Herniated Disc
Disc herniation
The spinal column is made up of vertebrae, between which the so-called intervertebral discs provide the flexible connection. The intervertebral discs are made up of two parts: an outer circular fibrous ring and an inner gelatinous nucleus. The intervertebral discs are the “shock absorbers” of our spine, ensuring the mobility and flexibility of the spinal column.
In a disc herniation, the outer fibrous ring of the disc ruptures and the nucleus pulposus protrudes through it. This is called disc herniation, or disc herniation. Because of the protrusion , nerve roots exiting the spinal cord can become pressurised, pinched and inflamed, and even damaged. Damage to the nerve fibres can lead to long-term mobility problems, including paralysis. Without proper treatment and attention, a prolapsed disc can tear and cause severe pain and further nerve damage, leading to reduced mobility.
Dr. Dóra Mihola
Rheumatologist specialist
Development of
The development of disc herniation is rarely related to injury or trauma. In most cases, it develops slowly and gradually over many years. The fibrous rings of the intervertebral discs are elastic due to their high water content. However, the water content of the intervertebral discs steadily decreases after the age of 20-25 years, causing the discs to dehydrate and start to wear. As the water content of the intervertebral disc decreases, the gelatinous inner part behind the fibrous outer part of the disc is pushed forward by pressure, which can put pressure on or damage the nerve roots exiting the spinal cord.
The slow wear and tear process is also greatly influenced by various lifestyle factors, as well as sudden injuries and traumas. Office workers, people with sedentary lifestyles, people who do heavy physical work and athletes are also particularly at risk. Scoliosis and other spinal diseases are an additional predisposing risk.
Symptoms
The main symptom of disc herniation is pain in the spine, which is also associated with other symptoms of neurology: numbness, radiating pain, a pinprick sensation, loss of sensation, possibly incontinence or bowel dysfunction. Symptoms are greatly influenced by the location of the hernia.
Lumbar disc herniation
The most common type is lumbar disc herniation, in which the sciatic nerve is affected. The main symptom of lumbar disc herniation is sciatica. In this case, severe pain in the lower back is accompanied by numbness and a sensation of pain radiating down the legs. Lumbar disc herniation is one of the most common causes of sciatica.
Cervical disc herniation
Cervical disc herniation is also a common condition. Pain and numbness radiate to the shoulders and arms, but can also cause headaches, loss of balance or even tinnitus. The pain in the neck is also of the characteristic sharp type, increasing with sudden movement.
Rarely, a disc herniation in the middle back develops. In this area, the ribs provide more support, so the vertebrae and discs in this area are under less strain.
If you have the following symptoms of disc herniation, you should see an orthopedics, rheumatology or neurology specialist as soon as possible for an examination:
- pain radiating from the spinal cord to the limb
- limb numbness
- emotional disturbance, loss of sensation
- muscle weakness
- an ant-like or pins-and-needles feeling in the limbs
- limb paralysis (even temporary!)
- incontinence, constipation.
Typically, the pain can be triggered by body position or movement, for example, the pain is increased by coughing, sneezing, medical examination techniques.
What is the difference between disc herniation and herniated disc?
Disc herniation is also known as a disc herniation. There is no difference in meaning between the two terms.
Dr. Maysam Moghaddam Amin
Orthopedic-Traumatologist Specialist, Robotic Surgeon
Diagnostics for disc herniation
The diagnosis of a disc herniation is made by an orthopedics specialist. At the Budapest Musculoskeletal Private Outpatient Clinic, we have developed a special patient journey protocol to ensure thorough examination and effective, targeted therapies.
Our mission is to help our patients regain their freedom of movement as soon as possible, and to permanently and long term relief from painful complaints.
The cornerstones of a successful investigation based on the BMM patient journey protocol:
- The medical history is half the diagnosis, and many diseases can be ruled out by detailed questioning.
- A thorough physical examination by a specialist. Based on the physical examination, a specialist will determine the need for any diagnostic imaging tests. Diagnostics tests can help to visualise and measure anatomical structural changes and reveal the true cause of the complaint.
- Bony lesions can be confirmed by an X-ray examination. This is often necessary for isolating purposes related to diagnostics.
- The condition of the soft tissues, discs, articular cartilage, muscles and tendons is accurately assessed by the radiograph.
- An MRI (magnetic resonance imaging) scan is often needed to make an accurate diagnosis of a disc herniation.
- In the case of nerve involvement, neurophysiological testing, ENG or EMG examination is recommended to determine the extent of suspected nerve damage.
Neuroconductive neurophysiological examinations (ENG/EMG) are available at BMM’s clinics in Pest and Óbuda. The necessary X-ray examinations, ultrasound examinations, CT scans and MRI examinations are provided off-site by our partner institutions for an additional fee.
- Based on the medical history, physical examination and imaging diagnostics, the orthopaedic specialist makes an accurate diagnosis.
- A personalised treatment plan is drawn up. We accompany our patients all the way to recovery!
Treatment of disc herniation
The treatment of a disc herniation depends on the extent and location of the herniation and the quality of the symptoms caused. In each case, a specialist will decide on the appropriate therapy after a thorough examination.
In most cases, disc herniation can be treated well with conservative therapy. Conservative treatment is led by an orthopedic surgeon, a neurologist or a rheumatologist. Acute pain relief and anti-inflammatory effects are usually achieved with medication, which may be a topical injection, oral or even patch; steroid or non-steroidal. Spinal decompression is also essential in the acute phase, but long-term strict bed rest is not recommended. Nerve mobilisation is recommended to release the pressurised nerve. Long-term conservative therapy is required once the acute pain has subsided. The main element of this is physiotherapy, which should be tailored to the individual. With McKenzie’s spinal exercises, nerve mobilisation training and manual therapy, disc herniation can be managed very well, even achieving complete symptom relief. In addition to physiotherapy, complementary physiotherapy treatments (ultrasound, TENS safe laser), therapeutic massage and balneotherapy are also recommended.
In severe cases, a disc herniation may require an intervention. This requires consultation and examination by a neurosurgeon specializing in neurosurgery. Disc herniation surgery is performed by a neurosurgeon. Physiotherapy also plays an important role in post-operative rehabilitation and in the way of life after surgery.
The key to success is doctor-patient cooperation and trust!
Avoiding disc herniation surgery
Even in the case of disc herniation, an intervention can be avoided with regular, professional physiotherapy. By performing individual, tailored and targeted exercises, the deep muscles of the spine are strengthened, reducing the strain on the discs. Physiotherapy should be complemented by therapeutic massage, physiotherapy (ultrasound therapy, TENS, safe laser treatment) or balneotherapy. In addition to therapy, lifestyle also plays a major role in avoiding surgery. In the case of overweight, weight reduction is recommended, as well as avoiding smoking and alcohol, following a healthy diet and drinking plenty of fluids.
The indication for surgery is always decided by a neurosurgeon.
Causes of disc herniation
In most cases, disc herniation is caused by a degenerative process, but there are factors that can increase the risk of developing disc herniation:
- Sedentary lifestyle
- Sedentary work, incorrect sitting, poor posture
- Heavy physical work, poor lifting technique
- Serious sports activity without strengthening the deep back muscles
- Scoliosis
- Ankylosing Spondylitis
- Other spinal diseases
The importance of prevention
The development of disc herniation can often be prevented by lifestyle changes. If you have a known back problem, it is highly recommended that you see a physiotherapist and learn specific exercises to strengthen the deep back muscles. It is also recommended to learn and practice correct posture, sitting posture and lifting techniques.
Regular back massage is also beneficial for the back muscles, reducing the strain on the spine.
With a healthy lifestyle, adequate fluid intake and a diet rich in vitamins and minerals, you can maintain healthy bones, discs, joints and muscles for a long time. Recommended minerals and vitamins.
In addition , regular exercise and sports such as swimming, running, walking are recommended.
Most Common Complaints Treated by Spine Medicine Center Specialists
- lower back pain
- lower back pain
- scoliosis
- nerve compression
- back pain
- neck pain
- stiff neck – neck stiffness
- osteoporosis
- spinal pain
- spinal stenosis
- back pain
- lumbar spine pain
- gluteal muscle pain
- poor posture
- sacrum pain
- shoulder blade pain
- morning lower back pain
- neck pain
Our Spine Medicine Specialists
Dr. Gréta Sterba
Rheumatologist specialist
Dr. Bence Moravcsik
Orthopedic-Traumatologist
Dr. Flórián Szeles
Rheumatologist general practitioner
Dr. Éva Bordán
Rheumatologist general practitioner