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February 10, 2012

Herniated Disc (cont.)

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How is a herniated disc treated?

Occasionally, disc herniation is incidentally detected when a test such as an MRI is performed for other reasons. If no symptoms are present, no particular treatment is necessary.

Depending on the severity of symptoms, treatments for a herniated disc include physical therapy, muscle relaxant medications, pain medications, antiinflammation medications, local injection of cortisone (epidural injections), and surgical operations. In any case, all people with a disc herniation should rest and avoid reinjuring the disc. Sometimes, even people with relatively severe pain early on can respond to conservative measures without the need for surgical intervention.

There are now a variety of surgical approaches to treat disc herniation. Each type of operation is customized to the individual situation and depends a great deal on the condition of the spine around the disc affected. Surgical options include microdiscectomy using small surgical instruments and open surgical repair (either from a posterior or anterior approach). Urgent operation can be necessary when cauda equine syndrome is present (described above).

Herniated Disc At-A-Glance
  • The discs are pads that serve as "cushions" between the vertebral bodies, which minimize the impact of movement on the spinal column.
  • Each disc is designed like a jelly donut with a central softer component (nucleus pulposus).
  • Abnormal rupture of the central portion of the disc is referred to as a disc herniation.
  • The most common location for a herniated disc to occur is in the disc at the level between the fourth and fifth lumbar vertebrae in the low back.
  • If the disc herniation is large enough, the disc tissue can press on the adjacent spinal nerves that exit the spine at the level of the disc herniation.
  • The physical examination, imaging tests, and electrical tests can aid in the diagnosis of a herniated disc.
  • Depending on the severity of symptoms, treatments for a herniated disc include physical therapy, muscle relaxant medications, pain medication, antiinflammation medications, local injection of cortisone (epidural injections), and surgical operations.

Last Editorial Review: 5/12/2008


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