Herniated Disc

What is Herniated Disc?

A herniated disk refers to a problem with one of the rubbery cushions (disks) between the individual bones (vertebrae) that stack up to make your spine. A spinal disk has a soft, jellylike center (nucleus) encased in a tougher, rubbery exterior (annulus). Sometimes called a slipped disk or a ruptured disk, a herniated disk occurs when some of the nucleus pushes out through a tear in the annulus. This can irritate nearby nerves and result in pain, numbness, or weakness in an arm or leg.

Symptoms

Symptoms depend on where the herniated disk is located: • Arm or leg pain (sciatica if in lower back, radiating pain if in neck) • Numbness or tingling in affected areas • Weakness in muscles served by affected nerves • Pain that worsens with certain movements • Pain that increases at night or with certain positions • Burning or aching sensations

Diagnosis

Diagnostic procedures include: • Physical exam to check reflexes, muscle strength, walking ability, and ability to feel light touches • Imaging tests including X-rays, CT scans, MRI scans • Myelogram to show pressure on spinal cord or nerves • Electromyogram (EMG) to determine which nerve root is affected • Nerve conduction studies

Treatment

Treatment approaches include: • Conservative treatment: rest, pain medications, physical therapy • Epidural steroid injections to reduce inflammation • Physical therapy exercises to strengthen back muscles • Pain medications including NSAIDs, nerve pain medications • Muscle relaxers • Surgery (discectomy, laminectomy, or spinal fusion) if conservative treatments fail • Weight management and lifestyle modifications

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