Herniated Disc

A disc between the spinal vertebrae that has become ruptured. These discs serve as cushions between the vertebrae, the bones that make up the spine. A ruptured or herniated disc occurs when the soft tissue inside the disc protrudes through a tear in its tough exterior. This may irritate surrounding nerves, causing pain, numbness, or weakness in an arm or leg, but some people have no symptoms. Most herniated discs can be treated conservatively — with physical therapy and medication — and do not require surgery.

Physical therapists can demonstrate positions and exercises to minimize pain and can offer such treatments as heat or ice, traction, ultrasound, electrical stimulation, and temporary braces. Over-the- counter pain medications such as ibuprofen or naproxen can be used to treat mild-to-moderate pain. A doctor may prescribe muscle relaxants and tricyclic antidepressants to help alleviate pain. Corticosteroids are sometimes injected directly into the area around spinal nerves. If other measures fail to adequately control pain, narcotics such as codeine or a combination of oxycodone and acetaminophen may be used for a short time.

If conservative treatment does not improve symptoms within four to six weeks, or if there is numbness or weakness, difficulty standing or walking, or loss of bowel or bladder control, surgery may be needed. Usually, surgeons can remove just the protruding part of the disc but, in rare instances, the entire disc may be removed, and sometimes the vertebrae are then fused together to stabilize the spine.

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