Herniated disc

A slipped disc is usually the result of a relatively normal aging process of the spine. This can take different forms: gradual - that is, the disc gradually becomes flatter and loses its resilience - or more sudden. In this case, aging manifests itself in a herniated disc. Tears occur in the ring of the disc, causing the core of the disc to bulge and protrude from the ring.

The typical age for a herniated disc is between the early 30s and mid-40s, during which time the nucleus of the disc is still elastic enough to squeeze through tears in the ring. In older age, herniated discs are therefore rather the exception. Typical risk factors are lack of exercise and being overweight.
 

Symptoms

Often a herniated disc does not cause any pain at all. It only becomes unpleasant when it presses on a nerve. The problematic thing with a fresh herniated disc is a high degree of inflammation of the nerves due to the very aggressive disc tissue. This inflammation of the nerve root leads to severe pain. And sensory disturbances up to paralysis are also possible. The symptoms also depend on where the herniated disc is located. If the cervical spine is affected, the pain may radiate into the arms, or there may be symptoms of loss of sensation or paralysis.

In the thoracic spine, a herniated disc is very rare and manifests as back pain, usually on the affected spinal segment. If the lumbar spine is affected by a herniated disc, severe pain may occur in the lower back, sometimes radiating into the legs. Sensory disturbances and even paralysis are also possible in this area. It is particularly unpleasant for patients when the sciatic nerve is affected by a herniated disc. The pain can then run from the buttocks through the back of the thigh and into the foot.
 

Diagnosis

In a detailed medical history, the localization of the pain is determined and the trigger is identified. For this purpose, the physician also performs physical and neurological examinations. Using palpation, tapping and pressure examinations in the area of the spine and back muscles, he checks, for example, whether there are any abnormalities or pain points. He also tests the range of motion of the spine.

The intensity of the pain and its localization usually already give the physician an indication of the location of the herniated disc in the spine, and imaging is not necessary. However, if this is not clear, a computer tomography (CT) and a magnetic resonance imaging (MRI) make a herniated disc visible. This also shows, for example, the extent and in which direction the herniated disc has occurred.
 

Therapy

In the case of pain or mild muscle weakness, conservative treatment is usually sufficient - for example, medication, physiotherapy or injection procedures. In the case of more severe symptoms, for example if the disc presses directly on the spinal cord or severe paralysis occurs, surgery is often necessary. A herniated disc can be operated on microsurgically, for example, or minimally invasive procedures are also used. This usually involves removing the affected disc to relieve pressure on the spinal cord nerves that are constricted by the herniated disc.

Sometimes the worn disc is replaced with a prosthesis. On the one hand, the implant maintains the distance between the vertebrae and the mobility of the spine, and on the other hand, it relieves the pain.