Herniated Disc Spinal Disc Herniation, Also Called

Herniated Disc Spinal Disc Herniation, also called slipped disc or herniated disc, is a medical condition that affects the spine. This may be caused by trauma, injury, or idiopathic causes that are combinations of issues. Physiologically, an injury causes a tear in the outer ring of the intervertebral disc, more specifically in the fibrous ring that surrounds the disc. This injury then allows the softer, central portion of the disc to bulge out beyond the damaged outer rings.

This tear sometimes causes the release of inflammatory chemicals causing intense pain, even with there is no severe root compression. In addition, herniated discs are almost always postero-lateral because of the way the ligaments are attached to the spinal cord (Postacchini, 1999). Most minor herniations heal within several weeks using anti-inflammatory treatment for pain and swelling. However, severe herniations, the so-called slipped disc, even though it is not accurate from a medical point, may require surgery or other intervention.

Causation and Epidemiology- Men have a slightly elevated chance of having a herniated disc, usually after age 35. The pain and/or discomfort, though, usually lasts less than 2 weeks, and in only 14% of those reporting issues, do their symptoms last longer than 14 days and/or require stronger medical intervention. In fact, most herniations occur age 30-50, when the nucleus of the spinal area is still relatively gelatinous.

After age 50-60, though, osteoarthritic degeneration is more likely the causes of back pain and weakening of the tendons to the point that herniated discs are more common. Herniated discs occur 15 times more often in the lumbar region of the back than higher up in the neck. Of course, disc herniation may occur in any spinal disc, but the two most common are those that occur in the lumbar disc causing lower back pain (lumbago) or cervical disc herniation, also called sciatica (Herniated Disc, 2012).

As with any bone/muscle region of the body, herniated discs may be caused from general wear and tear on the body, or jobs that require certain repetitive motion (constant sitting and squatting, or incorrectly lifting). These forms usually develop over time, and are not always chronic, but often part of fatigue and overuse of certain muscles. Over time, this can become chronic, however. Traumatic injury usually occurs when lifting bent at the waist, rather than using the legs to absorb the tension.

While sitting or bending, for instance, pressure along the spine can increase almost 20X. The actual pain is typically cause by the rupture of the sac containing the contents of the disc which presses against spinal nerves (Mayo Clinic, 2012). Signs and Symptoms- Symptoms actually vary per individual and location of the herniation. There can be minor pain or twinges or severe and unrelenting neck or back paint that radiates through the nerves into other parts of the body.

Quite frequently, herniated discs are not diagnosed immediately because patients complain more about weakness or numbness in other parts of the body, even into the knees and feet. It is also possible not to have immediate symptoms, but gradual pain occurs when the body compensates for the weakened area, and places more pressure on the opposite side of the injury.

Depending on the actual location of the hernia, though, the individual may experience nerve damage, partial paralysis; and in certain cases low of bowel and bladder control as well as sexual dysfunction (in men). In the cases of more severe symptoms, the intensity of the pain as well as the length of time one experiences that pain can also cause ancillary damage to tissues surrounding the spine (Ernst, et.al. 2005). Location and Position- Symptoms are typically experienced on only one side of the body and generally in the lumbar region.

Typically, less than 4% of the cases occur in the thoracic area. The position of the hernia also depends on the manner in which it affects other discs. Cervical herniations occur most often between the fifth and sixth or sixth and seventh cervical vertebrae (C5/6 or C6/7). Lumbar disc herniations occur in the lower back, usually between the 4/5 lumbar region or between the 5th lumbar and sacrum. The sciatic nerve is the most common to be affected, causing burning pain that radiates intensely.

Similarly, if the femoral nerve is involved, the patient might experience additional numbness and even a burning feeling in legs and hips (Postacchini; Baldwin, et.al., 2011). Diagnosis and Modality -- Diagnosis is usually made when patients complain of certain symptoms and location of the injury. Typically, imaging studies are needed to confirm or rule out other issues like tumors, lesions, or metastases (Baldwin).

Radiographic Issues- Six types of imaging studies are available when herniated discs are suspected, depending again on location, severity of pain, reported cause, and/or patient's age and lifestyle: X-Ray -- X-Rays are limited in their ability to image any soft tissue, but can rule out tumors, infections or fractures. CAT -- Computed Tomography shows the shape and size of the spinal canal and structures, including soft tissue. Depending on the herniation site, it is still sometimes difficult to completely see the affected area.

MRI -- Magnetic resonance images shows the spinal cord, nerves and surrounding areas at a higher resolution than a CAT scan. It is usually the image of choice for most herniated disc evaluations. Myelogram -- This is an x-ray of the spinal canal after the patient is given a contrasting injection. This reveals displacement of the contrast material and can find tumors, spurs or herniated discs. Nerve Conduction or EMG -- Nerve conduction studies introduce an.