A herniated disc, also known as prolapsed disc, herniated nucleus pulposus, or slipped disc, is characterized by the displacement of the vertebral disc’s components beyond the intervertebral disc space. A vertebral disc contains two cartilaginous endplates, an annulus fibrosus, and a nucleus pulposus. A herniated disc can cause severe low back pain, thus impairing movement. Jocelyn Idema is your Pittsburgh disc herniation specialist at Steel City Spine and Orthopedic Center who is dedicated to helping patients manage the symptoms of the condition.
Stages of Disc Herniation
There are four stages leading to the formation of herniated discs:
1. Bulging: During this stage, the disc margin extends beyond adjacent vertebral endplates.
2. Protrusion: The nucleus pulposus impinges on the annulus fibrosus.
3. Extrusion: The nucleus pulposus bulges through the annular fibers.
4. Sequestration: The longitudinal is damaged and the nucleus pulposus protrudes into epidural space.
Causes of Herniated Discs
Disc herniation is caused by repeated flexing of the spine, causing a tear in the annulus fibrosus. Ultimately, the nucleus pulposus loses its hydrostatic pressure and bulges outwards through the annulus fibrosus during mechanical disc compression. Other causes of herniated discs are trauma, congenital and connective tissue disorders, poor posture, smoking, and obesity.
Types of Disc Herniation
The different types of disc herniations vary according to the location of the protruded disc and include:
· Posterolateral disc herniation: The protruded disc is located posterolateral into the vertebral canal.
· Central disc herniation: The protruded disc is located above the second vertebra.
· Lateral disc herniation: Nerve root compression often affects the L4 nerve.
Signs and Symptoms of Disc Herniation
Although some people can be asymptomatic, the common signs and symptoms to watch out for are:
· Severe low back pain
· Impaired walking and disability
· Loss of bowel and bladder control
· Muscle spasms
· Valsalva Maneuver
Diagnosis of Herniated Discs
There are other conditions that exhibit the same signs and symptoms as herniated discs. Your doctor needs to conduct further diagnostic tests to confirm that your symptoms’ root cause is disc herniation.
Diagnostic test for herniated discs involve comprehensive physical assessment and may include additional imaging tests like:
X-rays are used by care providers to evaluate structural instability, narrowed disc space, and complimentary scoliosis.
CT scans provide detailed images of spinal vertebral structures used to visualize calcified herniated discs.
MRI is the most sensitive diagnostic imaging test for disc protrusion and nerve root compression.
Treatment of Disc Herniation
Most herniated disc symptoms can be managed non-surgically through:
· Physical therapy
· Drugs like NSAIDs and oral steroids
· Translaminar epidural injections and nerve blocks
Surgical Treatment Options for Herniated Discs
When the above non-surgical treatment options fail to offer relief, surgery is recommended as a last resort. The different surgical options that can treat herniated discs include:
· Artificial disc replacement surgery
· Lumbar fusion surgery
· Intradiscal electrothermal therapy
· Anterior cervical discectomy and fusion
· Disc arthroplasty
What to Do When Recovering from Disc Herniation Treatment
Your care provider may recommend additional physical therapy programs, such as exercises like yoga and cycling to strengthen and restore neurological functions in the spine.
Book a diagnostic appointment with Steel City Spine and Orthopedic Center today if you notice any of the above-mentioned signs of disc herniation.