Herniated disc: Symptoms, diagnosis, treatments

When back pain radiates in the leg or arm, the diagnosis is usually herniated. The herniated disc is a disease of the spine, in which parts of the intervertebral disc protrude into the spinal canal.

Herniated disc: Symptoms, diagnosis, treatments

SOS tips on a herniated disc

A herniated disc is extremely painful and must be treated by a doctor. Here are some first aid tips to alleviate some of the symptoms:

Painkillers: The use of painkillers prevents the muscles from cramping around the herniated disc and the pain is thus even stronger.

Relieve Spine: Relief by lying down and storing your lower legs. For this purpose, you should put pillows or blankets under your legs. If the cervical spine is affected by a herniated disc, you can immobilize it with a neck brace.

Provide with heat for relaxation: Place a heating pad, heat plaster, a hot water bottle or a thermal plaster on the painful areas. The heat relaxes the muscles and thus provides relaxation.

Analgesic ointments: Carefully massage pain relieving ointments. They warm and numb the pain at the same time.

What is a herniated disc?

Herniated disc: Symptoms, diagnosis, treatments

A herniated disc, also known as disc prolapse, is a breakthrough of the inner, soft nucleus of an intervertebral disc through its outer fiber ring. As a result, the intervertebral disc deforms, changes its position, presses on the nerves emanating from the spinal cord and it comes to violent pain.

A herniated disc, also known as disc prolapse, is a breakthrough of the inner, soft nucleus of an intervertebral disc through its outer fiber ring. As a result, the intervertebral disc deforms, changes its position, presses on the nerves emanating from the spinal cord and it comes to violent pain.

The human body has 23 discs. These consist internally of the gel nucleus (nucleus pulposus), which acts like a gel pad. It is surrounded by a hard fibrous ring (annulus fibrosus), which holds the intervertebral disc in position. With increasing age, the disc becomes less and less elastic and can store poorer water. Thus, the risk increases that the fiber ring ruptures, the gelatinous core bulges outwards and thus a herniated disc occurs.

In about 90% of cases, herniated discs occur in the area of? the lumbar spine (lumbar spine, lumbar disc herniation). Sometimes the transition from the thoracic to the lumbar spine (BWS) or from the lumbar spine to the sacrum (lumbosacral) is affected. In only about 10% of cases, there is a herniated disc on the cervical spine (cervical disc herniation, cervical disc prolapse of the cervical spine).

Herniated disc symptoms

Herniated disc: Symptoms, diagnosis, treatments

The exact location on the cervical, thoracic or lumbar spine and the affected nerve will determine which symptoms occur.

Symptoms of lumbar disc herniation:

  • Pain in the lumbar region
  • Pain radiates in one leg
  • Tingling on the back, leg or buttocks
  • Misperceptions (sensibility disorders)
  • Paralysis, weakness in the legs
  • Stool or urinary incontinence
  • Disorders of sexual functions (erectile dysfunction)

Symptoms of a herniated disc of the thoracic spine:

  • severe pain in the upper back
  • radiating pain in the chest area
  • breath-dependent chest or back pain

Symptoms of a herniated disc of the cervical spine:

  • severe pain around the neck
  • Pain radiates in one arm
  • Tingling on the neck, arm or hand
  • Misperceptions such as numbness, disturbed temperature perception
  • Paralysis, weakness in the arms

Herniated disc causes

The most common causes are

  • Advanced age
  • overweight
  • lack of exercise
  • posture
  • one-sided load z. B. when sitting for long periods
  • Hard physical work
  • injury
  • Smoke

In most cases, a herniated disc is due to years of age-related wear of the disc. In rare cases, an injury can be identified as a cause.

The intervertebral disc becomes less elastic with age and can store poorer water. The risk that the fibrous ring of the disc breaks rises. For this reason, mainly middle-aged people and only very rarely younger people are affected by disc problems.

The abdominal and back muscles support and stabilize the spine. If these muscles have little or no training, this additionally stresses the intervertebral disc.

Similarly, incorrect lifting of heavy loads is dangerous to the disc. Heavy should only be lifted with a straight back, because with a round back weighs about eight to twelve times the weight on the intervertebral discs.

Herniated disc treatment

Non-operative (alternative) treatment options

Many herniated discs are treated without surgery because in most cases, they heal on their own within 6 weeks. The term “alternative” collects a whole series of treatment methods. They all have in common that a so-called proof of efficacy is missing. It is therefore not scientifically proven that they contribute to the relief of symptoms.

Exercise, relaxation and relief: Prolonged relaxation weakens muscles and bones, which can lead to further problems. For this reason, a herniated disc is advised to remain active to promote mobility. On the back pain itself, it does not affect whether you stay active or sparing. As far as the pain allows it, it makes sense to continue with normal activities. In addition, it has been proven that exercise training can prevent new complaints.

Relaxation exercises can also help with back pain. Mental wellbeing makes some people better cope with the symptoms.

severe pain, however, sometimes there is no other option than to lie down in a relieving posture as possible. Many people find the step bearing comfortably: The lower legs are placed on a shelf that is about as high as the lower leg and thigh form a 90-degree angle.

Acupuncture: In this treatment, special acupuncture needles are pierced into specific acupuncture points of the body, stimulating the receptors of the muscles. The pain stimuli are transmitted via fast nerve fibers to the spinal cord. The nerve fibers release the body’s own, analgesic substances that relieve the symptoms.

Heat therapy: Heat promotes blood circulation and metabolism. Warm sand or mud will relieve tension in the affected back muscles.

Electrotherapy: This method of treatment contributes to pain relief and muscle stimulation.

Ultrasound: An ultrasound treatment works with heat through sound waves in a high frequency range. It is intended to influence the secondary problems of disc degeneration. The muscle tension and associated tension pain are reduced and the blood circulation promoted.

Massage: With the classical massage muscles are to be relaxed, the blood circulation of the musculature is stimulated and pain is thus alleviated. If you have a back problem, the massage should be done by a physiotherapist to prevent further damage.

Hydrotherapy / Balneotherapy: These therapies use water or other heat transfer fluids to relieve muscle tension. The temperature plays an essential role in this method. For example, wraps, baths, washes or even castings are used.

Manual therapy: During the mobilization of the body, the joint partner and the associated musculature, whole parts of the spine or the sacroiliac joint are moved by the physiotherapist. The effect of the therapy is attributed to mechanical and nervous processes in the body of the patient. However, therapy should only be given by physiotherapists or physicians to prevent further damage to the spine.

When is surgery necessary?

surgery is recommended if:

permanent nerve damage threatens, as the damaged disc so strong on the nerves that it comes to numbness and paralysis in the pelvis and legs.
Conservative therapies such as medication, physiotherapy, and manual therapy can not reduce severe and prolonged pain.

Surgical treatment can relieve pain and prevent dangerous complications. If there is no paralysis in the leg after a herniated disc, surgery is usually not necessary.

Herniated disc diagnosis

In order to clearly diagnose a herniated disc, a thorough neurological examination is necessary. It provides information about the affected pain-causing nerves and enables targeted treatment.

The doctor first checks mobility, sensitivity, reflexes, and nerve conduction velocity. This will determine if and where the pain is radiating and which nerve roots are affected.

Furthermore, the attending physician checks the pulse at the legs in order to rule out a circulatory disorder there. This can cause pain that resembles the discomfort of a herniated disc.

Based on the X-ray examination, the mobility of the spine can be estimated. During the x-ray, the patient takes different positions so that the x-ray images show the spine in different postures. Recordings in the so-called oblique beam path provide information about possible abnormal mobility of the vertebral bodies.

Imaging techniques such as Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) visualize the spinal cord and nerve roots. Contrast agent administered into the vein allows the physician to delineate a herniated disc from inflammatory tissue or a tumor.

In myelography, the doctor fills with a cannula X-ray contrast agent in the spinal cord (dural sac). Thus, the underlying spinal cord and the nerve roots as contrast medium recesses can be detected indirectly in the X-ray image. However, this method is rarely used.

Herniated disc prevent

they should pay attention to strong back muscles and avoid strain on the spine. The most important prevention measures are:

Exercise: Sports and gymnastics strengthen the back muscles and relieve the spine. Sports such. B. swimming or cycling with raised handlebar are particularly back-friendly.

Avoid overweight: A healthy body weight relieves the spine.

The right mattress: This will ensure that your spine does not remain in an unfavorable posture at night.

Back-friendly workplace: If you are mostly sitting in the workplace, you should set up your workplace as back-friendly as possible with an ergonomic chair. Change regularly between sitting and standing. Be sure to stretch regularly and move a little.

Moving loads back-friendly: Do not move heavy loads with a crooked back, but bend your knees, hold the cross straight and then lift it. Keep arms close to the body and do not lift loads on one side.

The best exercises for pain
Tiered bed storage: Lie flat on your back (on a hard mattress). Store your lower legs at a right angle on a thick pillow or cube. This relieves the entire back and the trapped nerve.

Isometric exercises: As soon as the pain has subsided, isometric exercises can stabilize and strengthen the back muscles. Isometric means that the muscles become tense, but their length does not change.

For example, the forearm support is suitable for this:

For the forearm support, first lay down on the stomach. From this position, straighten your torso by leaning on your forearms. The elbows are under the shoulders. Remove the legs from the floor, tense the abdomen and back and hold the position for a few seconds.
For the lateral forearm support, take a lateral position (eg on a yoga mat). Then lean on a forearm so that the upper body and pelvis float in the air while the head is straight. Belly and back are tense again.

Regular exercise: Swimming or cycling can help prevent a new herniated disc.

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