possibly take an MRI or x-ray. (There is always normal wear and tear to a disk, so doctor has to determine what is normal and what might actually be causing the problem.)
To treat a herniated disk, doctors will often try non-surgical methods before considering surgery, depending, of course on the symptoms and the severity of the pain. The first step is always to try to reduce the pain and inflammation the patient is experiencing by having the patient rest (usually on a firm surface). Though complete rest might be necessary at the beginning until the pain is alleviated, it is necessary to get up and moving as soon as possible. Bed rest for more than a day or two can actually slow recovery, but avoiding excessive bending or lifting is advised. Other non-surgical methods are usually tried in addition to rest. Non-surgical methods can include:
- Alternating ice and heat and other compresses
- Anti-inflammatories or other medications such as muscle relaxants (if the muscles in the back are in spasm), corticosteroids, and a new class of medications called neuropathic pain medications
- Bracing the spine and hydrotherapy (to remove the pressure from the spine)
- Chiropractic care (or spinal manipulation) and/or traction
- Electrical stimulations (called TENS)
The second step is to get the back moving again. Stretching exercises and mild activity is necessary. A doctor will probably recommend stretching along with some aerobic exercise along with core building exercises that will strengthen the stomach and back muscles.
Only one in 10 sufferers needs to have surgery. In most cases, if the person follows the healing regimen, the disk will shrink over time. Herniated disks tend to be very painful, and the pain usually eases up within one week, but it could take up to six months for the disk to fully shrink.
There are several surgical options if a person does decide on this route. Surgery is to reduce the pain, but also to get the protruding disk from causing nerve damage. Surgical methods include:
- Chemonucleolysis: An enzyme is injected directly into the disk to dissolve the portion of the disk that is protruding
- Diskectomy: Surgery under general anesthesia where a surgeon removes the protruding portions of the disk.
- Microdiskectomy: Similar to a Diskectomy, but it is less invasive, since the surgeon makes a smaller incision and the surgery is performed looking through a microscope, as opposed to the standard open surgery of a Diskectomy.
Most herniated disks heal on their own with time and proper care. Of the people who need to opt for surgery, depending on the individual case and which surgical method, full relief from the pain and symptoms is possible. After the initial surgery, the doctor will prescribe an exercise regimen that will increase mobility and strengthen the muscle that will help to stabilize the back and spine.
Back pain affects most American adults. There is no known, absolute prevention of back pain. However, the common belief is that staying physically fit to reduce the load on the spine and keeping the back and stomach muscles equally strong, so that the spine is able to keep in line, can reduce the chances of back pain and herniations.