What is a Herniated Disc?

The spine is composed of individual bones called vertebrae, stacked on top of each other. These are separated by flat, round cushions called intervertebral discs, which act as shock absorbers. Each disc has a soft, gelatinous core surrounded by a tough, fibrous outer shell, the annulus. A herniated disc occurs when pressure from the vertebrae above and below causes part or all of the nucleus to bulge through a weakened or torn section of the annulus. This herniation can compress the nerves near the disc, causing pain. Although they occur most often in the lower spine, herniated discs can also occur in the cervical and thoracic spine. They are often the cause of neck, back and/or leg pain (sciatica) and cervicalgia.

 

How Common are Herniated Discs?

Herniated discs are a common health problem, mainly affecting individuals aged 35 to 55. Statistically, they tend to affect men more than women.

 

Symptoms and Causes of Herniated Disc

What are the symptoms of a herniated disc?

In the case of herniated discs, it often happens that no symptoms appear. However, when a herniation is located in the lower back, here are the signs that you may experience:

• There is pain called sciatica that radiates to the buttocks, legs, and feet (with or without back pain);
• You experience tingling or numbness in your legs or feet;
• Muscle weakness;

Signs of a cervical herniation include:

• Painful sensations near or above the shoulder blade;
• A painful sensation that radiates to the shoulder, arm, and sometimes even to the hand and fingers;
• Severe pain is felt in the neck, especially in the back and sides (it can worsen when you bend or turn your neck);
• Neck muscle spasm;

The manifestation of a herniated disc problem in the middle of the back can be rather imprecise. One may experience pain in the upper or lower back, in the abdomen, or in the legs, often accompanied by a feeling of weakness or numbness in one or both legs.

What are the causes of a herniated disc?

A herniation occurs when the outer portion of the disc thins and ruptures. Many things can cause this weakening, including:

• Aging;
• Excess weight;
• Sudden strain caused by improper lifting or violent twisting;

What are the complications associated with a herniated disc?

Untreated herniated disc can lead to chronic (persistent) back or leg pain as well as loss of control or sensation in the lower limbs.

 

How is a herniated disc diagnosed?

During the consultation, the healthcare specialist will conduct a thorough assessment starting with a comprehensive physical examination and taking into account your medical history. They may also perform a neurological examination to test your muscle reflexes, sensations, and muscle strength.

To improve the accuracy of their diagnosis and better assess the location and severity of the herniation, the healthcare professional may also use other diagnostic tests. These tests may include:

• X-ray: Using low doses of radiation, X-rays provide images of the body. An X-ray of the spine can be performed to rule out other potential causes of back or neck pain;
• MRI or CT scan: The diagnosis of a narrowing of the spinal canal caused by a herniation can be obtained thanks to MRI and CT scan (computed tomography), two powerful and precise medical imaging techniques;
• Myelogram: A myelogram involves injecting a dye into the spinal canal, followed by a scan. This procedure can help determine the size and location of a herniation;
• EMG: Electromyography (EMG) involves inserting fine needles into several muscles to measure their electrical activity. This muscle response, revealing the level of nerve activity, is then evaluated. EMG can be helpful in identifying nerve roots affected by a herniated disc;

When to opt for surgery in case of a herniated disc?

Surgery may be necessary for people who do not respond to conservative treatment, whose symptoms progressively worsen, or who experience progressive neurological decline. In rare cases, a significant herniated disc may damage the nerves of the bladder or bowel, requiring emergency surgery.

 

For all surgical options, the most frequently used are microdiscectomy, laminectomy, and foraminotomy:

• Microdiscectomy is a surgical procedure recommended to remove fragments of a herniated disc. This procedure is frequently performed using an operating microscope;
• By choosing a laminectomy, the lamina, this bony portion that encloses and protects the spinal cord, as well as the tissue that may be compressing a nerve or the spinal cord, is removed. This procedure is performed under general anesthesia. The hospital stay lasts one to two days. Full recovery takes about six weeks;

What can be done to prevent a herniated disc?

To reduce the risk of herniated disc, there are actions you can take, even if it is not always possible to prevent it:

• When you get up, do not bend at the waist. Bend your knees while keeping your back straight and use the powerful muscles of your legs to help support the load;
• Maintain a stable and ideal weight. Excess weight puts pressure on the lower back;
• Adopt good posture when walking, sitting, standing, and sleeping. For example, stand tall, shoulders back, abdomen tucked in, and lower back flat. Sit with your feet flat on the floor or elevated. Sleep on a firm mattress, and sleep on your side, not on your stomach;
• Stretch often when sitting for long periods;
• Avoid wearing high-heeled shoes;
• It is essential to exercise regularly. This helps keep the back, leg, and abdominal muscles strong. Aerobic exercises are particularly beneficial. Remember to balance flexibility and muscle-strengthening exercises in your regular training program for better results;
• Stop smoking;
• Adopt a healthy and balanced diet;