Herniated disc

There are several terms commonly used to describe a herniated intervertebral disc including herniated disc, ruptured disc, slipped disc and bulging disc. A disc herniation occurs when when the annulus (a fibrous tissue around the vertebral bodies) weakens allowing the nucleus (the elastic jelly encased in the annulus) to bulge into the weakened area. Sometimes the annulus splits allowing some nucleus material to leave the disc and enter the spinal canal leading to inflammation and pain. Symptoms include axial pain (back and neck) and radicular pain, typically affecting the legs or arms and characterised by sharp, shooting pain, numbness and sensory loss. There may be associated motor weakness or loss of some movement. Treatment is variable based on symptoms and over time, herniated discs will resolve spontaneously and conservative management is recommended wherever possible. Prompt imaging is important and image guided spinal procedures can be helpful as a first line treatment. When disc herniation is large it may cause narrowing or obstruction of the spinal canal leading to bowel or bladder disturbance or numbness in the groin or perineum. This condition is known as cauda equine syndrome and requires emergency treatment.

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