Herniated Disc Expert at Arunalaya -

Expert Herniated Disc Treatment in Delhi

What is Herniated Disc?

A herniated disc occurs when the soft nucleus of a spinal disc pushes through a tear in its tough outer layer (annulus), protruding into the spinal canal. This displacement can compress nearby nerves, causing pain that may be severe. Herniated discs are most common in the lower back (lumbar spine) but can also occur in the neck (cervical spine), with symptoms depending on the affected area.

Causes of Herniated Disc

Disc herniation is often caused by a gradual, aging-related wear and tear known as disc degeneration.
As people age, discs become less flexible and more susceptible to tearing or rupturing from minor strains or twists.
Most individuals cannot identify a specific cause for their herniated disc.
Using back muscles instead of leg and thigh muscles to lift heavy objects can lead to herniation.
Twisting and turning while lifting may also cause a herniated disc.
Rarely, traumatic events like falls or blows to the back can be the cause.
A single excessive strain or injury may trigger a herniation.
Natural aging leads to disc degeneration and weakening of ligaments that hold the discs in place.
As degeneration progresses, minor strains or movements can cause the disc to rupture.
Some individuals may be more prone to disc problems, often suffering herniated discs in multiple areas along the spine.
There may be a genetic predisposition to herniated discs, with a family history increasing the risk.

Symptoms of Herniated Disc

The lower back is most commonly affected by herniated discs.
Symptoms include pain on one side of the body, sharp pain in the leg, hip, or buttocks, numbness, and weakness in the same leg.
In the neck, symptoms include neck pain, pain radiating to the upper arm, forearm, fingers, along with numbness.
Numbness or tingling can occur when pressure on nerves causes sensations to travel along the nerves into arms or legs.
Muscle weakness from nerve pressure may cause stumbling when walking.
Back pain often radiates to the arms or legs, described as burning or sharp.
Myelopathy
- When a herniated disc puts pressure on the spinal cord, it can affect your walking, grip strength, and other important functions. This is a very serious, although uncommon, result of a herniated disc. If you notice difficulties with balance, fine motor activities like buttoning your clothes, or even a change in your handwriting, you should seek immediate help.
- Myelopathy can lead to permanent paralysis and even death. In many cases, surgery from a qualified orthopedic surgeon is necessary.
Incontinence
- Another very serious symptom of a herniated disc involves a disruption in your body’s ability to remove waste. If you stop feeling the urge to urinate or have a bowel movement or cannot control your bodily functions, get help immediately. Although this is a rare condition, it can lead to permanent damage.
The pain of a slipped disc often feels worse:
- After standing or sitting
- At night
- When sneezing, coughing, or laughing
- When bending backward or walking more than a few yards.

Testing & Diagnosis

Testing modalities are listed below. The most common imaging for this condition is MRI. Plain x-rays of the affected region are often added to complete the evaluation of the vertebra. Please note, a disc herniation cannot be seen on plain x-rays. CT scan and myelogram were more commonly used before MRI, but now are infrequently ordered as the initial diagnostic imaging, unless special circumstances exist that warrant their use. An electromyogram is infrequently used.

X-ray: Application of radiation to produce a film or picture of a part of the body can show the structure of the vertebrae and the outline of the joints. X-rays of the spine are obtained to search for other potential causes of pain, i.e. tumors, infections, fractures, etc.
Computed tomography scan (CT scan): A diagnostic image created after a computer reads X-rays; can show the shape and size of the spinal canal, its contents and the structures around it.
Magnetic resonance imaging (MRI): A diagnostic test that produces 3D images of body structures using powerful magnets and computer technology; can show the spinal cord, nerve roots and surrounding areas as well as enlargement, degeneration and tumors.
Myelogram: An X-ray of the spinal canal following injection of a contrast material into the surrounding cerebrospinal fluid spaces; can show pressure on the spinal cord or nerves due to herniated discs, bone spurs or tumors.
Electromyogram and Nerve Conduction Studies (EMG/NCS): These tests measure the electrical impulse along nerve roots, peripheral nerves and muscle tissue. This will indicate whether there is ongoing nerve damage, if the nerves are in a state of healing from a past injury or whether there is another site of nerve compression. This test is infrequently ordered.

How to Prevent Herniated Disc Issues?

Aging weakens spinal discs and supporting structures, increasing herniation risk.
Injury and disease are common causes of herniated discs.
Most herniated discs occur in the cervical (neck) and lumbar (lower back) regions.
Herniated discs can occur anywhere along the spine.
Proper lifting posture can help prevent herniated disc problems by reducing spinal pressure.
Following are some easy or basic tips for reducing the risks.
- Improve posture: Keep your head up, shoulders back, and spine straight to maintain proper alignment whether sitting, standing, walking, or running.
- Regularly exercise: Incorporate exercises that strengthen back, leg, core muscles, and promote cardiovascular health, along with flexibility routines.
- Learn to lift items properly: Use your legs to lift heavy objects by bending the knees and keeping your back straight, avoiding twisting during the lift.
- Maintain a healthy weight: Avoid excess weight to reduce pressure on the back and knees and promote good posture.
- Manage stress: Engage in stress-relieving activities to prevent muscle tightness and reduce pressure on the spine.
- Change positions frequently: Move or stretch at least every 30 minutes if sitting or standing for extended periods.
- Stop smoking: Quit smoking to improve tissue health, prevent disc degeneration, and avoid increased spinal pressure from coughing.
- Do not wear high-heeled shoes: Avoid high heels to prevent misalignment and improper positioning of spinal discs.

Physiotherapy Treatment

Regular exercise can minimize the risk of developing a herniated disc, but once a herniated disc develops, there are exercises to avoid doing. The exercises to avoid are those that force the neck to bend or cause other spine misalignment and those that put excess pressure or force on the spine.

Avoid sit-ups to prevent lower back pressure.
Refrain from squats due to spinal strain.
Skip cycling, especially with long rides and poor posture.
Don’t do standing hamstring stretches that involve leaning forward.
Avoid deadlifts to prevent spinal stress and injuries.
Steer clear of high-impact aerobic exercises with jumping and quick moves.
Do not perform leg presses that round the spine.

TREATMENT

Patients who are diagnosed with herniated disc often think that surgical treatment is the only option when consulting a specialist. In reality however, herniated disc has various choices of treatment, depending on the condition and the level of severity.

Medication: includes both oral and injection, for pain killer, muscle relaxant along with steroid injection to reduce pain and inflammation.
Physiotherapy: helps muscle relaxations and reduces pain. It also facilitates in strengthening muscles. However, patient must be under doctor’s and physiotherapist’s supervision and be consistent with the program to achieve the highest effects of the treatment.
Advanced Physiotherapy- Manual therapy, Myofascial Release, Dry Needling, IASTM (Instrument-Assisted Soft Tissue Mobilization),Strengthening exercises etc.
Surgery: If the above mentioned (Medication and/or Physiotherapy) treatment options did not improve the symptoms, doctor may advise surgical treatment. Currently, with the help of cutting-edge technology that results in highest level of accuracy, surgery becomes less alarming than many would think.
Endoscopic surgery: a minimally invasive surgery using a microscope which results in a small wound and causes less damage to surrounding muscles. It also causes less blood loss, fewer complications and shorter recovery period.
Intraoperative Neuromonitoring: a technology that helps enhancing the safety of the patient during operation by continuously monitoring the central nervous system with Real Time program. Intraoperative Neuromonitoring, therefore decreases the risk of nerve injury during a critical surgical procedure.

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