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What is a Herniated Disc?
A herniated disc is a condition that occurs as a result of wear, tear or slipping of the discs between the vertebrae that form the lumbar spine, putting pressure on the spinal cord and nerves. If the five vertebrae that make up the lumbar spine wear, tear or slip, the intervertebral discs can put pressure on the spinal cord and the nerves radiating from there, causing a herniated disc.
What are the Causes of Lumbar Herniation?
Over time and with age, the fluid content in the intervertebral discs decreases, which reduces the ability of the intervertebral discs to withstand heavy loads. Traumas such as heavy lifting, sudden and uncontrolled waist movements, standing for a long time, falling, and impact increase the risk of herniated disc. These traumas can cause the intervertebral disc to rupture. Although herniated disc is most common in middle-aged and elderly people, it is not uncommon in young people and even children. The risk of a herniated disc, which affects both men and women equally, increases with rapid weight gain during pregnancy. Being overweight is also an important risk factor. Smoking can cause undernourishment of the discs, which can lead to dehydration and the risk of disc herniation. Long-term smoking can also prolong the healing process.
Other factors that increase the risk of a herniated disc include sitting at a desk for a long time, driving for a long time, a sedentary lifestyle, movements and activities that put excessive strain on the spine, and inappropriate exercise. As the muscles around the spine, core and abdominal muscles weaken, the pressure on the discs increases and the discs become vulnerable to herniation.
What are the symptoms of a herniated disc?
Although the symptoms of a herniated disc vary depending on the severity of the disease and its cause, general symptoms can be listed as follows:
- Pain: The most obvious symptom of a hernia is pain that radiates from the lower back to the leg (called radiation) and is usually felt on one side. The pain may be sharp, stabbing or numbing in nature. Activities such as coughing, sneezing, or straining may aggravate the pain.
- Numbness and Tingling: When the hernia puts pressure on the nerves in the legs, numbness and tingling sensations may occur. These symptoms are usually felt on the side where the pain occurs.
- Difficulty Walking: Nerve pressure can make walking difficult and cause a feeling of weakness in the legs. In some cases, the patient may experience limping or loss of balance.
- Difficulty Lifting the Foot: Patients may have difficulty lifting their leg straight up. This condition is evaluated with a clinical test called the Lasegue test.
- Muscle Weakness: Nerve pressure can cause weakness in the muscles in the affected leg. This condition may make the patient have difficulty in simple activities such as climbing stairs or walking on tiptoe.
- Bovic Dysfunction: In some rare cases, a hernia can put pressure on the nerves affecting the bladder or intestines, causing urinary or bowel control problems.
How to Diagnose Lumbar Herniation?
As MSM Clinic, we address the treatment of herniated disc in a holistic and detailed manner. The steps we follow in making the diagnosis are as follows:
- Medical History:
- Our doctor will ask when your pain started, how severe it is, when it got worse, and what triggered it.
- He or she will also ask if you have had back pain, injury, or surgery in the past.
- It will ask about your profession and daily activities.
- Physical Examination:
- Our doctor will check the range of motion and sensitivity of your waist.
- It will test the muscle strength and reflexes in your legs.
- Will check for numbness or tingling.
- Imaging Tests:
- X-ray: Our doctor may order an x-ray to get a general view of your spine.
- CT (Computed Tomography): A CT scan can provide a more detailed image of your spine and nerves.
- MRI (Magnetic Resonance Imaging): MRI can provide the most detailed image of your disc, bones, and nerves.
- Neurological Tests:
- Neurological tests: Our doctor may perform neurological tests to evaluate how much your nerves are affected. These tests may include:
- Electromyography (EMG): This test is used to evaluate how well your muscles are working.
- Neuroconductivity studies: These tests are used to evaluate how well your nerves are transmitting signals.
Using all this information, MSM Clinic will determine whether there is a hernia and, if so, what type of hernia it is.
What are the Treatment Methods for Herniated Disc?
Disc herniation treatment is adapted to each patient’s unique situation and the patient is informed in detail. Commonly used treatment methods for herniated disc are listed below:
- Rest:
- Initially, rest is the primary step in treating a herniated disc.
- It has been discovered that prolonged rest can be harmful.
- Typically, rest time and movement restriction are limited.
- In very painful cases, short-term bed rest may be necessary.
- Your doctor evaluates whether you can return to work.
- Drug Treatment:
- Painkillers and muscle relaxants are used.
- In some cases, steroid treatment may also be applied.
- Support:
- If necessary, a waist corset or bandage can be used.
- Physical Therapy:
- Methods such as heat therapy, ultrasound, laser therapy, electrical treatments, massage, mobilization, manual therapy, dry needling, taping and traction are used.
- Exercise practices are very important and should be started early.
- Stretching, posture exercises and other exercises that do not aggravate the pain are performed.
- Exercises aimed at increasing endurance and strength are started gradually.
- Surgical Interventions and Injections
- In suitable patients, injections are made around the spine and into the canal.
- If there are serious symptoms such as progressive loss of strength or incontinence, surgical intervention may be required.
Most patients can be treated without the need for surgery and can live their daily lives comfortably without pain.
