What is An Inter-vertebral Disc?
Our spinal cord is enclosed by multiple vertebrae. These vertebrae are linked to each other by intervertebral discs. These discs are made up of an outer fibrous ring (annulus fibrosus) and a soft central portion (nucleus pulposus).
Functions of Inter-vertebral Discs
- They work as shock absorbers and help in distributing body weight across the whole spine.
- They are responsible for maintaining the shape of the body.
- They provide a certain amount of flexibility to carry out movements like bending and twisting.
Inter-vertebral discs are prone to wear and tear. As the disc degenerates, it is unable to carry out its normal functioning. Patients observe signs and symptoms in correlation with the location and degree of disc degenerated and herniation.
What is Disc Herniation?
Spinal disc herniation is a medical condition in which a tear in the outer fibrous ring of the intervertebral disc causes the inner nucleus pulposus to bulge out.
When the inner portion of intervertebral disc bulges out, it can come in contact with the nerves of the spinal cord and also tends to compress them. An inflammatory reaction takes place in this situation which results in severe pain in absence of disc compression.
Disc Herniation can occur at any Level of The Spine. It can be Classified into The Following Types
- Disc degeneration – loss of fluid in nucleus pulposus
- Disc protrusion – bulging of a disc without complete rupture
- Prolapsed disc – inner soft portion is forced into the outer fibrous ring but complete rupture does not occur
- Extrusion of the disc – a small hole in outer fibrous ring causes fluid to move into the epidural space (outermost part of the spinal canal)
- Sequestration of the disc – fragments of disc move out of the disc area
Causes for Disc Herniation
- Repeated mechanical activities such as frequent twisting, bending and stretching
- Lack of physical activity or people living a sedentary lifestyle
- Trauma or injury to the disc
- Obesity and overweight
- Improper posture
- Cigarette smoking and tobacco abuse in other forms
Symptoms of Disc Herniation
Signs and Symptoms of Disc Herniation Correlate with The Location and Degree of Disc Herniation
- Pain may be variable ranging from no pain to pain or moderate or severe intensity.
- In an early stage of disease, a patient comes with unexplained pain of thighs, back or knees. Therefore, disc herniation is often diagnosed late.
- Tingling, numbness or weakness may be present
- Pain due to disc herniation is relatively continuous in a specific position.
- Restricted movements may occur
Can A Herniated Disc Heal by Itself?
When patients suffering from back pain and are diagnosed with this condition, they often wonder if a herniated disc can heal on its own without surgery.
The question that can a herniated disc heals on its own largely depends upon the stage at which the condition is diagnosed and the kind of treatment approach used.
Disc herniation does not necessarily require painkillers and surgery. Since a herniated disc can occur due to a number of causes or even a combination of the above-mentioned causes, an ideal approach towards it also needs to be multi-dimensional.
On the first visit to the doctor, you will be required to give a detailed history regarding the onset, duration, and progress of your signs and symptoms. Presence of illnesses such as diabetes, autoimmune diseases, and cancers need to be informed to your doctor while evaluating for disc herniation.
Your doctor may run a set of blood tests or advise an x-ray and MRI or CT scans to diagnose your condition and to understand the degree of disc herniation.
If your tests reveal a herniated disc but no significant neurological troubles like weakness and loss of bladder or bowel control, your doctor may suggest you a combination of therapies to treat your complaints without the need for surgery.
Approaches To Manage Symptoms of A Herniated Disc
The Following Approaches may be Suggested to Manage Symptoms of A Herniated Disc
- Pain medications such as non-steroidal anti-inflammatory drugs (NSAIDs)
- Patient education regarding his/ her condition
- Physical therapy to correct mechanical factors such as electrical stimulation, traction, massage therapy, etc.
- Analgesia-associated traction therapy
- Measures for back support
- Cessation of tobacco use and cigarette smoking
- Weight control for overweight or obese individuals
- Behavioral and postural therapy
- In severe cases of disc herniation, use of corticosteroids and epidural analgesics may be used
If the above-mentioned therapies work beneficially, they can be continued for as long as required. Usually, signs and symptoms of the herniated disc without neurological involvement can heal on its own over a period of time along with appropriate self-care measures.
A herniated disc cannot heal on its own if it has ruptured or if sequestration has occurred. In these cases, the affected intervertebral disc can greatly hamper your spine health and needs to be repaired surgically.
The recovery time for an uncomplicated herniated disc with an appropriate treatment plan can be expected to be up to 8 weeks without surgery. Back pain or discomfort for longer duration must be reported to your doctor for evaluation.
You may require surgical management if you notice one or more of the red flag symptoms mentioned below:
- Persistent pain and discomfort.
- Worsening of pain and other symptoms
- Complaints associated with fever and flu-like symptoms or rash
- Inability to control urine and feces
- A sensation of numbness in the genital region
- Numbness and loss of function of arms or legs
How to Heal A Herniated Disc?
A herniated disc can be managed with certain self-help methods and home remedies:
- Adequate Rest – This helps to ease muscle spasm and prevents worsening o signs and symptoms. Prolonged bed rest is however prohibited as it can cause stiffness due to lack of exercise.
- Apply heat – Heat application using a hot compress or a hot water bag can be used periodically to relieve pain and muscular spasm. Alternate heat and ice therapy help in improving circulation and reducing inflammation.
- Pain Medications – Over-the-counter medicines can be taken for pain and discomfort. Consult your doctor regarding a suitable dose for these medications.
- Manual Manipulation – Speak to your physician or chiropractor regarding this therapy. This method provides relief from pain by shifting pressure away from a particularly affected nerve.
- Other Therapies- Such as yoga acupuncture and massage can be used to improve circulation at the affected part and reduce discomfort. These therapies also help to provide strength to the spine.
- Reduce Weight – Overweight and obese individuals have trouble managing pain and discomfort. Consider reducing weight by means of following a regular exercise and healthy diet regime.
- Avoid Sedentary Lifestyle – Increase daily physical activity, eat a healthy balanced diet of fresh fruits and vegetables and quit alcohol and cigarette smoking.
Dr. Himanshi is a Homoeopathic consultant and currently working as a lecturer in Post-graduate faculty of Homeopathy, Parul University, Vadodara. Completed BHMS and MD in Homeopathy in January 2018 and also has a clinical experience of about 6 years. Personal interests include reading, spending time with family and traveling.