What is a Herniated Disc?
A herniated disc, also known as a slipped or ruptured disc, is a damaged intervertebral disc. Intervertebral discs separate each vertebra in the spine and act as a cushion and a shock-absorber.
When damaged, a herniated disc can cause disabling nerve pain, and bone damage.
What causes a Herniated Disc?
Compression of the vertebrae can occur whenever they are pushed together from an outside force, suddenly or over time, such as
- Falling
- Being flung forward or backward by a sudden movement, like a car coming to a sudden stop.
- Degenerative diseases of the spine and intervertebrae.
Is a herniated, or damaged intervertebral disc painful?
The intervertebral disc separates vertebrae and absorbs some of the impact that would otherwise cause vertebrae to “collide” and damage the bone. This can be extremely painful.
The intervertebral discs have a soft gel-like interior: nucleus pulposus, and a tough exterior: annulus.
A herniated disc occurs when pressure from the vertebrae above and below the disc forces some or all of the nucleus pulposus to break through a weakened portion of the annulus.
The herniation may irritate or compress a spinal nerve root or the spinal cord, causing back or leg pain. Herniated discs may develop in any part of the spine, but they most commonly occur in the cervical (neck) and lumbar (lower back) spine.
A herniated disc may develop from a fall or lifting injury. However, the disc damage most often occurs from degenerative changes that happen with age.
What are the symptoms of a herniated disc?
Not everyone with a herniated disc has symptoms. However, if a herniated disc irritates a nerve, these symptoms may occur:
- Dull, achy sensation in the neck or lower back
- Pain that radiates into the extremities
- Muscle weakness
- Poor balance
- Muscle spasms
Sciatica is a collection of nerve-induced pain symptoms that develop from compression or irritation of the sciatic nerve. A herniated disc in the lumbar spine is a common cause of sciatica.
More reading: Mayo Clinic on Herniated Discs.
What happens during a herniated disc IME?
Dr. Singla conducts an in-depth in-person examination of the person alleging herniated disc pain, or who may have an established medical history of pain from a herniated disc.
She asks detailed questions about symptoms, including when they started, the type of pain the individual is experiencing, and how the discomfort affects their daily routine. Dr. Singla performs a physical examination, paying close attention to the spine and the source of pain.
To determine the location and severity of the herniated disc, Dr. Singla requests diagnostic imaging tests such as X-rays or MRIs. In a medical-legal matter imaging may already be available. Dr. Singla considers the timeline of imaging in the records and may request new imaging. Improvement of the condition over time or as a result of treatment, is one of several elements in Dr. Singla’s findings and conclusions.
How is a herniated disc treated?
Non-surgical treatment of herniated discs can provide effective resolution. With the right care plan, most herniated discs resolve with conservative interventions.
Some of the herniated disc treatment options available include:
- Physical therapy
- Activity modification
- Posture therapy
- Bracing
- Anti-inflammatory medication
- Epidural steroid injections
- Nerve blocks
- Radiofrequency ablation
- Regenerative medicine
- Spinal cord stimulation
