A herniated disc is also referred to as a bulging disc, ruptured disc or slipped disc. As the disc deteriorates, the inner core leaks back into the spinal canal. This is the portion of the disc that actually bulges, with the membrane covering of the disc being the part that has ruptured or herniated.
Approximately 90 percent of herniated discs occur in the L4 or L5 lumber region or lower part of the back. Cervical herniated discs, or herniated discs of the upper part of the back, occur 10 percent of the time.
A herniated disc often causes pain in the lower back, buttocks, leg and foot area. It also causes these areas to tingle and become numb. The location of the pain depends on which disc is weak. The amount of pain depends on how severely the disc is pressing on the spinal or sciatic nerve.
Simply growing older is one thing that leads to a herniated disc. The water content of the inner disc dries up or is lost, and this makes it easier for the outer covering to rupture. As the disc is now more grainy than cushiony, it leaks out of the rupture. You should now more than ever take care in how you lift objects and perhaps try not to lift very heavy objects.
Treatments — Mild Cases
The first step in treatment is to see your doctor. Together you can decide what treatment is right for you. Almost certainly, you will need an MRI for him to make a proper diagnosis. If your pain is not too great, he may prescribe pain relieving medication for you. This can include over the counter pain killers, or for more severe pain, a prescription pain killer. He will likely tell you to rest and avoid strenuous activities. He might also recommend stretching exercises, hot or cold therapy, traction or electrical stimulation.
Treatment — Severe Cases, Without Surgery
If the MRI and the amount of pain suffered justify it, your doctor will refer you to a neurosurgeon for treatment. The neurosurgeon might treat you with a nerve block, which will temporarily relieve the pain for a period of weeks to months. This could be long enough for the pain to be reduced naturally to a bearable level.
Treatment — Severe Cases, Endoscopic Surgery
There are two types of surgery: minimal invasive surgery and decompression surgery. In minimal invasive surgery, called endoscopic or endoscopic diskectomy, a small incision is made in your back. This allows the surgeon to use suction or small tools to evacuate the leakage from the disc. A small camera is used for the surgeon to see his work, so that no bone is cut. The wound is closed with a small bandage.
Treatment — Severe Cases — Decompression Surgery
With decompression surgery there are two choices. With a diskectomy, you have a larger incision and part of the disc is removed. The doctor may also remove a small part of the area called the facet joint that might be pressing on the spinal nerve. A microdiskectomy might be performed. This is similar to a standard diskectomy except a smaller incision is made. The surgeon performs the operation while looking through a microscope, removing damaged portions of the disc.