Synonym
med: herniated disc
Introduction
The herniated disc is now one of the most common clinical pictures in the field of orthopaedics. Above all, the increasing age and years of incorrect or excessive strain on the spine lead to pronounced signs of wear and tear, which promote the development of a herniated disc. Contrary to what the majority of patients expect, a herniated disc does not necessarily lead to back pain.
In general, it can even be assumed that persistent back pain is relatively rarely caused by a herniated disc. Much more often, the complaints can be based on muscular tension. People who suffer from a herniated disc often notice sensory disturbances in the form of numbness or tingling due to nerve root irritation.
In addition, an advanced herniated disc, which leads to a significant compression of the nerve root, can lead to limitations in muscle strength. An untreated herniated disc can therefore have considerable consequences for the affected patient. For this reason, people who observe such complaints should consult a specialist in good time. Only through targeted diagnostics and the initiation of appropriate treatment measures can long-term consequences, which are mainly due to nerve damage, be avoided.
Consequential damage of a herniated disc
A slipped disc does not necessarily lead to pain in every case. Nevertheless, some of the affected patients describe sudden, stabbing pain. The exact location of this pain depends on the height of the affected spinal segment.
As one of the direct consequences of a herniated disc, the pain can radiate from the back to the arms, buttocks and/or legs. If a herniated disc occurs in the area of the cervical spine (cervical spine), particularly strong, stabbing pain in the neck area can be one of the consequences. A deep herniated disc in the lower part of the lumbar spine (lumbar spine), on the other hand, typically provokes pain in the back, buttocks and legs.
In addition, impairment of sensations can be one of the consequences of a herniated disc. Patients affected by an advanced disc herniation often experience sensations such as numbness and/or tingling. The exact location of these sensory disturbances depends on the affected spinal segment.
Already during diagnosis, such complaints can be assigned to a specific spinal segment on the basis of defined dermatomes (skin areas in which the sensations are perceived). In the case of a slipped disc in the cervical spine, sensory disturbances of the dermatomes of the arms are among the direct consequences. If the herniated disc tissue presses on the nerves running in the spinal cord over a longer period of time, restrictions in muscle strength can also be one of the consequences.
Even with this typical symptom of a herniated disc, only by identifying the muscles in which this muscle weakness occurs can a conclusion be drawn about the affected spinal segment. While herniated discs in the cervical or lumbar spine are comparatively common, the herniated disc of the thoracic spine (BWS) is rather rare. This is mainly due to the fact that the vertebral segments in the thoracic spine are only slightly mobile against each other.
If a herniated disc of the thoracic spine nevertheless occurs, blockages of the individual vertebral joints can often be observed. For this reason, belt-like pain running along the back and ribs is one of the direct consequences. In addition, affected patients usually react very sensitively to passive pressure on the thoracic spine segments.
Patients who notice such symptoms should consult a specialist as soon as possible. The reason for this is that the direct consequences of a herniated disc may not be permanent if appropriate treatment is initiated immediately. A sustained compression of the nerve root, on the other hand, can cause severe damage and lead to permanent complaints.
Furthermore, a long lasting compression of the nerve roots, especially in the area of the lumbar spine, can cause further more serious consequences. In this section of the spine, in addition to the sensitive and motor nerve fibres, the nerves involved in the regulation of intestinal and bladder function also run through this section of the spine. If the protruding disc tissue presses on these nerve fibres over a longer period of time, the affected person may develop intestinal and bladder voiding disorders (faecal and urinary incontinence).
In addition, the decreasing muscle strength can lead to a significant insecurity in walking. This can have a strong influence on normal everyday life and can have further consequences due to an increased tendency to fall. The herniated disc in the lumbar spine (lumbar spine) is the most common form of this disease, along with the high disc prolapse of the cervical spine (cervical spine).
Due to the fact that a herniated disc in the lumbar spine does not necessarily lead to back pain, the prolapse is often discovered very late. The consequences of a herniated disc in the lumbar spine are mainly shown by an impairment of the sensitive perception. Affected patients usually report pronounced numbness and/or tingling in the buttocks and legs.
In the area of the lumbar spine, a herniated disc occurs particularly frequently between the 5th lumbar vertebra and the first sacral spinal segment. In this form of disc prolapse of the lumbar spine, numbness in the dermatome of the nerve root L5 can be a direct consequence. The corresponding dermatome of the nerve root L5 extends over sections of the upper leg as well as over areas of the lower leg.
For this reason, a pronounced numbness and/or pain in the back of the thigh are among the typical consequences of a herniated disc between L5 and S1. In addition, the outside of the knee, as well as the front and side of the lower leg belong to the dermatome of this nerve root. In addition to the limitations of sensitive perception, impairment of muscle strength is one of the most common consequences of a herniated disc in the lumbar spine.
Affected patients are often no longer able to stand on their toes or heels without problems. The reason for this is the fact that individual muscles (so-called identification muscles) are no longer adequately supplied with nerve impulses due to the constant pressure on the nerve roots. A particularly pronounced herniated disc in the lumbar spine can also lead to damage of those nerve fibres that are involved in the regulation of intestinal and bladder function.
For this reason, intestinal and bladder voiding disorders can be among the consequences of a herniated disc in the lumbar spine. A herniated disc of the cervical spine (cervical spine) is comparatively common. The consequences of this form of disc herniation range from sensory disturbances to impairment of muscle function.
The continuous pressure on the nerve root of the affected spinal segment causes numbness and/or tingling in the area of the upper and lower arms. In addition, the consequences of a herniated disc in the cervical spine can manifest themselves in the form of neck pain radiating into the arms. The intensity as well as the nature (quality) of these pains depends mainly on the location and extent of the herniated disc of the cervical spine.
Although the development of back pain is not obligatory in the case of a herniated disc of the thoracic or lumbar spine, pain in the case of a herniated disc of the cervical spine is usually regarded as an initial sign of irritation of the nerve roots. Since the individual spinal segments of the thoracic spine (thoracic spine) are only slightly displaceable against each other, a herniated disc in the area of thoracic spine (thoracic spine) is a rarity. In most cases, the development of a herniated disc of the thoracic spine (BWS) can be linked to a previous traumatic event.
Affected patients usually feel significant pain in the area of the thoracic spine. These pains typically radiate along the ribs into the anterior thorax in a belt-like pattern. In addition to these pain phenomena, increased sensitivity to pressure is one of the most common consequences of a herniated disc of BWS.
All articles in this series:
