The second most common cause of disc herniation is trauma. This process will lead to a progressive disc herniation that can cause symptoms. The most common cause of disc herniation is a degenerative process in which, as humans age, the nucleus pulposus becomes less hydrated and weakens. Disc herniation occurs when part or all the nucleus pulposus protrudes through the annulus fibrous. Providers need to remain aware of treating the patient with a herniated disc and monitor for severe or rapidly progressing neurological changes this would be an indication for urgent neurosurgical referral.Īn intervertebral disc is composed of annulus fibrous-the annulus fibrous, dense collagenous ring encircling the nucleus pulposus. Epidural corticosteroid injections are effective pain relievers for disc herniation in the short term, while discectomy is more effective than conservative management until one year following surgery. Most cases of herniated disc heal conservatively, but refractory cases may require interventional procedures or surgical repair. Imaging is not indicated in a patient with signs and symptoms of a stable herniated disc until six weeks of persistent symptoms. Herniated discs are often seen on MRIs of asymptomatic patients. In many instances, the herniation of the disc does not cause that patient any pain. Within a few weeks, most cases of painful disc herniation heal. Unfortunately, there are limited effective conservative treatment modalities with significant effectiveness. In the spine, a disc or a nucleus pulposus is localized between vertebral bodies. It supports the spine by acting as a shock-absorbing cushion. In some instances, a herniated disc injury can compress the nerve or the spinal cord that causes pain consistent with nerve compression or spinal cord dysfunction, also known as myelopathy. Furthermore, in more severe cases, there can be associated with weakness or sensation changes. Unlike mechanical back pain, herniated disc pain is often burning or stinging, and may radiate into the lower extremity. The patients who experience pain related to a herniated disc often remember an inciting event that caused their pain. A herniated disc in the spine is a condition during which a nucleus pulposus is displaced from intervertebral space.
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