A herniated disc is one of the most common spinal conditions and is a leading cause of lower back and sciatic pain. According to research, approximately 2 to 3% of the total population will suffer from a herniated disc at some point in their lives, with this condition being most common among adults between the ages of 20 and 50.
This condition occurs when the nucleus pulposus, the soft part of an intervertebral disc, shifts and presses on the nerve roots or spinal cord, which can cause pain, a feeling of muscle weakness, and even neurological changes.
In this article, you'll find everything you need to know about herniated discs. We'll explore everything from what a herniated disc is, its types, causes, symptoms, and diagnosis to what treatments are currently available for herniated discs, and how to prevent their onset or worsening.
What is a herniated disc?
The intervertebral discs are the pieces that act as shock absorbers between the vertebrae, allowing them to move and protecting the spine from impacts. Each of these discs contains an outer fibrous ring and an inner gelatinous nucleus, which is characterized by its gelatinous nature.
A herniated disk is a condition that occurs when the outer fibrous ring tears or weakens, or when the nucleus pulposus moves out of its normal position, which then begins to compress nearby nerves.
This condition can occur anywhere in the spine, however, it is more common in the lumbar region, that is, in the lower back, in the L4-L5, L5-S1 vertebrae, and in the cervical region, in the C5-C6 and C6-C7 neck vertebrae.
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According to location
A lumbar disc herniation can occur, causing lower back pain and sciatica, with pain that can radiate from the lumbar region down to the leg. A cervical disc herniation can also occur, causing pain in the neck, shoulders, and arms. A thoracic disc herniation is much less common than the other two mentioned above and can affect and cause pain in the middle of the back.
According to the severity and form
According to this classification, a disc protrusion occurs when the nucleus shifts but the annulus fibrosus doesn't completely rupture. A disc extrusion occurs when the nucleus pushes out of the disc but remains connected to it. Finally, a disc sequestration occurs when fragments of the nucleus separate and can migrate, severely compressing the nerves.
Causes
The causes of a herniated disc can be many. Some of the most common factors include natural degeneration due to aging, which causes a loss of disc hydration. Sudden movements or improper lifting can cause the discs to flex or twist simultaneously.
Another factor that can cause a herniated disc is suffering from certain traumas, such as accidents or falls. There are also genetic factors that can predispose a person to greater disc weakness and, consequently, to developing herniated discs.
Factors riesgo
Age
Due to the natural process of aging, the spinal discs gradually lose their elasticity, so between the ages of 30 and 50, a person is at greater risk of developing a herniated disc.
Obesity
Excess weight increases the load the spine must bear and can cause wear and tear.
Sedentary lifestyle
Lack of exercise can cause the muscles that support the back to weaken, putting extra strain on the spine and affecting the intervertebral discs.
Demanding physical work
If repetitive step lifts are performed incorrectly, they can negatively affect the spinal discs.
Tobacco
Tobacco use reduces blood flow to the discs, which accelerates their degeneration process.
Symptom
General
General symptoms of a herniated disc usually include pain located in the affected area, such as the lumbar or cervical area, and a feeling of muscular stiffness in the area in addition to difficulties and limitations in movement.
Specifics
Symptoms of a herniated disc can also be more specific depending on its location.
Thus, for a lumbar disc herniation, symptoms may include sciatica, which is pain that radiates from the lower back to the foot, tingling or weakness in the legs, and, in severe cases, loss of bowel control, known as cauda equina syndrome.
In the case of a cervical disc herniation, the pain occurs in the neck and can extend to the shoulders and arms, and may also cause numbness or weakness in the hands.
How to know if the herniated disc is serious?
There are some symptoms that may indicate a more serious herniated disc and require urgent medical attention. These include loss of strength in the arms and legs, cauda equina syndrome, which causes urinary or fecal incontinence, and debilitating pain that does not improve despite rest.
Medical evaluation and diagnosis
The medical evaluation involves a physical examination that includes tests of reflexes, strength, and sensation, and a straight-leg raise test, or Lasègue sign, which is used to detect nerve compression.
In addition, imaging tests such as magnetic resonance imaging (MRI), which is the most accurate method for visualizing the hernia, a computed tomography (CT) scan, which is a good alternative if an MRI is not available, and X-rays, which, while they do not show discs, can rule out fractures or malformations, can be performed.
What complications does a herniated disc have?
A herniated disc often leads to complications such as persistent sciatica, which causes chronic leg pain, permanent muscle weakness due to nerve damage, cauda equina syndrome, which represents a surgical emergency, and a functional limitation that causes difficulty walking or moving the arms.
How is it corrected?
Conservative treatment
This is a non-surgical treatment that involves relative rest to avoid aggravating activities and not prolong immobility, the use of medications such as anti-inflammatories, muscle relaxants if there are spasms, stronger analgesics in severe cases or epidural infiltrations such as corticosteroids to reduce inflammation.
McKenzie exercises, which are core strengthening and stretching exercises, are also recommended, and electrotherapy, ultrasound or manual therapy.
Surgery
This is the last option, considered only if there is progressive loss of strength, pain does not improve after 6 to 12 weeks of conservative treatment, or cauda equina syndrome is present. A microdiscectomy, in which the herniated fragment is removed, a laminectomy, which is a decompression of the spiral canal, or spinal fusion can be performed in cases of instability.
Alternative treatments
Acupuncture can relieve pain in some patients, osteopathy involves controlled manipulations that can improve mobility, and Pilates or yoga can help strengthen muscles without impact.
Prevention and long-term care
posture and exercise
You should keep your back straight when sitting and avoid slouching. You should also engage in regular exercises such as swimming, walking, or lumbar strengthening. Active breaks are also recommended if you work while sitting.
No Smoking
Tobacco use accelerates the degeneration of the spinal discs.
lift weight
When lifting weights, you should do it correctly, bending your knees and not your back.
Control weight
Maintaining excess weight puts increased strain on the spine.
Frequently Asked Questions (FAQs)
Can a herniated disc be cured without surgery?
Yes, in 90% of cases a herniated disc can improve with rest, medication, and physical therapy.
How long does it take to heal?
With conservative treatment, improvement usually occurs in about 4 to 6 weeks, but this varies depending on the severity of the case.
Can a herniated disc cause paralysis?
Only in extreme cases, if there is severe compression of the spinal cord or cauda equina.
When should I have surgery?
If you experience loss of strength, unbearable pain, or incontinence.
Is a herniated disc the same as sciatica?
No, sciatica is a symptom caused by compression of the sciatic nerve, often, but not always, due to a herniated disc.
How long does it take for the pain of a herniated disc to go away?
The pain may disappear in a few days or weeks, but in chronic cases it requires prolonged management.
Can herniated discs recur after surgery?
Yes, they recur in 5 to 10% of cases, especially if poor postural habits are not corrected.
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Conclusion
A herniated disc is a treatable condition that usually does not require surgery. With a multidisciplinary approach, treatment can restore function and reduce pain.
If you have severe or persistent symptoms, you should consult a specialist as soon as possible. Prevention is key; you must take care of your back now to avoid future problems.
