Herniated Disc

The spine keeps the body up, and in between the 26 bones interconnected to form the spine are sacs or soft discs filled with a thick fluid that cushions the bones intact. Once these discs get out of place or rupture, pain will be experienced on the lower back and spread throughout the upper back, buttocks area and legs. This condition is called a ruptured disc, or more commonly known as herniated disc.

Causes

Causes for the spine sac to slip include accidents, falls, trauma, overuse, and age. During falls, the impact causes the muscles to constrict and the cushion sacs to slip out of place, causing swelling that leads to chronic pain felt on the lower back, upper back, buttocks and thighs. The elasticity of the discs doesn’t hold with age. Older individuals are more susceptible to this condition as their vertebrae discs get less rigid each year.

Symptoms

Main symptoms of a herniated disc include:

• Lower back and occasional leg pain
• Back pain when coughing or sneezing
• Muscle spasms or the feeling of weakness
• Tingling sensations

Diagnosis and Treatment

The only way to accurately spot herniated disc is the use of a detailed imaging study such as Magnetic Resonance Imaging (MRI) or CT scan. X-rays are not advisable for spotting a herniated disc because it is not used in soft tissue injuries such as this condition. Physical examination through testing the muscle strengths, responses and sensations of the patient will identify a herniated disc diagnosis. Tests such as raising the affected leg is done in a manner where the patient lies flat, and if the patient reacts with a painful back from the leg raise, the next step is MRI or CT scan. 

It is important to correctly know the diagnosis to ensure a proper treatment, whether it should be passive or active type. Passive treatments include deep tissue massage that uses pressure to alleviate muscle tension, heat therapy that stimulates the blood flow and promotes the flow of oxygen-rich blood to the herniated disk. Heat has been proven to significantly lower acute to severe back pain with the continuous use of a targeted heat therapy wrap.[1] Another form of painless passive therapy is transcutaneous electrical nerve stimulation (TENS) uses electricity to excite and stimulate the muscles. The same energy is used to help the body release endorphins, which are natural pain killers.

Active therapies for herniated disc patients involve physical therapy and widening the range of motion. Core stability is imposed by strengthening the abdominal muscles to extract pressure from the back. Exercises that improve the flexibility are also practiced to keep muscle stiffness at bay.

Patients prefer noninvasive forms of treatment because surgeries are expensive. People with herniated disc often do not need surgery because the symptoms and pain decreases with an ample combination of bed rest NSAIDs and physical therapy. In rare cases which the condition is severe that might need a Discectomy where the doctor removes the bulged disc that causes the pain, although it might cause a period of constant pain afterwards. Physical therapy and recovery period of 2-6 months is recommended for post-surgery rehabilitation.

[1] Nadler SF, Steiner DJ, Erasala GN, Hengehold DA, Abeln SB, Weingand KW.

Department of Physical Medicine and Rehabilitation, University of Medicine and Dentistry of New Jersey--New Jersey Medical School, Newark, NJ 07103, USA. sfnadler@cs.com