El Paso,TX. Chiropractor Dr. Alex Jimenez looks examines a herniated disc.
Herniated disc is a somewhat common condition that can occur anywhere along the spinal column, but most commonly affects the lower back or neck area. Also known as ruptured disk or a slipped disc, a herniated disc develops when one of the pillow-like pads between the vertebrae moves out of position and presses on nerves that are adjacent.
Herniated discs are usually caused by overuse injuries or injury to the back; however, disc conditions may also develop as a result of the standard aging process. It’s also known that there is a genetic factor that leads to the evolution of herniated disc and disc degeneration. As the size of herniation shrinks with time via resorption, typically, a herniated disc in the lower back will heal within six months. If physical therapy, drugs along with other treatments fail, operation may be needed.
What’s A Disk?
Spinal discs are cushion-like pads located between the vertebrae. Without these “shock absorbers,” the bones in the spinal column would grind against one another. Along with giving the backbone flexibility and making movements like twisting and bending potential, discs protect the spine by absorbing the effect of trauma and body weight. Each disk has a strong outer layer called annulus fibrosus and a soft, gel-like center, called nucleus pulposus. There are fibers on the outside of each disc that attach to adjoining vertebrae and hold the disc in position. A herniated disc occurs when the gel as well as the outer layer tears or ruptures -like middle leaks to the spinal canal.
The spinal canal has only enough space to place spinal fluid and the spinal cord. When a disc herniates and spills to the spinal canal, it could cause compression of spinal cord or the nerves. Alterations in sensation and intense, debilitating pain often happen. Furthermore, the gel-like substance inside the disk releases chemical irritants that bring about pain and nerve inflammation.
What Causes A Herniated Disc?
As we get older, the spinal disks gradually lose fluid volume. This process progresses slowly and begins at about age 30, over time. As the disks dry out, tears or microscopic cracks can form on the outer surface, causing it to become weak, fragile and much more susceptible to injury. The most common causes of herniated disc are:
- Wear and tear: Disks dry out and aren’t as adaptive as they were.
- Repetitive movements: Work, lifestyle, and certain sports activities that place stress on the spine, especially the lower back, further weaken an already vulnerable area.
- Lifting the wrong way: Never lift while bent at the waist. Proper lifting entails lifting with a straight back and your legs.
- Injury: High-impact trauma can create the disk to bulge, tear or rupture.
- Obesity: Carrying excess weight places an undue amount of strain on the back.
- Genetics: There are a few genes which might be more typically present in individuals with disc degeneration. More research is necessary to investigate the role of those genes—they could be targets of biological treatment in the future.
Which Are The Symptoms Of A Herniated Disc?
Pain from a herniated disc can fluctuate, determined by severity and the place of the harm. It is typically felt on one side of the body.
Little or no pain could be felt in case the injury is minimal. Pain might be severe and unrelenting, in the event the disk ruptures. If significant nerve impingement has occurred pain may radiate to an extremity in a certain nerve root distribution. For instance, sciatica is often resulting from herniated disc in the low back. Herniated disc can manifest itself with a variety of symptoms, including:
- Dull ache to severe pain
- Numbness, tingling, burning
- Muscle weakness; spasm; altered reflexes
- Loss in bowel or bladder control (Note: These symptoms constitute a medical emergency. When they occur, seek medical attention immediately).
How Is A Herniated Disc Diagnosed?
History and physical examination point to some diagnosis of herniated disc. A herniated disc is likely if low back pain is accompanied by radiating leg pain in a nerve root distribution with positive straight leg raising test (ie, elevating the leg while lying down causes radiating pain down the leg), as well as other neurologic deficits for example numbness, weakness, and altered reflexes.
Imaging studies usually are ordered to confirm a diagnosis of herniated disc. X rays are not the imaging medium of choice because soft tissues (eg, discs, nerves) are hard to capture with this specific technology. However, they might be used as an initial tool to eliminate other illnesses such as for instance fracture or a growing. Confirmation of the feeling of herniated disc is generally achieved with:
- Magnetic Resonance Imaging (MRI): This technology shows the spinal cord, surrounding soft tissue and nerves. It really is the best imaging study to support the identification of a herniated disc.
- Nerve Conduction Studies (NCS) and Electromyogram (EMG): These studies use electric impulses to measure the level of harm to the nerve/s brought on by compaction from a herniated disc along with other conditions that cause nerve impingement may be ruled out. NCS and EMG are not routine evaluations to diagnose herniated disc.
Herniated discs occasionally heal independently through a process called resorption. This means the disk fragments are consumed by the body. Most people suffering from herniated disc do not need surgery and react well to conservative treatment.
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Dr. Alex Jimenez DC, MSACP, CIFM*, IFMCP*, ATN*, CCST
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