The vertebrae of the spine protect the spinal cord and give supportive structure to the back. A disc is found between each of the vertebrae, which provides cushioning and protection. Injury and degeneration can damage these discs, resulting in a variety of spinal problems.
A bulging disc occurs when the disc extends beyond the space it should occupy. This condition is common among adults and is often considered to be a natural part of the aging process. A large portion of the disc is typically involved and the misshapened disc is often discovered during diagnostic testing rather than because of patient symptoms. Bulging discs usually require no treatment other than following good ergonomic practices and avoiding back strain.
Herniated / Ruptured / Slipped Discs
A ruptured disc, also called a herniated disc or a slipped disc, may become painful if it causes pressure on a nerve root or the spinal cord. The disc is referred to as being ruptured because the tough outer lining has ruptured or split, allowing some of the inner disc cartilage to be released. The inner disc cartilage, or nucleus, feels like cooked crab meat or shrimp when squished between your fingers. When this material presses against a nearby nerve root or the spinal cord, pain in the back or pain, numbness, or tingling in the body or limb areas served by the nerve may become evident. The sufferer may notice impaired movement in the affected area. In some cases, such as when no nerve root is severely compressed, no symptoms of a ruptured disc are apparent and the patient may be unaware of it until it is found during diagnostic testing.
Treatment for a ruptured disc is often dependent on whether or not the patient is experiencing symptoms. Chronic pain or interference with the ability to work or care for oneself frequently necessitate treatment, including physical therapy, a short course of pain medication, or muscle relaxants. Often, a brief rest period is ordered, followed by stretching or strengthening exercises. Occasionally, surgery is required when conservative measures fail or symptoms such as loss of bowel or bladder control are present. Some patients are candidates for minimally invasive spinal surgery to relieve severe symptoms. A herniated disc without symptoms requires no treatment other than following good ergonomic practices and avoiding back strain.
The condition known as a “collapsed” disc occurs when a disc between two vertebrae loses height in its outer, tough layer. The disc doesn’t actually collapse, but the compression due to height loss can affect the spinal nerves or spinal cord. This condition is frequently the result of the aging process, as the disc dries out and reduces in size over the years. Other degenerative conditions may also cause this spine problem. When the disc becomes compressed, there is less room for the nerves and spinal cord. Also, less cushioning can cause the vertebrae to grind against each other, irritating the nerve.
A patient may have no symptoms of a collapsed disc, but if the spinal cord or a nerve root is involved, pain, weakness, numbness or tingling may be noticeable in the area served by the nerve. Treatment typically consists of rest, physical therapy, special exercises, pain medication, or injections into the epidural space. Some patients are candidates for minimally invasive spinal surgery to relieve severe symptoms.
Bone spurs, sometimes called ostephytes, are bony growths that develop over time. As a spinal disc or joint wears down, the ligaments around it become loose. Eventually, the ligaments toughen and these bony growths may appear. Many bone spurs fail to produce symptoms or cause damage; they are often considered a natural part of aging although they sometimes have another cause. If they press upon a nerve or the spinal cord, however, discomfort may become apparent. Bone spurs can cause pain upon standing and walking. If the spur is in the neck region, pain may radiate into the shoulders or the sufferer may experience a headache. Spurs in the lower back may cause pain that radiates into the legs. If a nerve becomes increasingly compressed by a bone spur, weakness, tingling, and numbness of the affected limbs may develop. Treatments may include a brief initial rest period, muscle relaxants, anti-inflammatory medication, epidural injections, physical therapy, and exercise. When a bone spur severely compresses a nerve or the spinal cord, surgery may be required. Some patients are candidates for minimally invasive spinal surgery to relieve severe symptoms.
Degenerative spine conditions are defined as those that cause a gradual loss of function and healthy spine structure over time. While often considered a normal part of the aging process, they may also be due to arthritis, infection, tumor or other condition. Degenerative conditions may be painful and they may cause nerve irritation or impingement. Symptoms include chronic pain, occasional sharp pains, limited range of motion, and physical deformity. Degenerative spine conditions with nerve involvement may cause weakness or numbness of a limb. Occasionally, sufferers will experience bladder, bowel, or sexual dysfunction as the result of a degenerative spine condition compressing a nerve. Degenerative spine conditions are usually found on an x-ray, CT scan, or MRI. Typical treatments include a short period of rest, physical therapy, medication, exercise, or temporary bracing. Surgery is sometimes needed to relieve unrelenting pain or restore function. Some patients are candidates for minimally invasive spinal surgery to relieve severe symptoms.
Vertebral compression fractures occur when one or more vertebra in the spine break, often in the lower back. The most common cause is osteoporosis, but a car accident, fall, or other condition can also be at fault. Common symptoms include pain in the back or neck that may also be felt in the hip, leg, or abdomen. Pain may come on suddenly or develop over time. Weakness, tingling, or numbness may be experienced if the fracture leads to nerve compression. In some cases, the sufferer may experience bowel or bladder dysfunction. A person with vertebral compression fractures due to osteoporosis may experience height loss or have a stooped-over appearance. Diagnosis is usually made by x-ray, CT scan, or MRI. Many fractures heal on their own. Typical treatments consist of pain medication, muscle relaxants, rest, carefully directed exercises, or a back brace. Patients with osteoporosis or osteopenia are encouraged to ensure adequate intake of calcium and vitamin D, and patients with osteoporosis may have other medication recommended. A procedure called kyphoplasty may be recommended. This involves the insertion of a small catheter into the partially collapsed vertebral bone, and then restoring the height of the collapse bone by inflating with fluid a special balloon inserted through the catheter. After removal of the balloon, the opened space is then filled with bone cement. In rare cases, a larger surgery may be indicated to stabilize the spine or reduce pressure upon the spinal cord.