Disc Herniation and Disc Degeneration

Disc Herniation and Disc Degeneration are two common types of back problems that can cause a great deal of pain.

Disc Herniation

Disc Herniation is usually referred to as having a ruptured or herniated disc. Remember that the discs are located between the vertebrae and act as a suspension system.

In a herniated disc, the outer shell of the disc, called the annulus, will rupture, allowing the inside gel like substance of the disc to leak out.

If the annulus is only slightly torn, the major symptom will be back pain. However, if there is a full tear, it can cause back pressure or nerve pressure as well. This pressure causes not only back pain, but also acute leg pain, which extends below the knee.

The most common cause of a herniated disc is a sudden load of weight, such as by lifting something that is too heavy. Disc herniation can occur in people of all ages, but it is most common in those who are thirty to fifty years old. Those over fifty are considerably less likely to experience a herniated disc.

Depending on the severity of the tear, it is common for a herniated disc to cause back pain and pressure on the spine and nerves. In very severe cases, the pain will extend below the knee, causing pain and numbness of the leg. It can also change your leg reflexes.

If the disc that tears is one of the larger central discs, a very serious tear can also cause loss of bowel and ladder function, along with numbness of the genitals. In this case, back surgery is usually required. If one of the thoracic disc ruptures, surgery is also needed, as there is a risk of becoming paralyzed. However, in less severe cases, treatment is usually non-surgical.

Non-surgical treatment of a herniated disc involves medicine to control the pain, rest, and hot or cold compresses. Usually, the symptoms will clear up in several days. However, it is important that once the pain begins to go away, the patient returns to light activity. There should be no heavy lifting, but light exercise, such as walking or water aerobics is important.

Disc Degeneration

Disc Degeneration is when the discs begin to change, often as the result of aging. This change ultimatly affects all portions of the body, not just the spine, and can even begin as early as a person's teens. However, in most people this does not begin until they reach their fifties and it is considered a normal part of the aging process.

Disc Degeneration is caused by the discs loosing water, making them more brittle and not as well suited to absorb shocks. It causes the back to hurt, but this pain does not extend to below the knees. Usually the pain caused by disc degeneration is worse when sitting or standing, but not as bad when lying down.

Treatment is almost always non-surgical and involves ensuring that the patient does not sit or stand in positions that make it worse. Some types of exercises can also make it worse, so should be avoided.

Some of the positions that should be avoided are:

  • Maximal Trunk Side Bending and Maximal Trunk Rotation
  • Trunk Hyperflexion, which is bending forward to the maximum
  • Trunk Hyperextension, which is bending backwards to the maximum.

While there are some exercises that can make disc degeneration worse, there are also some that can help. The most important exercises are those that stabilize the spine, which help build the muscles that support the spine, without utilizing any of the above positions. Going to the Pool and water aerobics are some of the best types of exercise, as the water helps to reduce spinal stress.

If exercise is not effective, a back brace can be worn. There are also several surgeries that can be preformed, such as a fusion operation, which involves removing the bad discs and replacing them with a bone graft. Doctors are also experimenting with artificial discs, but this is not common practice yet. With a fusion operation, which usually also involves using screws in the vertebrae, most, but not all, of the pain should subside.

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