Herniated Disc Diagnosis and Treatment
Sometimes referred to as a slipped disc or ruptured disc, herniated discs occur when one of the discs cushioning individual spinal bones, or vertebrae, becomes torn or damaged. Damage to the tough outer exterior of a spinal disc may cause the softer, jelly-like substance to push through cracks.
Severe disc herniation may place pressure on nearby nerves that, in turn, can cause pain or numbness spreading as far as the arms or legs, depending on the location of the rupture. Pain is sharp, usually occurs on only one side of the body, and often increases while standing and decreases while lying down. A herniated disc may also cause weakness in the lower extremities, and bowel and bladder incontinence. These symptoms, combined with a can help a doctor determine whether a disc has ruptured.
Various blood tests may be performed to check for signs of infection or inflammation, along with a "straight leg raise" test. The straight leg test can be done quickly and is performed to evaluate pain, by having the patient lie on their back while a health professional raises one leg upwards, keeping the knee straight. This stretches the sciatic nerves that run down the back of your leg, and the nerve roots leading to the sciatic nerve. If pain runs down the back of the leg below the knee when the leg is raised, this helps confirm that one or more of the nerve roots leading to the sciatic nerve is compressed or irritated. The test will then be repeated on the opposite leg, which may cause pain again in the affected leg, further helping confirm that nerve compression or irritation is present.
Compression or irritation of the sciatic nerve or nerves leading to the sciatic nerve may have several causes, but a ruptured disc in the lower half of a patient's back is the most common. A CT scan or MRI scan is required for full diagnosis, however. While an X-Ray can hint at a tear in the spinal discs, or degeneration of the spine, a CT scan or MRI scan is needed to display the discs' actual statuses.
It is important to note that a herniated disc does not always cause severe pain in the inflicted individual. This is more common with small tears, and sometimes a herniated disc may not cause pain at all. These discs may go undetected or they may be noticed if an MRI scan or CT scan is performed on an individual for other reasons, but when no particular treatment plan is required when a ruptured disc exists without pain or other symptoms.
A herniated disc can have several different causes. These causes may be aided by the gradual, age-related degeneration of the spinal discs. Age causes discs to gradually begin losing some of their water content, making them less flexible and more prone to tearing.
Traumatic events such as falling or being hit hard on the back may cause a disc to rupture, but more often the disc tears as the result of physical labor. The lower back in particular is constantly absorbing the impact of daily activities and bearing the weight of the upper body, making the lower back the most common place to herniate a disc.
An individual's spine often supports the majority of their daily activities, which involves everything from turning and sitting to lifting objects or bending over to pick them up. Bending to pick up an object, particularly a large or heavy object, utilizes the back muscles instead of the leg muscles, and is one common example of what may cause a herniated disc. However, most people who have been afflicted with a herniated disc are unable to pinpoint the exact cause.
People with a herniated disc should first rest and give the rupture a chance to heal itself. Even people who experience severe pain at first may be able to avoid surgery by resting or partaking in physical therapy sessions with a licensed physical therapist after the herniation has been diagnosed. Other early treatment solutions may include medications, including those for muscle relaxants, pain, or inflammation, or epidural injections that aim to decrease inflammation and irritation in an affected nerve root or roots.
Depending on the severity of the pain and which nerves are affected, particularly when cauda equina syndrome is present surgical treatment not only becomes urgent, but also necessary. Cauda equina syndrome can be caused by various factors, including a herniated disc, and help to control the bowel and bladder. If immediate treatment is not sought to relieve pressure, this type of nerve damage may lead to permanent bladder and/or bowel incontinence, loss of sexual sensations, or other problems.