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Herniated Disc — What is it?
A herniated disc is a disease of the spine that occurs when parts of the disc protrude into the spinal canal. The spinal canal forms the space in which the spinal cord lies. As a rule, the herniated disc is the result of overloading and damage to the fibrous cartilage rings and the membranes located between the discs. This can be due, for example, to constant obesity, lack of exercise, incorrect posture or genetic predisposition. But there can also be damage to the intervertebral disc caused by an accident or injury.
Spinal canal stenosis can also occur, especially in older people. This is a chronic degenerative disease that is associated with a narrowing of the spinal canal. Spinal canal stenosis can occur in the cervical spine as well as in the lumbar spine. If the nerves in the nerve canal are compressed, typical symptoms or failures can occur. This is not a “simple herniated disc” and the treatment requires appropriate expertise and possibly microsurgical surgical techniques.
A herniated lumbar disc can also occur at a younger age. A prerequisite for this are small tears in the outer fiber ring of the intervertebral disc. The intervertebral disc must also have enough swelling pressure, which allows it to exit through a tear. In most cases, the previously damaged intervertebral discs are overloaded, but a herniated disc can also occur without any external cause.
The intervertebral disc bulge is the preliminary stage of the herniated disc. From a bulging discThis is when a vertebral body pushes against another vertebral body due to vertebral sliding and thus additionally narrows the spinal canal, which is already narrowed by bony formation. So-called semi-permeable membranes separate the cartilage rings from each other. These membranes can lose their function due to the effect of shear forces, with the intervertebral disc and gelatinous core drying out. If a herniated disc occurs, the gelatinous core, which consists of 80% stored water, is no longer in its original form. In a healthy intervertebral disc, the gelatinous core consists of gelatinous mass, a cell-poor body tissue which, in interaction with the cartilage rings and the membranes, performs the function of a hydraulic ball.
The herniated disc and the facet syndrome, which is the most common cause of back pain , can be detected by a CT or MRI.
Typical symptoms of a herniated disc
A herniated disc often causes severe back pain, which can radiate to the extremities. This can be accompanied by numbness and even signs of paralysis in the area supplied by the pinched nerve root
While the fibrous ring tears in a herniated disc, it is not severed in the preliminary stage, the bulging of the disc. However, if an intervertebral disc in the lumbar spine area bulges, this can lead to severe pain and temporary stiffness. This type of intervertebral disc curvature is referred to as classic lumbago .
Prevention and possible treatment methods
In the past, patients with a herniated disc were prescribed bed rest for one to two weeks, but this has proven to be counterproductive. Prolonged lying weakens the muscles and bones, which does not benefit healing. That is why the advice these days is to stay active. Normally, the symptoms of a herniated disc heal on their own within about six weeks in most sufferers and disc surgery is only mandatory in severe cases.
If it is not possible without surgical intervention, microdiskectomy is the most frequently performed surgical method. A 3-5 cm long incision is used to remove slipped intervertebral disc tissue. Endoscopic transforaminal disc surgery and percutaneous laser disc decompression are also being performed more and more frequently.
In addition to pain therapy with local anesthetics or painkillers, there are numerous treatment methods that help to improve mobility. Massages, ultrasound therapies or heat and cold treatments are used here. Alternative practices such as acupuncture or Reiki are also used, but are controversial because there are few meaningful studies demonstrating their effectiveness.
With moderate fitness training or with the so-called back school, you can prevent a herniated disc, as it strengthens bones and muscles. Although the connective tissue weakness is a central cause of the herniated disc, a consistent muscle build-up in the back area is recommended. Sports such as swimming, running, dancing, cycling or horseback riding can also be advantageous, since the intervertebral discs are enabled to perform alternating pressure movements, which are essential. In a healthy state, the intervertebral discs have a high collagen content, which decreases over time due to progressive degeneration. In consultation with a doctor, taking dietary supplements such as glucosamine and chondroitin can be beneficial. If possible, lifting heavy loads should be gentle on the back or avoided altogether. If you suspect a herniated disc, it is advisable to see a doctor. A thorough physical and neurological examination can be revealing here.
