Anatomy of the spine
The spine consists of a set of bones called vertebrae. We are born with 33 vertebrae. There are seven cervical vertebrae, 12 thoracic vertebrae and five lumbar vertebrae. Five vertebrae fuse together to form the sacrum and the remaining three or four vertebrae form the coccyx.In between the vertebrae sit the intervertebral discs. These discs work like shock absorbers for the spine. Each disc is comprised of a outside fibrous ring called the annulus fibrosis and a soft inner core called the nucleus pulposis.
Why do discs herniate?
The discs start out very plump, with a high water content. As we age, the discs lose fluid and become dry. Cracks can form in the annulus pulposis, causing the nucleus pulposis to break through, or “herniate.” A herniation is often precipitated by trauma or by bending or twisting the back.What are the symptoms?
- Back pain
- Pain that shoots down one or both legs
- electric sensations
- numbness in the legs
- back spasms
- weakness in the legs
What is the treatment
There are many different treatment options for herniated discs. These include:- Physical therapy - A physical therapist can decrease the pain by using heat, ice and electrical stimulation. The therapist can perform stretches and instruct you in a home exercise program.
- Medications - Medications such as NSAIDS, muscle relaxants, anticonvulsants and opioid analgesicas are used to treat pain from disc herniations
- Injections - Epidural steroid injections may be recommended. These injections can decrease pain and inflammation by injecting an anesthetic and a steroid to the affected area.
- Alternative treatment - Some people with disc herniations may try chiropractic, massage therapy or acupuncture.
- Surgery - Surgery is generally considered if other treatments have failed. The main options are discectomy, laminectomy and microdiscectomy. With a discectomy the herniated disc is surgically removed. With a laminectomy, a piece of the vertebra is removed, leaving more space for the disc. With a microdiscectomy, the disc material is removed through a very small incision in the back.
Source:
Jenkins David B. “Hollinshead’s Functional Anatomy of the back and limbs."