Herniated Disc

Herniated Disc
(Her-knee-ate-did Disk)

To better understand what a Herniated Disc is - a brief anatomy lesson is in order.

Basic Anatomy
Okay - in the spine there are bones called vertebrae (plural). In between each vertebra (singular) is an Intervertebral Disc. Don't let the word "intervertebral" scare you. It simply means between (inter) the vertebrae. The disc is the target of our discussion.

Moving along - each disc looks a bit like a small, flat, round plate. Some discs are larger and thicker than others. For example, the discs in the neck are smaller than those found in the low back. The vertebrae in the lumbar region (low back) are the largest.

Discs are made of fibrocartilage (fy-bro-car-till-edge). Fibrocartilage is cartilage bundled up into dense fibers. Each disc acts like a spinal shock absorber. There are 3 main parts to each disc.

(1) The outer ring of each disc could be compared to a tire on a car. The tire's job is to hold air to keep the tire inflated. The medical term is Annulus Fibrosis (Ann-you-lus Fie-bro-sus).

(2) Inside this outer ring is spongy gel-like material. The medical term is Nucleus Pulposus (New-clee-us Pull-poe-sus).

(3) The top and bottom of each vertebra is coated with a thin layer of cartilage - called Endplates. The fibers of the endplate attach to the disc and help hold it in place. That is why discs do not "slip" out of place.

Now we know the basics about intervertebral discs.

So, what does Herniated Disc mean?
A disc becomes herniated when the outer tire-like ring breaks or tears open, which allows some of the gel-like stuff to leak out. Sometimes intense stress or injury to the spine can cause the disc to suddenly herniate.

Why is this bad?
To begin with, a herniated disc can be very painful. Remember the gel that leaked out of the disc? That gel had to go someplace in the spine! More than likely the gel is pushing on a nearby nerve. Nerves don't like to be pushed around! The affected nerve cries out, "Hey, I've got uninvited company here!"

Travel'in Pain
Sometimes the pain travels to other places, such as an arm or a leg. Pain can travel because the nerves in our bodies are similar to a huge system of highways, streets, and roads.

For example, a herniated disc in the neck (cervical spine) might cause pain in the neck, shoulders, and arms. In the low back (lumbar spine), pain may travel downward into the butt, thighs, and legs. Other symptoms such as numbness, tingling, and weakness are common.

Dear Doctor
At this point, you are probably wondering, "How does the doctor know a disc has herniated?" This is a good question! First, the doctor examines the spine while the patient is lying down and while standing. The doctor moves the patient's legs, knees, and hips and checks other parts of the body for pain, numbness, tingling, or weakness.

X-rays can be helpful, but a CT Scan (Computed Tomography) or MRI (Magnetic Resonance Imaging) provides pictures of the spine in much more detail. A herniated disc can best be seen on an MRI. The results of the examination and tests help to confirm the doctor's diagnosis.

What happens next?
Most patients with a herniated disc get better without surgery (thank goodness!). Treatment may begin with some bed rest and medication for pain and inflammation (such as muscle swelling). Then the doctor might order physical therapy, which often includes exercise and massage.

If surgery is needed, the usual procedure is a Discectomy (diss-eck-toe-me). During a discectomy, either part or the entire bad disc is removed. After surgery, the patient goes to physical therapy to regain strength and learn about spine safety. The good news is, even if you need surgery, the chances for a full recovery are excellent, even higher than for an adult.