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McKesson Clinical Reference Systems: Women's Health Advisor 2002.2
Spanish version
Illustration
Herniated Disk
What is a herniated disk?
A herniated disk is a disk that has bulged out from its
proper place in your back. Disks are small, circular
cushions between the bones of the spine (vertebrae).
Normally, disks act as shock absorbers to cushion your
vertebrae from each other as you move. A herniated disk may
press on nearby nerves and cause severe pain.
How does it occur?
When a disk is damaged, the soft rubbery center of the
disk squeezes out through a weak point in the hard outer
layer. A disk may be damaged by:
- a fall or accident
- repeated straining of your back
- a sudden strenuous action such as lifting a heavy
weight or twisting violently.
A herniated disk may also happen spontaneously without any
specific injury.
What are the symptoms?
Symptoms of a herniated disk in your neck may begin suddenly
or gradually. You may wake up and feel a sudden aching. Or
you may have a twisted neck that you cannot straighten
without extreme pain. You may also have numbness, tingling,
or weakness in one or both arms.
If your herniated disk is below your neck, your symptoms
may develop gradually or begin suddenly. Symptoms include:
- back pain
- pain down one or both legs
- numbness, tingling, or weakness in one or both legs
- changes in bladder and bowel habits.
How is it diagnosed?
Your health care provider will review your symptoms and ask
about the history of your pain. Then he or she will examine
your spine and test the movement and reflexes in your arms
and legs. Finally, your provider may want you to have one
or more of the following tests:
- x-rays of your spine
- CT scan (computerized x-ray images of your spine)
- magnetic resonance imaging, also called MRI (an image of
your spine and herniated disk generated by sound waves)
- electromyography (tests of electrical activity in your
muscles)
- myelography (injection of dye into the fluid around the
spinal cord that can be seen on x-rays)
- diskography (injection of dye into a disk and x-rays
taken).
How is it treated?
In most cases, treatment without surgery will relieve your
pain.
Treatment for a herniated disk in your neck may include:
- hot or cold packs
- anti-inflammatory drugs
- muscle relaxants
- prescription pain relievers
- a neck collar or neck brace to relieve muscle spasms
- neck and shoulder massage
- traction, which is the process of putting bones or
muscles under tension with a system of weights and
pulleys to keep them from moving or to relieve pressure
on them.
For a herniated disk in your back, treatment may include:
- several days or more of lying flat on your back on a firm
mattress or on an ordinary bed with a stiff board under
the mattress, or lying on your belly with a pillow under
your chest, whichever is more comfortable
- muscle relaxants
- anti-inflammatory drugs
- prescription pain relievers
- hot or cold packs, depending on your health care
provider's preference
- traction
- back massage or physical therapy
- steroid injections into the space near the herniated disk
to control pain and inflammation.
As your pain lessens, your health care provider will want
you to begin a physical therapy program in which you will do
exercises to strengthen your back muscles and joints.
Recently, stabilizing exercises have been used successfully
to treat herniated disks. This therapy involves learning
how to control the movement of your spine in all recreation
and work activities.
If you continue to have symptoms, you may need to have
surgery. However, most people who have herniated disks do
not need surgery.
How long will the effects of a herniated disk last?
The initial intense pain should go away within a few weeks,
but some pain may remain for a few months. You may be prone
to backaches throughout your life and therefore must
remember to protect your spine when lifting or being
physically active.
If the weakness and numbness in your legs continue or if you
lose control of your bowel or bladder function, contact your
health care provider immediately.
How can I take care of myself?
Practice correct posture when you are walking, sitting,
standing, lying down, or working.
- When lifting heavy objects, don't bend over from your
waist. Kneel or squat down by the object, while keeping
your back as straight as possible. Use your thigh
muscles to do the lifting. Avoid twisting.
- When you stand, always stand up straight with your
shoulders back, abdomen in, and the small of the back
flat. When standing for long periods, move around
frequently and shift your weight from one foot to
another while standing as straight as possible.
- When you sit, have your feet flat on the floor or
elevated. Get up every 20 minutes or so and stretch.
Sit in a chair that has good back support.
- Sleep on a firm mattress or one with a bed board under
it. Lie on your side (never on your stomach) with your
knees bent or on your back with a small pillow under
your head and another pillow under your knees.
What can be done to help prevent a herniated disk?
Herniated disks can often be prevented by keeping your
weight down, eating a proper diet, and exercising to keep
your muscles firm. Strong, flexible muscles can stabilize
your spine and protect it from injury. This includes
keeping your stomach muscles strong. Walking and swimming
are two good exercises for strengthening and protecting your
spine.
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