Herniated Discs - Causes and Cures
A herniated disc is something that usually affects us as we age. The intervertebral discs that serve so well as spinal column shock absorbers most of our lives can be the cause of trouble as we - and they - age. This problem goes by many names: ruptured, prolapsed, or protruding herniated disk; the scientific-sounding herniated nucleus pulposus; and the erroneous but oft-used “slipped disk” (the spinal structure holds the disks firmly in place; they do not “slip” anywhere).
During life, the disk goes from being a very fluid-filled, movable shock absorber to basically a piece of bone that doesn’t have movement or shock absorption abilities. Basically, two things happen. The soft inner core (nucleus pulposus), which had jellylike consistency during youth, begins to take on the fibrous nature of the disk’s tough outer shell (annulus fibrosus).
Meanwhile, through wear and trauma, the outer tissue can tear, allowing material from the herniated disc to push out, or rupture, into the spinal canal. Sometimes, the material doesn’t fully escape, but merely causes the disk to bulge.
It may come as a surprise to learn that none of this necessarily causes any pain at all. The pain happens not from the herniation or bulge itself, but when the herniated disc causes the disk to press on a nerve root, irritating or pinching it.
The pain is not always felt in the back; it is common to experience the problem along the path of the nerve. A herniated lumbar disk, for example, typically produces sciatica - pain down the back of the leg, sometimes extending to the side of the calf, and sometimes into the side of the foot. Sensory and/or motor function of the affected nerve root can also be impaired, causing numbness or weakness in the areas served by the nerve.
Disks of the neck or lower spine are the most common sites for ruptured, protruding or herniated disks. Lumbar disk problems almost always involve the three lowest disks - 95 percent of the time, the lower two - and in the vast majority of cases, the nerve root being compressed is the one exiting the level below. Obviously any herniated disc treatment options you pursue need to take into account exactly which discs are affected.
Pain tends to be sharp and specific and worsens with movement. If the problem is in the lumbar spine, you’d feel severe pain in the low back or the back of one leg, the buttock, or even the calf down to the foot. Pain usually affects one side, and coughing, sneezing, lilting, or straining can make it worse. You might also feel weakness in or numbness of the leg. If a cervical disk in the neck is involved, you’d feel pain in the neck, shoulder, or down one arm, with possible weakness or numbness in that arm.
Herniated disk ruptures usually heal without surgery, but slowly, so no herniated disc treatment is needed if you are happy to let your body heal itself. It’s often a quality of life issue. People can’t stand pain and disability for a year or two, but want surgery to get better quickly and move on with life.
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