Herniated discA herniated disc can go unnoticed, but it can also lead to severe discomfort. The pain usually subsides within 6 weeks. Learn more about causes here. Treatment of the disease.
At a glance
– Severe pain that moves down the leg and into the feet may be the first sign of a herniated disc. – A herniated disc can also cause numbness or tingling sensations. – Mostly the complaints disappear by themselves after a few weeks. – Until the pain subsides, it should be treated in order to remain active.
What is a herniated disc?
Almost everyone knows back pain. Its cause can rarely be determined precisely. However, if the pain radiates down the leg into the foot, a herniated disc may be the cause. The pain subsides in most people within 6 weeks.
The intervertebral discs consist of a gel-like core (gelatinous core) surrounded by an elastic sheath of cartilage fiber. They sit between the vertebral bodies of the back vertebrae.
A herniated disc is said to occur when disc tie protrudes between the vertebrae. This tie can irritate adjacent nerves in the spine and cause severe discomfort. However, a herniated disc can also be painless.
What can cause back pain??
The following video shows possible causes, triggers and symptoms of non-specific and specific low back pain.
What are the symptoms of a herniated disc??
A sudden onset of pain or severe pain in the lower back are common symptoms of a herniated disc. Other typical signs are pain that radiates down one leg to the foot and is referred to as sciatica (colloquially "sciatica"). They are usually caused by herniated discs in the area of the lumbar spine.
In the case of a herniated disc in the cervical spine, the pain can also be felt in the arms.
Sensory disturbances in the buttock area or signs of paralysis indicate a serious problem such as nerve damage. However, this rarely occurs.
Important to know: Studies show that herniated discs do not always cause discomfort. In the studies, symptom-free adults were examined using magnetic resonance imaging. More than half of those examined showed a bulging disc. In about 20 percent of those studied, more severe damage to the disc was already visible or even leaked tie. Nevertheless, none of them had pain.
How does a herniated disc occur?
The intervertebral discs act as buffers between the individual vertebrae, absorbing shocks and cushioning loads on the spine. When this function is impaired, a herniated disc can occur. Pain in this case probably occurs because disc tie presses on nerves in the area of the spinal cord.
Most often, herniated discs occur due to wear and tear. These are part of the normal aging process – but can manifest themselves differently in different individuals. The elasticity of the intervertebral discs decreases the older you get. You lose fluid. Can develop cracks. Very rarely, an accident or serious injury can also lead to a herniated disc.
What is a herniated disc?
In the following video you will learn more about the causes, symptoms and treatment options of a herniated disc.
Especially the typical sciatic pain is known to many people. They occur when disc tie presses on a nerve root in the area of the lumbar spine. This is where the sciatic nerve runs, into which the spinal nerves of the spinal canal flow. The sciatic nerve supplies the legs. If it is irritated, this becomes noticeable through pain, sometimes also through tingling and feelings of numbness.
Experts distinguish between the following degrees of severity:
– Protrusion of the intervertebral disc (protrusion): In this case, the intervertebral disc protrudes in a bulge between the vertebrae. The outermost shell is still intact. – Extrusion: Here the outer shell of the intervertebral disc shows cracks. Disc tie can leak out, but is still attached to the disc. Sequestered herniated disc (sequester): the disc tie has leaked into the spinal canal. No longer has a direct connection to the intervertebral disc.
Important to know: The definition of severity says little about the nature and severity of the discomfort. The type of herniated disc can be decisive for its progression. The choice of treatment, however, plays an important role.
How often does a herniated disc occur??
About one to 5 percent of all people experience back pain during their lifetime that is due to a herniated disc. Mostly affects people over 30 years of age – men about twice as often as women.
How long does a herniated disc last? In some people, the pain occurs suddenly. Disappear similarly suddenly by itself again. Some suffer pain over a long period of time, others have repeated attacks of pain. A herniated disc can therefore take a variety of different courses.
In about 90 percent of those affected, symptoms subside on their own within 6 weeks. Presumably, the body eliminates some of the leaked tie or it shifts so that the nerves are no longer irritated. If the pain is still present after 6 weeks, it should not be expected to go away on its own.
How a herniated disc is diagnosed?
In most cases, doctors can make a diagnosis after an interview and a physical examination.
With back pain, there is little good reason for other elaborate investigations. For example, radiographs are unlikely to be suitable because they often show disc damage even in people without symptoms. Imaging studies, then, may show a putative cause of low back pain that is not actually causing the discomfort. Such a misdiagnosis can in turn lead to treatments that, in the worst case, may even cause harm.
Examinations with other imaging methods such as magnetic resonance imaging are only indicated in the following rare cases:
– if there are signs of paralysis in one or both legs – if there is a disorder of the bladder or bowel function – if the pain is hardly bearable despite treatment or lasts for weeks – if there is a suspicion that the pain is caused by another disease, such as a tumor
How is a herniated disc treated?
The focus is on pain-relieving treatment of the symptoms so that one can remain as active as possible. Recovery cannot be accelerated by pain therapy, but it can be accelerated by surgery. However, even severe sciatica usually resolves gradually on its own. Surgery is rarely necessary.
Important to knowIf the nerves are so badly affected that bowel or bladder function is disturbed or paralysis occurs, surgery is necessary. In addition, surgery is sometimes performed to relieve the affected nerve: for example, if sciatic pain from a herniated disc persists for more than 6 weeks.
For more in-depth information on the topic, such as when a ligament-writing operation is advisable, see gesundheitsinformation.en.
Which rehabilitation measures may be useful?
Rehabilitation is an option for people who are unable to work because of their back pain or who are severely restricted in their daily life. Rehabilitation programs include psychological support as well as specific movement exercises such as back training, strength training, stretching, and relaxation exercises. The exercises are designed to reduce discomfort and impairment, strengthen the trunk muscles and stabilize the spine.
References
– German Medical Association (BaK), National Association of Statutory Health Insurance Physicians (KBV), Association of the Scientific Medical Societies (AWMF). Non-specific low back pain (PDF). National health care guideline, long version. AWMF register number nvl-007. 03.2017. Accessed on 29.04.2020. German Society for Orthopedics. Orthopedic Surgery (DGOOC). Guideline on conservative and rehabilitative care for herniated discs with radicular symptoms (PDF). S2k guideline. AWMF register number 033-048. 07.2014. Retrieved 29.04.2020. – Jordan J, Konstantinou K, O'Dowd J. Herniated lumbar disc. BMJ Clin Evid 2011; pii: 1118. Retrieved 29.04.2020. – Lewis R, Williams N, Matar HE, Din N, Fitzsimmons D, Phillips C et al. The clinical effectiveness and cost-effectiveness of management strategies for sciatica: systematic review and economic model. Health Technol Assess 2011; 15(39): 1-578. Retrieved 29.04.2020. – Oosterhuis T, Costa LO, Maher CG, de Vet HC, van Tulder MW, Ostelo RW. Rehabilitation after lumbar disc surgery. Cochrane Database Syst Reviews 2014; (3): CD003007. Called on 29.04.2020. – Pinto RZ, Maher CG, Ferreira ML, Ferreira PH, Hancock M, Oliveira VC et al. Drugs for relief of pain in patients with sciatica: systematic review and meta-analysis. BMJ 2012; 344: e497.