Does a Herniated Disc require Surgery?

Herniated Disc

If the term herniated disc upsets you, try calling it ruptured disc, protruding disc or even slipped disc if that makes you more comfortable….as they are all one and the same. This condition refers to problems with the cushioning rubber disc found in-between the spinal bones and can be extremely painful and debilitating. The condition is quite common in India with more than 10 million cases occurring every year.

Some herniated discs produce no symptoms while others can irritate the nearby nerves resulting in excruciating pain, numbness or weakness in an arm or leg. Symptoms are generally relieved after a few weeks and surgery is needed only when the symptoms persist,get worse or cause nerve compression leading to weakness.

Although herniated discs can occur in any part of the spine, majority of the cases occur in the lower back (lumbar vertebra); less commonly the neck (cervical vertebra) and rarely the upper back (thoracic vertebra). These vertebral bones make up the spine in the back and are cushioned from one another with small spongy discs that act as shock absorbers for the spine and help in keeping it flexible.

Under certain traumatic or degenerative conditions, these discs can get damaged and the soft center then protrudes out into the spinal canal through a crack in the tougher exterior wall casing. This is known as a herniated disc. Fortunately not all cases of herniated discs require intervention. Most of the time medications and physiotherapy are enough to contain the problem, but in severe cases of low back pain which significantly affects the quality of life or cause weakness due to nerve compression, surgery is suggested.

Some of the causes of developing a herniated disc include lifting something the wrong way, suddenly twisting the spine, being overweight or suffering from degenerative diseases like osteoporosis related to ageing.

The symptoms of a herniated disc usually get better after a few weeks and you would need to follow your doctor’s advice, medication and therapy religiously. Don’t go on complete bed-rest either as light movement is necessary to keep the muscles strong. Heating pads and ice packs should be used to ease pain and reduce swelling along with the recommended medications. Sometimes steroids as well as non-steroidal anti-inflammatory medications and narcotics are given to relieve pain. Epidural injections of steroids, anesthetics or anti-inflammatory medications may also be given directly into the epidural space around the spinal canal. Your therapist may also suggest the use of high-frequency ultrasonic waves, traction, short-term bracing (to improve support) or even electrotherapy – where electric impulses are used to relieve pain.

If all these are ineffective and you still have persistent pain even after a few months, then you need to talk to your orthopedist about the possibility of surgical intervention.

In most cases, only the protruding portion of the disc may be removed through a small opening – a microdiscectomy; less commonly, the whole disc may be removed to reduce pressure on the nerves. Alternatively, spinal fusion may be done by fusing two or more vertebra together; this may also require rods and screws to provide additional support to the spine.

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