Disk herniation describes the sudden onset of pain as a result of a problem with an intervertebral disk in the spine. Disk herniation is characterized by the sudden onset of pain that can be severe. Disk herniation can cause pain in the back or neck, numbness, tingling, weakness in arms or legs, muscle spasm, and muscle weakness.
The spine consists of bones (vertebrae) stacked upon one another. Each vertebra is connected to the other by an intervertebral disk. The intervertebral disks help increase the spine's flexibility and function as shock absorbers. Each intervertebral disk has a tough outer fibrous layer surrounding a jelly-like inner layer.
A disk herniation, or slipped disk, can describe a tear of the outer fibrous layer of the intervertebral disk with or without protrusion of some of the inner gelatinous layer. In a disk herniation, a tear of the outer fibrous layer can cause significant pain, usually localized to the neck or back, depending on which disk is involved. Suppose there is also a bulging of the inner gelatinous layer that irritates or compresses one of the nerves around the spine. This can result in significant pain, numbness, weakness, or tingling that extends into a limb. This is most often seen in the legs and is commonly called sciatica.
Disk herniation can occur following a specific injury or episode of heavy lifting. However, disk herniation occurs more commonly due to age-related wear and tear. As we age, our intervertebral disks become stiffer and are more at risk of rupturing.
In most instances, the pain from a disk herniation gets better on its own and does not require any treatment. More than 9 out of 10 people with a disk herniation will improve within six weeks.
Occasionally, if a disk herniation is very large or in certain locations, it can cause compression of the spinal cord or certain important nerves. In these rare instances, more urgent investigation and treatment may be required.
If you develop severe neck or back pain following an injury, you should seek urgent medical attention. If your symptoms have any of the following associated features, you should seek urgent medical attention;
If you do not have any of the above features, you should see your doctor if your symptoms have failed to improve after six weeks or if they are associated with swelling, pain worse at night, or recent unintentional weight loss.
The doctor will ask you about your symptoms and examine you. Without any concerning features, you may be given advice regarding exercises to help relieve your symptoms in addition to simple pain medications. Depending upon the local services available, you may be referred to a physiotherapist. On occasion, depending upon your symptoms and your examination, you may be sent for further investigations, which can include blood tests, X-Ray, or MRI scans. If you have any concerning symptoms or features on examination, your doctor may send you to the hospital for further investigation and treatment.
A disk herniation gets better in 9 out of 10 people without requiring treatment. You may be referred to a spinal surgeon if your symptoms do not improve. Further treatments for disk herniation include injections to relieve your pain or surgery to remove the prolapsed disk.
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