What Is A Prolapsed Disc?
Prolapsed disc explained by San Antonio, Austin, Houston, Dallas Texas top pain doctors
The spinal column is made up of many bones called vertebrae. In between every vertebra is a spongy intervertebral disc. The intervertebral discs contain the nucleus pulposus (inner layer) and the annulus fibrosis (outer layer). The nucleus pulposus is soft and jelly-like, and the annulus fibrosis is strong and fibrous. The role of the annulus fibrosis is to protect the nucleus pulposus from bulging out. However, when there are weaknesses in the outer layer, the nucleus pulposus can bulge out toward the spinal nerves, resulting in a prolapsed disc.
Other names for prolapsed discs include herniated discs, ruptured discs, or slipped discs. When the disc bulges out, it places pressure on other structures within the spinal column, oftentimes compressing the spinal nerve(s) in the affected region.
Prolapsed discs can occur in any spinal region; however, most disc prolapses occur in the lumbar spine. The size of the bulge can vary; typically, individuals who have larger disc prolapses experience more severe pain.
The pain that individuals experience with prolapsed discs is thought to be the result of compression of nerves and by inflammation of the surrounding area. Symptoms of prolapsed discs vary widely among patients. Some patients report a dull diffuse ache, while others experience a sharp, localized type of pain. Most patients report severe pain that comes on suddenly. Pain is usually relieved when lying flat and aggravated with coughing, sneezing, and leaning backward. Additional symptoms of prolapsed discs can include a numbness or tingling sensation, or radiating pain into an extremity.
Research has shown that some individuals have no symptoms even when a prolapsed disc is found on imaging. It is believed that these prolapses may be small or may occur away from spinal nerves and therefore cause no irritation or discomfort.
Causes Of Prolapsed Discs
It is unclear why some individuals develop prolapsed discs while others do not. It is thought that certain individuals may have congenital weaknesses of the annulus fibrosis of the intervertebral disc and are therefore more susceptible to injury. Moreover, some researchers believe that these intervertebral weaknesses can occur over time with normal aging.
Other factors have been associated with an increased risk of suffering a prolapsed disc, including:
- Heavy, awkward lifting
- Improper body mechanics when bending, lifting, or sitting
- Weight-bearing sports (i.e. weight lifting)
- Increasing age
Treatments For Prolapsed Discs
There are a variety of treatment options available for individuals suffering from a prolapsed disc. For patients experiencing mild pain, at home treatment options, including rest (initially), ice, and specific stretching as well as strengthening exercises, are recommended. Additionally, over-the-counter pain relievers and anti-inflammatory medications can be utilized to reduce pain and inflammation of the involved area. Conservative home treatment options will help many patients return to their normal activity levels.
Oral steroids, including prednisone and cortisone, may be suggested to patients who do not respond to conservative home treatments. These steroid medications will help to reduce pain and inflammation at the affected site.
Narcotics, including codeine, may be utilized for patients who do not report relief from over-the-counter medications, as they have shown positive results for the management of acute, severe pain. However, research has suggested that narcotics carry the risk of dependence and misuse. Therefore, caution should be used when prescribing this type of medication and long-term use is contraindicated.
Epidural steroid injections, TENS therapy, and spinal cord stimulation are procedures that are sometimes recommended when patients fail to respond to other treatment options. Epidural steroid injections entail injection of an anesthetic and steroid into the affected area to decrease pain. TENS therapy involves using electrodes on the skin to deliver a low electric current to the painful region. Spinal cord stimulation utilizes an implanted device close to the spinal cord to deliver electric impulses to control the transmission of pain signals from the nerves of the spine.
Biofeedback training can be utilized in combination with other therapies for the management of pain associated with prolapsed discs. Biofeedback training involves teaching patients relaxation and coping mechanisms that help them to control some of their pain symptoms.
Lastly, research has shown that when acupuncture is used in conjunction with other therapies, positive results may be seen in patients suffering with a prolapsed disc.
Prolapsed discs arise because of weaknesses in the outer layer of the intervertebral disc. When the nucleus pulposus of the intervertebral disc protrudes out, it may compress a spinal nerve, resulting in chronic pain. Patients may report that their pain is dull and achy or they may describe a sharp, stabbing type pain. Other symptoms may accompany spinal pain and may include numbness, tingling, and weakness of the affected area. Conservative home treatments should be tried initially before progressing to more aggressive and invasive options. Discussing your symptoms in detail with your physician will help to develop the best treatment plan for your case.
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