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Ask the Experts
A prolapsed (herniated) disc occurs when the outer fibres of the intervertebral disc are injured, and the soft material known as the nucleus pulposus, ruptures out of its enclosed space.
Herniated discs rarely occur in children, and are most common in young and middle-aged adults. A herniation may develop suddenly, or gradually over weeks or months.
The prolapsed disc or ruptured disc material can enter the spinal canal, squashing the spinal cord, but more frequently the spinal nerves.
Symptoms of Disc Prolapse
The symptoms of a herniated or prolapsed disc may not include back or neck pain in some individuals, although such pain is common:
- In severe cases, loss of control of bladder and/or bowels, numbness in the genital area, and impotence (in men)
- Numbness, pins and needles, or tingling in one or both arms or legs
- Pain behind the shoulder blade(s) or in the buttock(s)
- symptoms helps determine your diagnosis.
- Weakness involving one or both arms or legs
- Pain running down one or both arms or legs
Causes & Effects
The causes of Disc Prolapse are as follows:
- A single excessive strain or injury may cause a herniated disc.
- Disc material degenerates naturally as one ages, and the ligaments that hold it in place begin to weaken.
- As this degeneration progresses, a relatively minor strain or twisting movement can cause a disc to rupture.
- Certain individuals may be more vulnerable to disc problems and, as a result, may suffer herniated discs in several places along the spine.
Some of the advantages of Disc Prolapse include
- Relieve leg and lower back pain.
- Reduce muscle spasms.
- Improve lower body mobility.
- Restore pain-free movement.
- Strengthen core muscles.
A spinal nerve exits the spinal canal through a side-hole called the neural foramen. This is also one of the commonest sites where spinal nerves are compressed by slipped discs. The procedure of transforaminal epidural steroid injection (TESI) is performed by a spine surgeon or pain specialist in an operating room or a special procedure suite, because video X-ray is required. A thin needle is inserted just above the nerve root near the neural foramen under X-ray guidance. A mixture of a long-lasting corticosteroid and a local anaesthetic is injected around the nerve root in order to reduce the inflammation and pain.
Patient can go home the same day. Many people feel a little better immediately, but it takes one to two weeks for the full benefit of the treatment to be felt. Most patients feel better after TESI [9, 10]. As the pain is reduced, physiotherapy will switch from pain relief to regaining strength and motion. Although TESI reduces swelling associated with disc herniation, it cannot reduce the size of the disc herniation itself.
Patients who have small to medium sized slipped discs, but suffer from significant radiating leg pain and numbness, and do not respond to rest and medicine, benefit most because their symptoms are usually caused by nerve irritation and inflammation. TESI should not be performed on patients who: are pregnant; have an infection; have bleeding problems; or have uncontrolled diabetes.
Although most of lumbar disc herniation can be treated non-operatively, studies show that operation can achieve a faster relief in leg symptoms  and better long-term outcome and satisfaction compared with nonoperative treatment [14,15].
The most usual operation is 'discectomy'. This is the surgical procedure to remove the herniated parts of the intervertebral disc. It does not remove the entire disc. The operation is performed in hospital with the aid of an anaesthetic.
In the conventional technique of discectomy, an incision is made in the skin and the back muscles are moved to the side so that the surgeon can see the laminae (the bone forming the back of the vertebra).
Self-care measures for disc prolapse include:
- Apply heat to your back in the morning or prior to stretching/exercise to decrease muscle tension.
- Walking outside or on a treadmill.
- Use a pillow under your knees to help relieve tension in the lower back
- Use a lacrosse ball or massage cane to put pressure on tender/trigger points in the lumbar area..
- Cycling on a recumbent bicycle.
- Using an elliptical trainer