Herniated Disc

La hernia de disco ocurre cuando uno de los discos de la columna se desplaza o se degenera, pudiendo comprimir los nervios y generar dolor o molestias neurológicas.

Signs and symptoms

It may present one or more of the
following:
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  • Low back pain
    o cervical
  • Pain that
    irradia a brazos
    o piernas
  • Tingling or
    loss of
    sensation
  • Debilidad
    fatigue
  • Causes of a herniated disc
    • 1. Aging and Degeneration
      2. Physical Effort and Poor Technique
      3. Repetitive Movements.
      4. Overweight and Obesity
      5. Sedentary lifestyle
      6. Prolonged Postures
      7. Smoking
      8. Injuries
  • Types of herniated disc
    • Disc herniations are primarily classified by their location (cervical, thoracic, lumbar) or by their degree of progression (protrusion, extrusion, sequestration). The most common are lumbar (L4-L5, L5-S1) and cervical (C5-C6, C6-C7), according to their structure (grades).

      Disc protrusion (bulging): This occurs when the nucleus pulposus presses against the fibrous ring, causing a bulge, but the ring does not rupture.

      Disc extrusion: The fibrous ring ruptures and the nucleus pulposus comes out, but remains attached to the disc.

      Disc sequestration or sequestered hernia: This is the most serious. Part of the nucleus protrudes and detaches, becoming free in the spinal canal, which often causes severe sciatica or radicular symptoms.

      Depending on your location

      Lumbar: Affects the lower back (L4-L5, L5-S1), causing pain that extends to the legs (sciatica).

      Cervical: It occurs in the neck, causing pain, stiffness, and sometimes pain that radiates to the arms or hands.

      Thoracic/Dorsal: Affects the middle or upper back. It is the least common form.

      According to the Starting Position.

      Central: The gelatin flows towards the center of the spinal canal.

      Posterolateral or paracentral: The hernia shifts slightly to the sides, being the most common.

      Foraminal: It exits through the foramen, the hole through which the nerve exits the spine, which usually causes intense pain.
  • Risk factors
    • Aging: Natural wear of the disc.

      Effort: Lifting heavy objects incorrectly.

      Lifestyle: Overweight, smoking and sedentary lifestyle.

      When to consult a specialist:See a specialist when a problem arises

      Neurological emergency (immediate attention): Loss of control of urine or feces, numbness in the genital/anal area (cauda equina syndrome) or sudden severe muscle weakness ("my foot drops").

      Intractable pain: Sciatic or cervical pain that does not improve with rest, medication, or physical therapy after 4 weeks.

      Progressive neurological deficit: A tingling sensation, numbness, or obvious loss of strength in the limbs.

      Impact on quality of life: Inability to perform normal daily activities, walk or sleep due to pain.
  • Complications
    • Main Neurological and Physical:
      Neuropathic Pain: Sharp, burning or intense pain in the back, neck, legs or arms that does not respond to painkillers.

      Muscle Weakness and Atrophy: Constant pressure on the nerves can cause weakness in the limbs, leading to difficulty walking or holding objects.

      Numbness (Paresthesia): Constant loss of sensation in areas connected to the affected nerve.

      Cauda Equina Syndrome: Urgent and serious complication due to compression of the lumbar nerve roots, causing incontinence (bladder or bowel), saddle anesthesia (numbness in buttocks/genitals) and severe weakness in legs.

      Paralysis or irreversible nerve damage: If the compression is not treated in time, the nerve damage can become permanent.
  • When to consult a specialist
    • Cuando se presente una Emergencia neurológica (atención inmediata):

      Loss of control of urine or feces, numbness in the genital/anal area (cauda equina syndrome) or sudden severe muscle weakness ("my foot drops").

      Intractable pain: Sciatic or cervical pain that does not improve with rest, medication, or physical therapy after 4 weeks.

      Progressive neurological deficit: A tingling sensation, numbness, or obvious loss of strength in the limbs.

      Impact on quality of life: Inability to perform normal daily activities, walk or sleep due to pain.

    • Specialist in spinal pathologies

    Each case requires

    a different approach.

    Not all back pain requires surgery. The first step is a specialist evaluation to identify the source of the problem and determine the most appropriate treatment for each patient.