Healthcare professionals use many terms to refer to spinal disc pathology including ‘herniated disc’, ‘pinched disc’, ‘bulging disc’, ‘slipped disc’, ‘collapsed disc’, ‘black disc’ or even ‘ruptured disc’. Some of these terms sound really dangerous to the layman, but instead of focusing on the terminology, it’s more useful to understand what exactly a herniated disc is.
A herniated disc basically refers to a tear in the outer fibrous ring of an inter-vertebral disc which is a rubber-like cushion that nature has provided to separate out the different bones making up the spine. The tear in the outer ring is followed by bulging out of the jelly-like center of the disc resulting in severe pain in many people. The good part is that not all people require surgical intervention and some don’t even present with any symptoms.
Most disc herniations follow an existing disc protrusion, where the outer ring is still intact and the disc only bulges out when under pressure. Most minor herniations heal up within a few weeks with only anti-inflammatory drugs needed to ease the pain. Severe herniations however need surgical intervention. Herniated discs are more common in the lumbar region (lower back) but can be seen in the cervical area (neck region) too.
Some of the common symptoms of herniated disc include intense pain in the buttocks, thigh, calf and part of the foot when pain originates from the lumbar region; if it originates from the cervical region, then the pain will be more intense in the arm and shoulder with the pain increasing upon movements of the spine. There might also be a feeling of tingling or numbness in some parts of the body due to nerve compression. Weakness of muscles affected by these nerves can make you stumble or incapable of lifting or holding objects. And then there are those luckier ones who don’t have any issues and herniated discs are just incidental findings found on them during spinal imaging for other reasons.
Most herniations are age-related as the water content of these discs reduces with age, making them prone to ruptures even on minor stress. Other reasons could be excess body weight or repetitive lifting, pulling, pushing and bending or twisting sideways.
Herniated discs can be confirmed by the use of CT scans or MRIs which show the exact extent and location on the spine.
Conservative therapy includes planned exercise and physiotherapy regime, avoiding pain-inducing positions and anti-inflammatory medications, narcotics and/or steroid shots. In cases where there is a neurological deficit, microsurgical lumbar discectomy will be required to ease the pain and help the weakness improve.
So, on a general note, herniated discs are conditions that can be managed effectively without necessarily resorting to surgical intervention, but with a change in lifestyle as well as medications.