Disc herniation or Hernia is one of the most common causes of back pain; it can affect one or more vertebrae of the spine, causing severe pain and difficulty in movement and walking.
A hernia is a discopathy, i.e., a disease that affects the intervertebral disc, the bearing interposed between a vertebra and the other with the aim of facilitating the movements and shock mitigation. Often classic is the case of those who carry a neck pain or low back pain for months without going to investigate the origin of the problem, or without undergoing an orthopedic visit or carrying out the diagnostic tests provided in these cases: radiographs, magnetic resonances, CT scans.
What are the causes of a Herniated Disc?
It is a wear and tears pathology that affects both men and women of young or mature age – the most affected band is the one that goes from 35 to 55 years – determined by the leakage of the softcore of one or more intervertebral discs, to due to compression.
To better understand what happens to the spine in these cases, we need to do a minimum of anatomy review. Our spine is structured in such a way as to alternate the vertebrae, which are the bony portions, with insulating pads that act as shock absorbers, filled with a soft pulpy core of a gelatinous consistency, which make the movements elastic and the spine flexible.
The intervertebral disc is made up of a more fluid central portion and a more external, harder one. In some cases, the central portion can “leak” through the peripheral portion and come into conflict with the medulla (if it is a cervical and/or dorsal disc) and/or with the nerve roots (in all other cases, of course including the lumbar-sacral level) causing, in some cases, a compression such as to cause damage to these structures.
Sometimes, due to trauma, or, more easily, repeated microtraumas over time, as well as postural defects that have never been corrected, a lateral compression of the disc occurs with crushing and release of part of the shock absorber bearing (protrusion ). This is the initial stage of the hernia, which can create painful discomfort and loss of sensation in the limbs of the affected area when the compression of the vertebrae irritates the nerve endings. It is no coincidence that one of the most common symptoms of a herniated disc is sciatica or the very painful inflammation of the sciatic nerve that runs through the entire leg from the buttock.
Types of Hernia
Hernias can be classified as:
- A contained hernia (or protrusion) is the most typical form of lumbar disc herniation. The herniated nucleus pulposus is wedged in the cracks of the degenerated fibrous ring, without however going beyond the outermost lamellae;
- Ejected or extruded hernia completely passes through the fibrous annulus and is further subdivided;
- The migrated hernia is the condition in which the expelled fragment migrates away from the disc, frequently caudally (downward), laterally, and very rarely cranially (upward).
Cervical Disc Hernia
The hernias medians in the neck, causing a compression of the spinal cord that suffers ( myelopathy ) by developing a variety of disorders such as numbness of the hands, clumsiness, weakness borne by the arm, weakness of the hand, stiff legs, loss of balance, urgently to urinate and, in severe cases, sphincter control disorders (urethra and anus).
Lateral hernias, on the other hand, compromise the well-being of the nerve root, which manifests itself with pain and/or radicular deficit, i.e., cervical pain radiating to the shoulder, scapula, and arm.
The cervical spine consists of 7 vertebrae; these are identified with the letter C and progressively numbered from C1 to C7. If the hernia is at the C6-C7 level, the pain radiates to the lateral edge of the forearm and to the middle finger of the hand. When it affects the C5-C6, the pain radiates on the lateral edge of the forearm, on the back of the hand, on the thumb and index finger, while if it is on the C4-C5, there is an impairment of the deltoid muscle, which manifests itself with difficulty to raise and bend the arm.
Dorsal Disc Hernia
The dorsal area is less exposed to this type of disorder because the vertebrae, articulating with the ribs of the rib cage, are more stable. The dorsal vertebrae can affect the stretch between D8 and D11.
A hernia can compress the spinal cord or nerve roots. Characteristic symptoms of spinal cord compression include pain in the spine, reduced strength in the lower limbs with difficulty walking.
Lumbar Disc Hernia
Lumbar disc herniation is a degenerative disease of the intervertebral disc, and, statistically, it manifests itself most prominently in people aged 30-50 years. In the lumbar spine, there are five vertebrae, and between one and the other, there is an intervertebral disc (similar to a cushion), which softens the contact between them. Each disc, which acts as a shock absorber, is made up of the annulus, which is the hard-fibrous external part similar to a ring and a pulpy nucleus, with a gelatinous consistency mainly formed by water which absorbs and uniformly distributes the stresses received. The fibrous ring can deform under the elastic thrust of the nucleus-pulposus (contained hernia) or break, causing the nucleus-pulposus (expelled hernia) and invading an irrelevant space.
Non-surgical Hernia Treatment
Among the treatments that can be proposed are:
- Manual mobilizations of the neck or lumbar area performed by a physiotherapist;
- Percutaneous symptomatic treatment, with the use of a needle electrode that emits radio frequencies.
Do not wait to begin the conversation for your mobility issues or back pain relief. Dr. Munish Lal will assist you in solving your frequent concerns and help you master how to enhance the health of your spine for optimal wellness. Right at the heart of Torrance, CA, pain care is just a call away.