The spinal discs are located between the vertebra or bony segments of the spine and play an essential role in providing flexibility and shock absorption to the spine. Occasionally, due to injury or deterioration, these discs can develop a tear in the outer fibrous layer allowing the inner jelly-like nucleus pulposus to extrude out beyond its natural borders.
A disc extrusion can occur due to various reasons such as trauma, excessive forces placed on the discs (which can happen in whiplash or auto accident-related injuries), age-related wear and tear, and degenerative disorders of the disc.
The most commonly affected regions of the spine are the lumbar (lower back) and cervical (neck) regions, as they are the most flexible areas of the spine hence more prone to injury and degeneration. Surrounding nerves can also receive pressure due to the unevenness caused by the disc extrusion.
One of the primary symptoms of disc extrusion is pain in the neck or lower back. However, it is common for a disc extrusion also to have associated:
- Tingling down buttocks, leg(s), shoulder or arm(s)
- Weakness in one or both arms or legs
- Headaches (in a neck-related disc extrusion)
The above symptoms can present with a disc extrusion because it can put pressure on the surrounding nerves and trigger inflammation in the same area creating discomfort and pain.
How is Disc Extrusion Diagnosed?
Medical imaging tests are the most accurate method of diagnosing a disc extrusion. An MRI is the most precise way to diagnose a disc extrusion.
Another common finding that you may have developed a disc extrusion is that the pain starts in the neck or back and then develops into a pain in the arm or legs. The reason for this is while the disc is breaking down over time, there are nerves in the disc that are pain sensitive that cause back or neck pain. Once the disc ruptures and the inner part leaks out, the pain then transmits to the arm or legs from inflammation and nerve pressure caused by the extruded disc material.
The treatment for disc extrusion varies depending on the severity of the condition. Initially, the treatment focuses on reducing the inflammation surrounding the injury. This includes using ice packs for the first 24 to 72 hours, taking anti-inflammatory medications, and avoiding too much physical activity. This can allow swelling and pressure on the spinal nerves to calm down. Physical therapy, gentle manual therapy or massage, gentle chiropractic treatment, and spinal injections for pain and inflammation may also help in the recovery process.
If conservative treatment fails to relieve the symptoms, or there is a weakness that is not improving, surgery may be required. The surgery can commonly be performed as an outpatient procedure via a minimally invasive approach. The surgery aims to remove the extruded portion of the disc to relieve pressure on the nerves and alleviate symptoms.
In conclusion, disc extrusion is a common spinal condition that can cause significant discomfort and pain, as well as numbness and weakness. Seeking medical attention for a proper workup when suspected can be crucial to prevent further damage. It is important to note that in some cases, a disc extrusion can reduce in size and symptoms may subside over time without surgery. To get through the initial acute phase, effective treatment options can include reducing inflammation with ice packs and medication, a short course of rest, physical therapy, gentle massage, chiropractic treatment, and pain injections. If your symptoms persist, make an appointment with your physician as soon as possible to discuss additional options.