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General Practice 2023

Hé disc rupture: what é, types, symptoms and treatment

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Hé disc rupture: what é, types, symptoms and treatment
Hé disc rupture: what é, types, symptoms and treatment

A herniated disc is characterized by the bulging of the intervertebral disc, which can lead to symptoms such as back pain and a burning sensation or numbness. It is more frequent in the cervical spine and lumbar spine, and its treatment can be done with medication, physical therapy or surgery, and depending on its severity, it can be completely cured.

The herniated disc can be classified according to the region of the spine it affects and, therefore, it can be:

  • Cervical disc herniation: affects the neck region;
  • Herniated thoracic disc: affects the mid-back region;
  • Lumbar disc herniation: affects the lower back.

The vertebral disc is a fibrocartilage structure that serves to avoid direct contact between one vertebra and another, and to cushion the impact generated by jumping, for example. Thus, a disc injury, or discopathy, as this condition is also known, impairs the function of the vertebral disc itself and even puts pressure on other important structures of the spine, such as the nerve root or spinal cord.

Types of herniated discs

Types of herniated discs

Types of herniated discs

The beginning of a disc injury can happen when the person does not have good posture, lifts weights without bending the knees and does not drink about 2 liters of water a day. In this case, despite not having formed a hernia, the disc is already damaged, is thinner, but still maintains its original shape: oval. If a person does not improve their posture and lifestyle, within a few years, they will likely develop a herniated disc.

A hernia occurs when the vertebral disc loses its original shape, ceasing to be oval, forming a bulge, which is a kind of 'drop', which can put pressure on the sciatic nerve root, for example. So, the 3 types of herniated discs that exist are:

  • Protruding disc herniation: is the most common type, when the disc core remains intact, but the oval shape is already lost;
  • Extruded herniated disc: when the disc core is deformed, forming a 'drop';
  • Sequestered herniated disc: when the nucleus is badly damaged and can even split into two parts.

Posterolateral protruding disc herniation

A person can have more than one herniated disc and it can increase in severity over time.Usually when a person has only disc dehydration, they don't have any symptoms and only find out if they have an MRI for some other reason. Symptoms commonly arise when the hernia has already worsened and is in the protrusion stage.

The hernia must still be classified according to its exact location, which can be postero-lateral or posterolateral. A herniated posterolateral disc can put pressure on the nerve causing tingling, weakness or loss of sensation in an arm or leg, but when there is a herniated posterior disc, the pressured region is the spinal cord and so the person may have these symptoms in both arms or legs, for example.

Symptoms of a herniated disc

The main symptom of a herniated disc is intense pain where it is located, but it can also generate the following symptoms:

Herniated cervical disc Lumbar disc herniation
Pain in the back of the neck Lower back pain
Difficulty moving the neck or lifting the arms Difficulty moving, bending over, getting up or turning over in bed, for example
There may be a feeling of weakness, numbness, or tingling in one of your arms, elbow, hand, or fingers Sensation of numbness in the buttocks, and/or legs, in the back, front or inside of one of the legs
--- Burning sensation in the path of the sciatic nerve that goes from the spine to the feet

The pain of a herniated disc usually gets worse with movement and can be aggravated by coughing, laughing and can get worse when the individual pees or has a bowel movement, and can appear suddenly or get worse over time.

How the Diagnosis is Made

The diagnosis of a herniated disc can be made through observation of symptoms and physical examination, but it can also be confirmed by exams, such as computed tomography or magnetic resonance imaging, which serve to evaluate the disc, its thickness, the exact location of the hernia and what type of hernia the person has.

The X-ray exam does not clearly show the hernia but it can be enough to show the alignment of the spine and the integrity or destruction of the vertebrae and therefore, sometimes the doctor initially requests the X-ray and with the result of this, order MRI or CT scan to assess severity.

When confirming that there is one or more herniated discs, the doctor can indicate the treatment that can be done with physiotherapy, Pilates, RPG, osteopathy, or surgery. Surgery is usually the last treatment option, being reserved for cases where the person does not show improvement in symptoms with other forms of treatment, for a period longer than 6 months.

What causes a herniated disc

The main cause of a herniated disc is poor posture in everyday life, and the fact that the person is not careful when lifting and carrying very heavy objects. Thus, it is common for people who work as servants, painters, maids, drivers and bricklayers to develop discopathy or herniated discs around the age of 40.

About 10 years before discovering a herniated disc, it is common for a person to have symptoms such as back pain that does not go away quickly. This is one of the first warning signs that the body gives out, but it is usually ignored until the hernia in the spine appears.

Some factors that favor the installation of a hernia are aging, excess weight and inadequate physical effort and, therefore, for the success of the treatment it is important to eliminate all these factors.

Herniated Disc Treatments

When treatment is performed correctly, symptoms may disappear within 1 to 3 months, but each individual responds differently to treatment and, therefore, in some cases this period may be longer.For successful treatment it is important to know the exact location of the hernia and what type it is. The most common type, which is disc protrusion, can be treated with:

  • Use of painkillers and anti-inflammatories prescribed by the doctor;
  • Physiotherapy sessions with equipment, stretching and individualized exercises;
  • Osteopathy which consists of cracking the spine and realigning all bones and joints;
  • Exercise such as RPG, hydrotherapy or Pilates guided by a physical therapist.

During the treatment, it is recommended that the person stay away from the activities that caused the hernia, do not make efforts and do not practice any type of physical activity.

Check out these and other tips in the following video:

Surgery for herniated disc is indicated when the person has an extruded or sequestered disc hernia and clinical and physical therapy treatment was not enough to reduce symptoms and improve the individual's quality of life.

Herniated disc in pregnancy

Woman who has already diagnosed herniated discs before becoming pregnant should know that during pregnancy a herniated disc can worsen, causing intense back pain that can put pressure on nerve roots, such as the sciatic nerve. When the sciatic nerve is affected, the woman feels pain in her back, buttock or behind her thigh.

This happens because during pregnancy, progesterone leads to an increase in the laxity of all the ligaments in the body, and as the spine also has ligaments, these become more elastic and end up allowing the vertebra to drain a little, which can aggravate or lead to a herniated disc.

During pregnancy, medicines other than paracetamol should not be taken, so if the woman has back or gluteal pain, she should lie down, with her legs supported on a pillow or pillow, for example. Placing a warm compress on the area of ​​pain can also relieve this discomfort.Learn about the risks to the baby, what the delivery is like and the treatment options for herniated discs in pregnancy.

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