Disc Prolapse
Disc Prolapse causes severe pain in the vertebrae with few or no symptoms in the disc. Herniated Disc, Ruptured Disc, Slipped Disc, Bulging Disc or Sciatica are terms used for disc prolapse based on symptoms.
The spine consists of individual bones called the vertebrae. A stack of vertebrae is referred to as the spinal column. Between the vertebrae, there are disc’s called Inter-vertebral disks which are thin, flat structures that act as cushions between the bones to give extra support and strength to the spine. Various muscles are also attached to the spine. The joints of the spinal column are called facet joints. The spine structure is designed to protect the spinal cord, along with the various pairs of nerve roots exiting through the neural foramina. Subsequently, the nerve carries messages to various parts of the body.
Each disc contains a soft gel core called the nucleus. The annulus is an outer fibrous ring that surrounds it. Such a structure maintains space between the vertebrae and soft gel which is enough to compress when the spine flexes. In most of the cases, the annulus can become weak, tears, the central gel or nucleus fragment can come out from the disc. This creates pressure on the neural elements inside the spinal canal. The pressure over the nerve roots and other internal contents causes pain in the legs, altered sensations in the legs or feet and may lead to muscle weakness.
Disc Prolapse - Symptoms
The symptoms of an individual with Disc Prolapse will vary depending upon various stages and the severity. In many cases, the first symptom is usually back pain in the area of the affected disk. Secondly, the pain radiates down the buttocks and hips into the legs, which we call Sciatica. Finally, malfunctioning of the compressed nerves leading to either tingling, numbness in the legs and feet or muscle weakness. The untreated disc prolapse may lead to permanent neural damage and even paralysis. Sometimes affected disk may produce a disaster called Cauda-Equina Syndrome. In such cases, there may be damage to all the nerve roots going below the level of compression. As a result, patients may have varying weakness of the lower limbs as well and the loss of bladder control and bowel movements.
Disc Prolapse - Risk Factors
Most of the back pains are due to some mechanical problems. Prolapsed Disc is rare among youth. Generally, men between 30 to 50 are more prone to getting a prolapsed disc. With age, the discs degenerate’s slowly. Studies say that some may inherit a predisposition to prolapsed disc genetically if the conditions run in the family. Excessive body weight, bad posture, performing abnormal activities which produce excessive strain to the back, smoking and sudden pressure on the back may lead to Symptomatic Disc Disorder.
Diagnosis of Disc Prolapse
The diagnosis of a prolapsed disc is by reviewing the patients’ medical history. Following it, we conduct a detailed physical examination of the back. Recommend Spinal X-rays, Computed Tomography (CT) scan or Magnetic Resonance Imaging (MRI) scan, to confirm the abnormality.
Treatment
Depending upon the diagnosis & investigations and the severity of the condition, Disc Prolapse can be treated in two forms. Either through conservative treatment or through surgery. In many cases, patients will respond to conservative treatment. Generally, about 90% of individuals with low back pain respond to treatment within 6 weeks.
Conservative therapy includes;
- Two to three days of bed rest with a small pillow under the knees. Moreover, prolonged bed rest may be harmful. It is not advisable.
- Various modalities of physical therapy with heat, cold pads. Placing these pads on the affected area may provide a kind of relief. However, they also result in muscle spasms in the back.
- Analgesics, non-steroidal anti-inflammatory drugs (NSAIDs) and muscle relaxants
- Spinal injections
Surgery
Patients who do not respond to conservative treatment need aggressive treatment such as surgery. Patients may experience progressive nerve damage and some may also lose control of bowel and bladder movements. Surgical options include micro-discectomy or a conventional discectomy depending upon the size and position of the disc prolapse. Micro-discectomy surgery enables more accuracy and greater focus. In many cases, with major surgery, one can remove the Prolapsed Disc. Furthermore, nowadays doctors suggest minimally invasive operation. This involves the removal of the Prolapsed Disc through a hollow tube inserted by a tinny incision. Minimally invasive surgery enhances the patient outcome with a faster recovery period.
Prevention
It is not possible to prevent a prolapsed disc, but you can able to decrease risk by avoiding repetitive bending, proper lifting technique, avoiding heavy lifting, maintaining a healthy because excess weight put pressure on the spine, avoiding a long time sitting, avoiding smoking, regular excesses to strengthen muscle and to improving back and abdomen flexibility. Nowadays, eating healthy, well-balanced meals and doing exercising regularly especially aerobic exercise swimming, cycling and walking help to a considerable extent. Overall, little change in the lifestyle will help to heal many of the diseases without medicine.