The spine is mainly made up of a series of bones, often called vertebrae, that cover and protect the spinal cord. In each vertebrae, a disc containing gelatin-like substances is usually present. This disc, usually referred to as the nucleus pulposus, functions to provide cushioning and lubrication between these bones. When the nucleus pulposus, or a part of it, slips out between the bones of the spine, the condition is commonly called herniated nucleus pulposus. Other terms for herniated nucleus pulposus include lumbar radiculopathy, slipped disc, prolapsed intervertebral disc, and ruptured disc.
Trauma to the spine caused by stress and strain due to heavy physical activity is a common cause of a herniated nucleus pulposus. People who drive for a living are at increased risk for this condition due to the constant vibration experienced by drivers while on the road. Aging and smoking may also play a role in its occurrence. Most cases of herniated nucleus pulposus are usually seen in adults and in elderly individuals.
Herniation of the nucleus pulposus may affect the cervical discs of the neck and shoulder area, and the lumbar discs in the lower back area. The thoracic discs, located in the middle of the back, may also be affected, but less often than the cervical and lumbar discs. Lumbar disc herniation is said to be the most common.
Symptoms of a herniated nucleus pulposus usually depend on which area of the spine is affected. In cervical disc herniation, weakness of the arms and neck, along with shoulder pain, are usually felt. Some patients may also experience increased pain when bending their necks or moving their heads from side to side. A herniated nucleus pulposus in the lumbar area usually brings pain in the lower back section. There may also be tingling, numbness, and weakness in the feet and the legs. Laughing and coughing frequently intensify these symptoms.
Neurologists and neurosurgeons are usually the specialists who treat patients with brain and spinal cord problems. They often perform physical examination and neurological tests to assess and determine the cause of the patient's symptoms. Imaging tests such as an X-ray, computed tomography (CT) and magnetic resonance imaging (MRI) may also be used during the evaluation of these patients.
Treatment of patients with herniated nucleus pulposus often involves the use of medications to relieve pain. Rest and physical therapy are also often recommended. Those who are overweight are frequently advised to observe lifestyle changes as part of their pain management. Some patients who do not respond well to medications and other therapy may need surgery to relieve their symptoms.