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An intervertebral disc is a flexible, fibrocartilaginous connection between the vertebrae. The total of 23 intervertebral discs in the spine make up around a quarter of the total length of the spine.

Intervertebral discs consist of a soft gelatinous core (nucleus pulposus) and a ring of connective tissue made of fibrocartilage (anulus fibrosus). As a flexible connection between two vertebrae, the intervertebral disc withstands pressure loads caused by muscle tension, buffers shocks when walking and running and enables the individual vertebral bodies to move relative to one another.

Underlying causes:

A herniated disc usually occurs due to age- and/or stress-related degeneration of the connective tissue ring of the intervertebral disc. This leads to loss of its stabilizing function allowing the inner gelatinous core to move into the spinal canal where it presses on a nerve root or the spinal cord. Risk factors for a herniated discs include overweight, lack of physical activities and incorrect, repetitive and excessive strain on the spine.

In principle, a herniated disc can occur in all three sections of the spine (cervical spine, thoracic spine, lumbar spine), with the lumbar spine being most commonly affected.

Symptoms:

Many patients with a herniated disc do not notice any symptoms at all - whether a herniated disc causes pain and other symptoms or not depends on the direct mechanical pressure on nerve structures (pressure on the nerve roots, pressure on the spinal cord, pressure on the bundle of nerve fibers).

If the bulge presses on sensitive nerves, severe and sometimes unbearable pain can occur; many patients are severely restricted in their mobility or can hardly move; The muscles are very tense and hardened at the site of the herniated disc, and there can also be accompanying sensory disturbances such as tingling and numbness. Paralysis of the sphincter muscles of the bladder and intestines can also occur, which can subsequently lead to stool and urinary disorders.

The specific symptoms depend on the exact location of the herniated disc – pain caused by herniated discs in the lumbar spine often affects the legs and feet and can put pressure on the sciatic nerve, in such cases it is referred to as sciatica.

However, if a disc herniates in the cervical spine, the pain can radiate into the arms and hands.

Therapy:

Treatment for a herniated disc can be conservative or surgical. Therapy depends on several factors. As a rule, the treatment of a herniated disc initially consists of conservative treatment, which can consist of various treatment measures, including rest (no bed rest), warmth, physiotherapy and infiltrations.

The basic requirement for conservative therapy is that there are no motor and/or sensory deficits; in such cases, the herniated disc must be treated surgically.

Operation:

Surgical treatment can be considered if symptoms persist for several weeks or if symptoms do not noticeably improve with conservative treatment measures.

An operation is definitely necessary if the prolapse puts pressure on the spinal cord or the bundle of nerve fibers, if the herniated disc causes severe paralysis and if the function of the bladder and intestines is impaired by the herniated disc. In order to prevent crushed nerve fibers from dying as a result of the incident, the operation should be carried out very fast.