The part of the body that provides structural support to the entire body and connects all the bones, muscles, and joints to each other in the spine, commonly known as the ‘backbone’. The spine helps the body to perform motion and functions in various planes and axis. The spine consists of 26 bones called vertebrae. Each vertebra is separated by a structure termed as ‘disc’. The disc is a shock-absorbing structure that provides cushioning effects and supports the spine. It has an outer layer known as ‘annulus’ and an inner layer called ‘nucleus’. Along with the purpose of shock absorbance, discs also provide stability and allow movements in the spinal segments.
Disc problems are of various types, which the most common type is disc degeneration. A disc degenerative disease found among most individuals is ‘disc herniation’.
A herniation is referred to as protrusion or expulsion of a structure. In the case of disc herniation, the inner layer of the disc, which is known as the ‘nucleus’ is pushed out through the outer layer of the disc called ‘annulus’. In other words, it is the protrusion of the nucleus into the spinal canal through a tear or rupture in the annulus. Some other common names of this condition are:
- Disc bulge or bulged disc.
- Disc slip or slipped disc.
- Disc rupture or ruptured disc.
- Disc protrusion or protruded disc.
Disc herniation determines the early stage of degeneration which is usually caused due to the weakening of the vertebrae as degeneration is a factor related to age. As the age increases, the discs become prone to injuries and an excessive strain or trauma to the spine can lead to disc herniation.
This condition can occur anywhere in the spine but, the most common site of disc herniation is the lower back spine which in other words is known as the ‘lumber spine’.
Discussing the etiology or the factors that cause disc herniation, the age factor is the most common reason. Other causes of this condition can be observed to be excessive strain or injury to the spine.
Every condition has some specific symptoms that help in diagnosing the problem more accurately. In the case of disc herniation, the common symptoms include lower back pain, either acute or chronic history of intermittent lower back pain. Intermittent pain, in other words, can be described as an on-and-off occurrence of pain. Sciatica and cervical radiculopathy are also some of the marked symptoms of disc herniation.
The symptoms, however, help in creating a hypothesis about the condition that might have occurred but, in order to confirm the disease or medical condition, some diagnostic protocols are followed which help in confirmation of the diagnosis. For diagnosing an individual with disc herniation, X-ray, CT scan, MRI, Myelogram, EMG, and NCS are performed.
Once the diagnosis of disc herniation is confirmed, further treatment and management are planned and applied Disc herniation, if mild, can go away on its own in four to six weeks with proper rest and preventive measures. If the condition persists, the medical professional either decides to treat the condition with surgical or non-surgical intervention.
Non-surgical treatment may include:
- Physical Therapy.
- Epidural Steroid Injections.
Physical Therapy plays a vital role in the prevention, management, and treatment of disc herniation. With the help of Physical Therapy intervention, the patient’s condition is recovered and not only the pain is relieved, but also Physical Therapy helps in body conditioning and prevention of further injury. Usually, when treated with Physical Therapy, there is no further need for surgery and the patient is able to follow his ADLs effectively.
Physical therapy interventions for disc herniation may include deep tissue massage, thermotherapy including heat therapy and cold therapy, hydrotherapy, and exercise plan.
Moreover, in order to prevent disc herniation, the following points are to be kept in mind and followed on daily basis. These important points include:
- Maintain a proper posture
- Practice ideal lifting techniques.
- Maintain a healthy body weight.
- Wear comfortable shoes.
- Regular exercise.
- Balanced diet.
In case of persistent disc herniation even after the Physical Therapy intervention, if no positive effect is observed, the only treatment option left is surgery. The surgical procedure can be carried out in the spinal segment where the herniation of the disc occurs. These segments are either the cervical segment or the lumber segment.