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By Sue Benzuli, RN HealthDay Reporter
(Health Day)
MONDAY, June 26, 2023 (HealthDay News) — The pain and discomfort of a herniated disc can have a significant impact on the quality of your life.
Here’s what you need to know about herniated disc, including what it is, causes, symptoms, diagnosis, and treatment. Plus, learn about medications, self-care, surgery, and lifestyle options that can help relieve pain.
What is a herniated disc?
The Cleveland Clinic describes a herniated disc as an injury to the spine. Your spinal cord is made up of bony parts called vertebrae; between the vertebrae are discs that act as cushions. These make it easy to fold and move. When it tears or leaks, it is called a herniated disc. The injury usually occurs in the lower back or neck region. A herniated disc can also be called a slipped disc, ruptured disc, or bulging disc.
Herniated disc causes and risk factors
Disc herniation often results from aging; discs become less flexible over time. THE Mayo Clinic lists the following risk factors:
- Weight: Excess weight puts pressure on the back.
- Occupation: People with physically demanding jobs that require repetitive lifting, pulling, pushing, and bending are more likely to have a herniated disc.
- Genetic
- Smoking: Smoking is thought to decrease the oxygen supply to the discs and may cause them to break down faster.
- Frequent driving: Sitting for long periods of time can put pressure on the spine.
- Sedentary lifestyle
- Pain that occurs on one side of the body
- Sharp pain in part of the leg, hip, or buttocks
- Numbness in part of the leg, back of the calf or sole
- Weakness in one leg
- Pain when moving the neck
- Deep pain near or above the shoulder blade
- Pain that travels down your arm. It may get worse after sitting or standing at night, sneezing, coughing or laughing or walking more than a few feet or leaning back.
Your health care provider will examine your pain, muscle reflexes, sensations, and strength and may order diagnostic tests, including:
- Magnetic Resonance Imaging (MRI): The most common and accurate test for herniated disc.
- X-rays: These help doctors rule out other causes.
- Computed tomography (CT): This is to see the bones in your spine.
- Myelogram: A dye injected into your spinal cord helps locate the herniated disc.
- Electromyogram (EMG): This is used to assess the function of your nerves.
“Doctors prefer non-surgical treatments to surgery whenever possible,” Dr Mark Wangorthopedic spine surgeon Desert Institute for Spine Care in Phoenix, writes. “If surgery is needed, they’ll go for the least invasive option with the best chance of success, given your condition.”
Wang lists several non-surgical treatment options:
- Physiotherapy: may also include hot and cold therapy.
- Hot and cold therapy: Cold therapy reduces inflammation and pain, while hot therapy promotes circulation and healing.
- Alternative therapies: Acupuncture and chiropractic care can help.
- Selective nerve root blocks: This is a minimally invasive steroid anesthetic injection that interrupts the pain signal between the spinal nerves and the brain.
- Epidural steroid injections: The drug is injected into the epidural space of the spine.
THE Mayo Clinic lists several medications for herniated discs:
- Over-the-counter pain relievers: For mild to moderate pain, acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen sodium (Aleve).
- Neuropathic drugs: These decrease pain by affecting nerve impulses to the brain, and include gabapentin (Gralise, Horizant, Neurontin), pregabalin (Lyrica), duloxetine (Cymbalta, Drizalma Sprinkle), venlafaxine ( Effexor XR).
- Muscle relaxants: To reduce spasms.
- Opioids: May be considered if other medications do not work, due to risk of addiction or side effects.
There are several types of surgery for herniated disc, Wang noted. They understand:
- Microdiscectomy: A minimally invasive procedure to remove the part of the disc causing pain; the disc can be repaired by plumping it up with hyaluronic acid and sealing it with collagen.
- Lumbar laminectomy: A minimally invasive or open surgery in which part of the vertebral bone (lamina) is removed to relieve pressure on the spinal cord or nerve roots.
- Spinal Fusion: Surgeons fuse two or more bones together in the spine; it may limit mobility but is effective in reducing painful movements of the spine.
- Artificial disc replacement or artificial cervical disc replacement: The affected disc is replaced with a metal or plastic disc.
- Endoscopic foraminoplasty: Relieves pain by releasing the nerves inside the foramen (the hollow bone tunnel where your spinal cord nerves exit to your arms or legs).
Living with a herniated disc
If you have symptoms, seek the advice of a health care provider. Early treatment can prevent further problems. Most people get better in about four weeks, according to the American Academy of Family Physicians.
Self-care for a herniated disc includes some lifestyle changes:
- Maintain a healthy body weight
- Avoid sitting or standing for long periods
- Wear flats, not high heels
- Carry objects close to your body
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