Disc Herniation
There are small and spongy discs that act as the cushions between the vertebrae in your spine. These discs also serve as shock absorbers for the spine and help to keep the spine flexible. We are able to flex, bend and assert force thanks to these discs. However, these discs may become damaged by bulging or breaking open, which causes a common spine condition known as a herniated disc. A herniated disc (or disc herniation) can occur in any part of the spine, but they are most common in the lower back (lumbar) areas of the spine.
The seven vertebrae between the head and chest (i.e., C-1 through C7) make up the cervical spine. However, there is no disc in C1-C2. A cervical herniated disc is commonly found in the C5-7 areas of the spine. The rest of the vertebrae (T1-T12 and L1-S1) represent the thoracic spine and lumbar spine. The most common thoracic spine disc herniations are found in the T8-T12 areas. As for the lumbar area, the L4-L5 or L5-S1 levels are the most common areas for disc herniation.
Causes
A herniated disc may occur as a result of normal wear and tear as you age when the spinal discs lose some of their water content, making them less flexible and more prone to tearing or rupturing. This occurrence is commonly found in individuals within the age range of 35 to 55.
Another cause of herniated disc may originate from trauma or injury to the spine that may cause tears or cracks in the outer layer of the disc. This forces out the gel inside the disc through the tears or cracks, and causes the disc to bulge or break.
There are many more common causes associated with herniated disc including weight (excessive body weight places extra stress on the discs), and occupation (demanding jobs with repetitive lifting, pulling, pushing, or bending).
Symptoms of a Disc Herniation in the Cervical Spine
A herniated disc in the cervical spine will usually cause pain in spinal movement. Other symptoms of a herniated disc includes limited range of motion, discomfort, pain when turning or bending the neck along with difficulty when using arms or hands. However, there are also neurological problems associated with certain areas of the spine, as follows:
- C4 – C5 (C5 nerve root) – Can cause weakness in the upper arm (more specifically, the deltoid muscle area). This area may cause shoulder pain.
- C5 – C6 (C6 nerve root) – Can cause weakness in the bicep area (the muscles in the front of the upper arms) and wrist extensor muscles. Patients may also experience tingling and numbness, along with radiating pain to the thumb side of the hand.
- C6 – C7 (C7 nerve root) – Can cause weakness in the back of the upper arm and forearm area (triceps) along with the finger extensor muscles. Patients may also experience tingling and numbness, along with radiating pain from the triceps and into the middle finger.
- C7 – T1 (C8 nerve root) – Can cause weakness when gripping with the hand. Patients may also experience tingling and numbness, along with radiating pain down the arms to the little finger side of the hand.
Symptoms of a Disc Herniation in the Thoracic and Lumbar Spine
Similar to the symptoms affecting the cervical spine, a disc herniation in the lumbar spine will cause pain during spinal movement. Patients may also experience upper back pain, chest pain, leg pain, numbness, weakness, and/or tingling in the legs, along with buttock pain. A loss of bowel or bladder control may be an indication of a serious condition and will require immediate care. The vast majority of herniated discs in the Lumbar Spine occur on the L4-L5 and L5-S1 levels of the spine. Below is a list of neurological symptoms within these areas:
- L4 – L5 (L5 nerve root): Can cause weakness when elevating the big toe and ankle. Patients may also experience pain and numbness on the top of the foot, and also feel radiating pain into the buttock area.
- L5 – S1 (S1 nerve root): Can cause weakness and loss of reflex in the ankle. Numbness and pain on the sole of the foot may also occur.
Treatment
Treatment of a disc herniation varies depending on the location and severity of the condition. Over-the-counter pain medications may help to relieve mild to moderate symptoms. However, if your pain persists, the doctor may prescribe narcotics, nerve pain medications, muscle relaxers, or cortisone injections. Physical therapy can also help to minimize the pain of a herniated disc as well as to help to improve the core strength and flexibility in your back. An epidural injection may also be recommended.
In severe cases, patients may necessitate surgical intervention, especially if the herniated disc has failed to improve after six weeks of conservative treatment. Surgical intervention may also be needed when a disc fragment lodges in your spinal canal leading to progressive weakness, or the pain significantly interferes with your activities of daily living. Surgeries such as an anterior cervical discectomy and fusion or disc replacement will therefore be recommended.
Healthpointe has top-of-the-line physicians and spine specialists who are trained to provide treatment for neck and back pain, and the associated symptoms. Come to Healthpointe!
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