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One of the most common injuries we see in our workers’ compensation and personal injury practice is disc herniation. If you’ve suffered a disc herniation as the result of your work activities, or as the result of a motor vehicle collision, you may be entitled to compensation.A disc herniation, also commonly referred to as a prolapsed disc, ruptured disc or “slipped disc,” is a medical condition affecting the spine, where a tear in the outer, fibrous ring (annulus fibrosus) of an intervertebral disc allows the soft, central portion (nucleus) of the disc to bulge out. A tear in the outer disc ring may cause the release of inflammatory chemicals into your body, causing severe pain. If the bulge or prolapse compresses on a nerve root, it can cause pain and symptoms extending from the neck or back into the arms or legs. A disc herniation may begin as a disc protrusion, or disc bulge, where the outer layers of the disc are intact, but protrude outward when the disc is under pressure.
Disc herniations can occur at any level of the spine, but most commonly, they occur in the cervical spine (neck) or in the lumbar spine (low back). Lumbar disc herniations occur 15 times more often than cervical spine disc herniations. Cervical disc herniations occur in 8% of cases, and herniations occur only 1-2% of the time in the thoracic spine (mid-to-upper-back). Lumbar disc herniations often cause leg pain, which is commonly referred to as sciatica.
Lumbar herniations occur most commonly between the fourth and fifth vertebrae (L4-L5), and between the fifth vertebrae and the sacrum (L5-S1). Symptoms from a herniation in the lumbar spine can affect the low back, buttocks, hips, thigh, calf, foot, and toes. The sciatic nerve can be affected, causing symptoms of sciatica. The femoral nerve can also be affected, causing a numb, tingling feeling throughout one or both legs, or a burning feeling in the hips and legs.
Cervical herniations occur most often between the sixth and seventh vertebrae (C6-C7). Symptoms from a herniation in the cervical spine can affect the back of the skull, the neck, shoulder girdle, scapula, arm, and hand. The nerves of the cervical plexus and brachial plexus can also be affected.
Interestingly, most disc herniations occur to persons in their thirties or forties. After age 50 or 60, intervetebral discs tend to “dry out” and are less likely to herniated. Low back pain after the age of 50 or 60 is more frequently caused by spinal degeneration or spinal stenosis.
Disc herniations can be caused by repetitive motions, overuse, general wear and tear, blunt force trauma, lifting injuries, sharp impacts, or a variety of other strains.
Symptoms of a herniated disc depend largely on the location of the herniation. Herniations can cause little or no pain, isolated to the neck or back, or they can cause severe and disabling pain throughout virtually the entire body. Other than pain symptoms, herniated discs can cause sensory changes, such as numbness, tingling, muscular weakness, paralysis, paresthesia, decreased sensation and decreased reflexes. Generally, symptoms are experienced on one side of the body or other, in correlation whith the side of the spine where the herniation has occurred. If the herniation is large and presses on the spinal cord or cauda equina in the lumbar spine, both sides of the body may be affected.
A herniated disc is diagnosed by a doctor based on the patient’s history, symptoms, and physical examination. If a disc herniation is suspected, X-rays, a CT-Scan, an MRI, or a Myelogram may be performed to confirm a suspected herniation and to pinpoint its location.
Many herniated discs will heal after several weeks or months without surgical intervention. Often, conservative therapies including chiropractic treatment, physical therapy, bed rest, support belts, prescription anti-inflammatory medications, yoga therapy, prescription pain killers, spinal decompression, prescription muscle relaxers, oral steroid medications, and cortisone and steroid injections, are used to treat the symptoms of a herniated disc.
Surgery is generally considered as a last resort after conservative treatments fail to relieve pain or heal the disc herniation. Surgery is generally required if a patient has a significant neurological deficit, such as paralysis or cauda equina syndrome (in which there is incontinence, weakness and genital numbness). This condition is considered a medical emergency.
Surgical options include:
- Microdiscectomy
- IDET
- Laminectomy
- Hemilaminectomy
- Lumbar/Cervical fusion
- Anterior cervical discectomy and fusion
- Disc arthroplasty
- Dynamic stabilization
- Artificial disc replacement
- Nucleoplasty
Visit Minnesota Workers' Compensation and Personal Injury Law Firm, Meuser & Associates, P.A., at MeuserLaw.com
