HERNIATED DISC
Spinal/vertebral pain, better known as "back pain", is one of the most prevalent symptoms in the population. It is estimated that at least 80% of the world's population, at least once in their lifetime, have complaints of spinal-related pain. Most of the time, it is sufficiently intense and incapacitating, with important interference in the ability to work and quality of life.
The potential causes of "back pain" are diverse, taking into account the bony elements (the vertebrae), the discs, the nerves, the ligaments and the vertebral joints. However, in the vast majority of cases, pain is secondary to disc disease (classified in the medical nomenclature by "protrusions", "procidences" or "hernias"), especially in the lumbar and cervical segments of the spine.
Intervertebral discs are flexible structures, located between the bodies of the vertebrae that serve as protective pads, allowing all spinal movements, while helping to withstand mechanical impacts and body weight.
Intervertebral discs may be displaced or herniate, compressing nerve roots and cause besides back pain, symptoms related to dependent segments of nerve structures, translated by pain, numbness or weakness in the arm or leg (commonly referred to as "sciatic pain"). In more severe cases, a herniated disc can compress the nerves that control the bladder and bowel, resulting in urinary incontinence and loss of bowel control.
HERNIATED DISC SYMPTOMS
- Lower back painLombar Pain
- Cervical Pain
- Back pain
- Numbness of the Arms or Legs
- Pain with irradiation to the Arms or Legs
- Burning sensation on the Back
- Cramps
- Tingling in the Hands or Feet
- Sleeping Toes
- Pain in the Lower Back
WHAT CAUSES A HERNIATED DISC?
Is not understood fully, the causes that are at the root of disc disease. Most theories attribute this to a combination of the following factors: aging of the disc, genetic factors, poor posture, overweight from obesity, excessive physical exertion or after a traumatic event.
CAN YOU PREVENT THE ONSET OF HERNIATED DISCS?
In many cases it is not possible to avoid a herniated disc. However, it is possible to reduce the probability of its appearance with general measures, such as practicing good posture, maintaining a healthy weight, avoiding physical inactivity and excessive physical exertion, and practicing regular physical exercise, particularly walking and swimming.
HOW DO YOU EVALUATE "BACK PAIN"?
For a correct diagnosis it is essential that the doctor thoroughly review the medical history and symptoms, followed by a physical examination to exclude other diseases that may cause back pain. If there is any doubt about the initial diagnosis and especially if the symptoms persist or worsen, a radiograph of the spine, a computerized axial tomography (CT) scan, or an MRI scan may be recommended. In specific cases, additional electromyography may be necessary.
WHAT ARE THE OPTIONS FOR DISC HERNIA TREATMENT?
In most cases, pain associated with a herniated disc will gradually improve only with measures of general character and pharmacological treatment. When these conservative measures do not function, there may be a need for more aggressive treatment, including minimally invasive spinal intervention techniques or possibly surgery.
DOES VERTEBRAL PAIN NECESSARILY MEAN DISC DISEASE?
In addition to disc disease, spinal pain may originate from other vertebral elements (eg spinal muscles distension, osteoporotic or traumatic bone fracture, etc.), or reflect a disease elsewhere in the body (eg, kidney infection and/or "kidney stones", etc.).
SYMPTOMS OF THE DISEASE
In the cervical region the herniated discs are usually characterized by neck pain with irradiation to the shoulders or arms and by headache in the nape of the neck.
CAUSES
Neck and arm pain associated with cervical discomfort can have several causes, but it is mostly related to cervical disc hernias that are due in large part to disc wear, genetic factors, poor posture, obesity, sedentary lifestyle, excessive physical efforts, and abstaining from regular exercise.
DIAGNOSIS AND EXAMINATION
For a good diagnosis of herniated discs, the doctor evaluates the patient's medical history, performs a physical examination to evaluate the location of the pain and the sensitivity in the affected region. Next a neurological examination is performed to evaluate the reflexes, muscle strength, walking and sensitivity. To help the diagnosis and exclude other possible causes of pain may still be requested from the patient diagnostic exams such as computed tomography, magnetic resonance imaging, and electromyography.
TREATMENT
Treatment of disc hernias at an early stage can only be through resting and medication, such as analgesics and muscle relaxants. In some cases, doctors may advise on physical therapy and muscle strengthening. In cases where pain caused by disc hernias is refractory to medication, minimally invasive treatments (Plasmalight nucleoplasty (most popular), ozone therapy or radiofrequency) may be used.
Lumbar Hernia
The intervertebral disc is located between two vertebrae and is surrounded by a fibrous ring. When the disc is worn or ruptured, the disc overflows causing a hernia or a protruding disc.
This disc compresses the nerve causing pain. This problem is more common in the lumbar region since it is the region that supports the weight of the body.
SYMPTOMS OF THE DISEASE
The most common manifestation of lumbar disc herniations is sciatica, loss of muscle strength in one or both legs, and tingling or numbness in a leg or buttock.
CAUSES
Back or leg pain associated with lumbar discomfort can have a number of causes, but it is mostly related to lumbar disc herniations, which are due in large part to disc wear, genetic factors, poor posture, obesity, sedentary lifestyle, excessive physical efforts, and abstaining from regular exercise.
DIAGNOSIS AND EXAMINATION
For a good diagnosis of herniated discs, the doctor evaluates the patient's clinical history, performs a physical examination to evaluate the location of the pain and the sensitivity in the affected region. Next, a neurological examination is performed to evaluate the reflexes, muscle strength, walking and sensitivity.
To help the diagnosis and exclude other possible causes of pain may still be requested from the patient diagnostic exams such as computed tomography, magnetic resonance imaging, and electromyography.
TREATMENT
Treatment of disc hernias at an early stage can only be through resting and medication, such as analgesics and muscle relaxants. In some cases, doctors may advise on physical therapy and muscle strengthening.
In cases where pain caused by disc hernias is refractory to medication, minimally invasive treatments (Plasmalight nucleoplasty (most popular), ozone therapy or radiofrequency) may be used.
Is surgery the only therapeutic option?
No. There are several non-surgical treatment techniques for herniated discs, with a comparable or, in some cases, higher success rate (especially at 1-year follow-up) and which does not require surgical removal of the herniated disc.
Minimally invasive fiber optic treatment is one of the alternative options to invasive surgery. It is a procedure free of serious complications, with a short hospital stay and recovery, allowing a quick return of the patient to routine daily activities.
Furthermore:
- does not require general anesthesia;
- does not interfere with bone structures;
- does not imply disk removal;
- leaves no skin scar;
- as a high expected success rate;
- does not prevent surgery if strictly necessary.
