By: Dr. Ahmad Elakil
Insight Hospital and Medical Center Chicago – Disc herniation, also known as a slipped or ruptured disc, is one of the most common causes of back, neck, and leg pain. But did you know that this is a serious injury that can compromise mobility, require comprehensive treatment, and even lead to surgery for many patients? If you or a loved one are experiencing complications from this condition, it is important to understand how the structure of the spine can lead to injury, as well as common symptoms and factors associated with disc herniation.
What is a Disc?
Featuring a soft component in the center, known as the nucleus pulposus, the design of a disc is similar to that of a jelly donut. When an injury damages or ruptures the nucleus pulposus, this can lead to disc herniation. This typically occurs between the fourth and fifth lumbar vertebrae in the lower back. If the disc herniation is sufficiently large, the disc tissues can exert pressure on the nearby spinal nerves, which can aggravate the health of the spine.
Understanding the Design of the Spine
As a spine surgeon, I believe that in order to understand the complexities of disc herniation, you must also understand how the spine and its discs are designed. The spine is made of bony building blocks known as vertebrae, and the discs provide support and mobility to the larger vertebrae. Surrounding the spine and discs are ligaments.
There are seven vertebrae in the neck, known as the cervical vertebrae. In the mid-back there are 12 vertebrae, known as the thoracic vertebrae. In the lower back there are five vertebrae, known as the lumbar vertebrae. And tucked beneath the fifth lumbar vertebrae in the mid-buttock region, adjacent to the tailbone (coccyx), is the sacrum.
The human spine is designed in a manner that allows the vertebrae to be stacked together to create a moveable structure, provide ample support, and protect the spinal cord. The spinal cord is made of sensitive nervous tissue, which connects the spinal column to the brain.
The vertebrae protect the spinal cord from injuries. Each vertebrae boasts a spinous process, which is a bony presence that protects the nerve tissues in the spinal cord. The vertebrae also boost a sturdy skeletal form that provides the spinal cord from the front and allows greater flexibility and protection for bearing weight.
The discs are cushiony pads that provide support and minimize the impact of physical exertion to protect the spinal column and enhance flexibility. Ligaments are sturdy fibrous tissues that serve the function of attaching the bones together firmly. They also attach all of the vertebrae and are placed alongside each of the discs. As the disc starts to degenerate, the ligaments get injured and become painful in the affected area.
Now that I have explained the structure of the spine, let’s take a closer look at disc herniation and how it occurs.
What is Disc Herniation?
As I explained above, the design of the disc is very fragile and similar to the makeup of a jelly donut. Discs usually degenerate as the body ages, but a back injury can also cause degeneration. The nucleus pulposus, the soft part in the center of the disc, can herniate or get ruptured from the annulus fibrosus – the outer ring that surrounds the disc.
Disc herniation refers to the abnormal rupturing of the nucleus pulposus, more commonly known as a slipped disc. A herniated disc typically occurs in the disc located between the fourth and fifth lumbar vertebrae, tucked within the lower back. It is important to note that the lower back is constantly exposed to the impact of lifting the weight of the upper body.
The lower back vertebrae and discs play a crucial role in supporting our bodies while sitting or standing. More importantly, the lower back is heavily involved in supporting various movements as we go about our daily chores. The lumbar vertebrae and discs are involved in twisting the torso, side-to-side rotations, and in allowing flexion and extension every time we bend and lift something off the ground.
The risk factors of a herniated disc typically include heavy lifting, spine degeneration, excessive bending of the spine, and spinal injury. However, this condition can be prevented by taking care of spinal health, avoiding serious injuries, and limiting heavy lifting.
What are the Symptoms of Disc Herniation?
Symptoms of disc herniation vary depending on the exact condition and severity of the rupture. Some of the factors include: the condition of the spine, the exact location where the herniated disc has occurred, and whether or not there has been any damage or irritation to the nerve tissues. There may be no symptoms in some cases, but it can cause pain in the spinal area that has been affected.
A massive disc herniation can cause the disc tissue to press against the nearby spinal nerves located in the affected area that connects the spine and brain. This can lead to extreme pain in the network of that nerve, and it typically occurs on one side of the body. This shooting nerve pain is called sciatica. For example, if the disc herniation occurs between the fourth and fifth lumbar vertebrae of the lower back, it can result in sciatica pain that travels down the buttock and impacts the back of the leg and calves.
If the disc herniation takes place in the cervical spine, it can cause the pain to travel down one arm and cause muscle spasms and stiffness in the neck. In a massive disc herniation, the disc tissue can press against spinal nerves located on both sides of the body. This can result in pain on one or both sides of the body. It also leads to severe muscular fatigue in the lower body. In some cases, patients may experience bladder and bowel incontinence as well. Medically, this condition is known as the cauda equina syndrome.
If you think you are suffering from symptoms of disc herniation, spinal pain, or painful sensations traveling down your back and legs, it is important to consult an expert immediately. Patients often neglect treatment and rely on over-the-counter medications to counter pain and experience temporary relief. To request an appointment with Dr. Ahmad Elakil or to learn more about the services offered at Insight Hospital & Medical Center in Chicago, Please call (312) 567-2273 or click here to find out about next day appointments.
References
https://www.spine-health.com/conditions/herniated-disc/surgery-options-a-herniated-disc
https://www.hopkinsmedicine.org/health/conditions-and-diseases/lumbar-disc-disease-herniated-disc
https://www.spine-health.com/video/video-can-herniated-discs-heal-their-own
https://www.medicinenet.com/herniated_disc/article.htm
https://www.webmd.com/pain-management/treatments-for-herniated-disk