Intervertebral discs can also rupture as a result of weakening outer fibres of the disk. This is usually due to repetitive minor injuries which build up over time. This damage may occur with aging, hereditary factors, work- or recreation-related activities. Often there is no obvious reason why such a process should have occurred. Then at some point you may lift something, twist or bend in a manner which puts enough pressure on the disc to cause it to rupture through its weakened outer fibres.
Intervertebral disc prolapses most commonly occur in the lumbar spine lower back and cervical spine neck.
Less commonly, they occur in the thoracic spine mid-back region. Both the pressure on the nerve root and the chemical irritation can lead to problems with how the nerve root works.
The symptoms of a herniated or prolapsed disc may not include back or neck pain in some individuals, although such pain is common. Diagnosing a prolapsed disc begins with your specialist taking a complete history of the problem. A "slipped disc" can be a bulged disc, or a herniated disc, but what that describes is when the disc starts to degenerate, it no longer can perform that function of a ligament, which is to hold the bones on top of each other in a uniform manner. So the discs start to shift back and forth on one another to a certain degree.
That's a so-called slippage that people are talking about. But when the disc slips and pushes back and forth on the bone, sometimes it hits a nerve, and that's why people complain of sciatic pain or nerve pain from a slipped disc.
The final analogy I like to talk about is the herniated disc, and the analogy I like to use the jelly donut. As you know, the jelly donut is bread on the outside, jelly on the inside. We all know there's also a little hole used to fill the jelly donut full of jelly.
What happens when you press on the center of a jelly donut? A lot of times, the jelly actually comes out of that hole. That, actually, is a herniated disc. If your bulging discs have caused lumbar stenosis and the symptoms are affecting your quality of life, surgery called lumbar decompression is an option. The procedure is very patient-specific based on the type and level of stenosis, but, in general, it involves decompressing the spinal canal so that the nerves are no longer compressed.
This, in turn, relieves the pain. Smith: Pain from a herniated disc comes on abruptly and usually affects one individual nerve root. Herniated discs are sometimes caused by an acute injury. In some cases, you may know the cause of the injury, such as twisting incorrectly. Other times, I see patients who just woke up one day and noticed this pain in their back.
If you've experienced symptoms for less than 6 weeks and have no nerve damage, anti-inflammatory medications, physical therapy, and steroid injections if needed can help resolve the issue in 6 to 12 weeks. If those don't work, an outpatient surgery called a microdiscectomy can alleviate pain quickly by relieving the pressure on the affected nerve root. Smith: Within the Spine Center, our multidisciplinary approach allows us to care for most patients without surgery, from start to finish.
We also have a surgery team in place so that patients who come to us initially who end up needing surgery can receive that continuity of care. In terms of technology, we're at the forefront of adopting and implementing new technologies and minimally invasive surgical techniques.
But the good news is that oftentimes, if this is the first time you've had either a bulging or herniated disc, it can be managed without surgery. From bulging discs to herniated discs and everything else spine-related, find out how Penn Medicine's Spine specialists can help your pain.
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