What Is A Disc Hernia?

The intervertebral disc is an elastic disc between the vertebrae of the spine. It is installed between two adjacent vertebrae. Their function is to absorb the body weight that acts on the spine and distribute it evenly (i.e., during the walk).


The intervertebral disc is not supplied with blood and is provided by the synovial fluid’s diffusion (inlet and outlet) in healthy people. With age, it is typical for the intervertebral disc to degenerate: it breaks with time. The intervertebral disc is divided into two parts, the outer fibrous ring consisting of strong fibrous structures and the pulpous gelatinous nucleus. The outer part consists of solid fibers that hold the whole inner position. The inner part is dense and comparable to a kind of gel.


In the case of a disc hernia, the inner part of the disc emerges through a tear of the outer part in the canal of the spine (freely sequestered) or between the column and a ligament that covers the column (sub-ligamentous). The spinal cord or the spine’s nerve roots can be trapped, which is why the symptoms appear.


What Are The Causes Of A Disc Hernia?

The causes of the degeneration of the intervertebral discs are multiple. These include sustained pressure on the intervertebral disc tissue, incorrect load on the spine, lack of nutrients in the intervertebral segment, lack of exercise, and poor tissue quality due to heredity.


What Are The Symptoms Of A Disc Hernia?

Radicular pain (related to nerve roots, radius) or discomfort may occur in a disc hernia. These are pains caused by the impression of a nerve root. Each spine segment has two nerve roots on each side (right and left). For example, the posterior nerve root receives information about an arm’s pain. If we burn on the forearm, this burning pain is transmitted by the arm’s nerves to the posterior origin and from the spinal cord to the brain. We then consciously feel pain in the forearm.


The frontal nerve root works in the other direction. It directs information from the brain to the arm, for example, that the arm should move. A disc hernia can cause paralysis, spasticity, pain, and discomfort.


In addition, a disc hernia can cause myelopathic injury if the spinal cord is directly depressed. Since all nerve root fibers are routed to the brain through the spinal cord, movement or sensation can also be affected here.


In the case of a myelopathic injury, paraplegia can even occur under the herniated disc because all the fibers of the spinal cord contain all the emotional and motor information of the parts of the body located under the herniated disc. Thus, one can be paralyzed from the bottom of the navel if a complicated herniated disc develops at this height.


Therapy Or Conservative Surgery For A Disc Hernia Disc?

Conservative treatment is first applied for 4 to 6 weeks if there are no neurological deficits (e.g., numbness or paralysis). This includes local thermal therapy, pain and inflammation medications, massages, electrotherapy, and physiotherapy.


In case of conservative treatment failure, the disc’s volume can be reduced by sucking liquid (reduction of the intradiscal volume). Surgery is recommended in case of motor deficits and signs of spinal cord compression. Due to the relatively high rate of complications, surgery is recommended only for urgent indications (need for surgery).


Method Of Healing A Disc Hernia

Most disc hernias usually heal without surgery through conservative therapeutic measures. The healing process duration varies from person to person. This also applies to the healing process after intervertebral disc surgery. After the therapy phase, a rehabilitation phase follows after the operation and sometimes after the end of conservative therapy. This includes rehabilitating outpatient or inpatient patients and integrating them into the work process. In the case of an uncomplicated disc hernia, it takes about 12 weeks for the patient to recover. The healing process can also be faster or slower. The patient must cooperate in movement therapy and be very patient. The general prognoses are tricky because each disc hernia and each patient are different.


Which Doctors And Clinics Specialize In Disc Hernia?


In principle, different specialists can diagnose a herniated disc. The family doctor is usually the first doctor for back pain, numbness or paralysis. The latter can decide whether to consult a neurologist or an orthopedist. However, patients can also communicate directly with an orthopedist or go now to an orthopedics and spinal surgery clinic in the case of acute pain or paralysis. General practitioners, orthopedists, and neurologists can safely assume a disc hernia based on the symptoms, a physical examination, and the history of the incident.


To validate the diagnosis, specialists usually use imaging procedures such as magnetic resonance tomography or computed tomography. In addition, neurological examinations can help to make a diagnosis. The sensitivity and reflexes are checked, or the nerves, their excitation, and their lei speed are tested by specialized techniques (evoked potentials, EMG, nerve conduction speed). If disc surgery is necessary, spine surgery specialists are the right contact person.