Disc Herniation

A disc may herniate because of sudden trauma; anything from a fall on an icy sidewalk, to an athletic injury, or by simply lifting the wrong bag of groceries in the wrong way at the wrong time. Disc herniation may also be caused simply by the cumulative long term effects of what doctors like to call poor body mechanics - a lifetime of too much bending and twisting, and too many awkward positions. Herniations in the lumbar and cervical spine occur with increased frequency in middle aged patients (30-50 years old). This is because the relatively flexibility and regenerative ability of youth is slowly replaced with the stiffness and disc degeneration of progressive age.

Depending on where the herniation occurs, and the degree to which nerves entering the spine, or the spine itself, are affected, a wide range of symptoms are possible. In addition to pain around the site of the herniation, many disc patients also experience significant pain somewhere other than where the disc is because the discs ooze and bulge into spaces occupied by nerves. The nerves carry impulses from different parts of he body to the spine and then to the brain. The pain is experienced as if it were occurring in the area from where the nerve originates.

In herniations of discs in the neck, pain may appear in the shoulder, neck, outer part of he upper arm, or the inside of the forearm.

Herniations in the neck often reveal sensory deficits and weaknesses in the muscles of the arms, the thumb and some of the fingers, depending on the location of the affected disc. Several kinds of imaging tests, including x-rays, CT scans, MRI's and other more exotic imaging tests can confirm and elucidate the findings of a physical exam. In general, bulging discs are rarely a diagnostic mystery.

Treatment is a different story. To be honest, doctors often disagree about the treatment of disc disease. The fact is, there are many different kinds of treatments available;and just as different doctors often approach the same problem in different ways, different patients sometimes respond to the same treatment in very different ways.

Most doctors at least agree, that initially, conservative treatment is best, unless there is clear evidence of severe nerve involvement, significant loss of sensation, partial paralysis, or bowel or bladder dysfunction. Conservative therapy includes such things as bed rest, mild stretching exercises, heat or ice, massage, and drugs to reduce pain, relax muscles and reduce inflammation. Cervical traction, ultrasound therapy and electronic nerve stimulation are also options.

For discs that do not respond to conservative treatment, there is a surgical option. Actually, the truth is there is more than one surgical option, and this is where most of the controversy in the treatment of disc disease originates.