Herniated Disc Injury Explained

Many patients with lower back pain, leg pain, or weakness of the lower extremity muscles are diagnosed with a herniated disc or are sometimes referred to as a ‘slipped disc' . When a disc herniation occurs, the cushion that sits between the spinal vertebra (the bones which make up the spinal column) is pushed outside its normal position.

A herniated disc would not be a problem if it weren't for the spinal nerves that are very close to the edge of these spinal discs. This injury can often occur with sporting activities such as rugby that involve repeated bending and extension of the back.

Herniated Disc Signs & Symptoms

Some players who have suffered a slipped disc may not even experience immediate symptoms. This is due to the damage to the discs being small which only results in a small bulge in the spinal vertebra, or it may not be pressing on the nerves, or spinal cord.

However, the majority of players that suffer from a slipped disc do experience substantial pain. The pain may begin in the lower back and radiate to other parts of the body.

Sciatica

In most cases the pain is caused when part of the disc starts to press on one of the spinal nerves. The sciatic nerve is the most commonly affected nerve. The sciatic nerve is a large nerve that runs from the lower back and deep inside the buttocks and the back of both legs.

If you have pressure on the sciatic nerve it can cause:

• Chronic aching pain and numbness,
• A tingling sensation in one, or both, of your legs.
• Symptoms may start in the lower back, and radiate to the buttocks and legs.

Other nerves

If the slipped disc presses on any of the other nerves that run down your spinal cord, your symptoms may include:

• Muscle paralysis,
• Muscle spasms,
• Loss of bladder control.
• Muscle spasms and paralysis in your arms, legs and buttocks.
• Coughing or sneezing may increase pain as it may cause the disc to press on the nerve.
• The pain can also be worse when you go to sit down because, again, pressure is put on the spine and nerves.

Cauda equina syndrome

Cauda equina syndrome is a serious condition where the nerves at the very bottom of the spinal cord become compressed. The symptoms of the syndrome include:

• Lower back pain,
• Numbness in the groin,
• Paralysis of one or both legs,
• Rectum pain (pain in the lower bowel and anus),
• Bowel disturbance, being unable to pass urine,
• Pain in the inside of your thighs.

If you develop any of these symptoms, you should contact your GP immediately. If cauda equina syndrome is not promptly treated, the nerves to your bladder and bowel can become permanently damaged.

Herniated Disc Treatment

Symptoms from a herniated disc usually get better in a few weeks or months. To help you recover:

• Pain killers will help to manage pain.
• Heat packs may be necessary in the first week of the injury.

Reusable hot and cold pack

• Rest if you have severe pain. Otherwise, stay active. Walking and other light activity may help.
• A back brace can be helpful to improve posture and relieve pain by preventing aggravating movements.
• Lying on your front or lying on your back over a back stretcher. A back stretcher will position the spine in the opposite position to the injury and will encourage the nucleus gel to go back into the disc.
• Massage by a qualified physiotherapist may help in the treatment of disc related problems and sciatica.

Usually a herniated disc will heal on its own over time. About half of people with a herniated disc get better within 1 month, and most are better after 6 months. About 1 person in 10 still has enough pain after 6 weeks to think about surgery.

Be patient, and stick with your treatment. If your symptoms don't get better in a few months, you may want to talk to your doctor about surgery.

The most common and well-researched herniated disc surgeries are:

Discectomy, which is the surgical removal of herniated disc material that presses on a nerve root or the spinal cord.

Laminotomy and laminectomy, Laminotomy removes a portion of the thin part of the vertebrae that forms a protective arch over the spinal cord (lamina). Laminectomy removes all of the lamina on selected vertebrae and also may remove thickened tissue that is narrowing the spinal canal , the opening in the vertebrae through which the spinal cord runs.

Percutaneous discectomy, A special tool in inserted through a small incision in the back. Disc material is then removed or destroyed to try to reduce pressure on the nerve root. Percutaneous discectomy is considered less effective than open discectomy.

What you can do

• Consult a expert
• Remain as active as possible and apply a reusable heat pack for pain relief
• Wear a back brace to improve posture & relieve pain
• Use a back stretcher to assist the healing process
• Use a Swiss Ball to increase lower back muscular stability
• Strengthen spine supporting muscles with carefully selected exercises.

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