Cervical, Thoracic and Lumbar Disc Herniation
A herniated disc occurs when the fibrous outer portion of the disc ruptures or tears, and the jelly-like core squeezes out. When the herniated disc compresses a nearby nerve, as in the video below, the result can be a “pinched” or impacted nerve. A pinched nerve may “radiate” causing pain, numbness, tingling or weakness in the arms or legs. The substance that makes up the disc’s jelly-like core can also inflame and irritate the nerve, causing additional pain at the location of the herniation.
The sections of your spine, are broken down into three segments: The cervical, thoracic and lumbar portions of your spine.
Cervical. The cervical portion of your spine involves the first seven vertebrae at the top of your spine near your neck.
Thoracic. Below cervical spine is the thoracic portion of your spine, which is home to the next 12 vertebrae.
Lumbar. Underneath the thoracic spine sits the lumbar portion of your spine, which involves the next five vertebrae.
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What’s the Difference Between a Bulging Disc and a Herniated Disc?
You've probably heard the terms bulging disc and herniated disc before. And, chances are, you know they both have to do with something in your spine. You probably know both can be painful, too — but are they the same thing? In a word: Nope.
Different terms may be used to describe a herniated disc. A bulging disc (protrusion) occurs when the disc annulus remains intact, but forms an out-pouching that can press against the nerves. A true herniated disc (also called a ruptured or slipped disc) occurs when the disc annulus cracks or ruptures, allowing the gel-filled center to squeeze out. Sometimes the herniation is so severe that a free fragment occurs, meaning a piece has broken completely free from the disc and is in the spinal canal.
Both a bulged disc and a herniated disc are serious injuries. Depending upon whether the herniated disc is pressing on nerves, it may cause extreme pain and functional limitation or no pain or functional limitation at all. Regardless, a herniated disc is a permanent disability. The injured disc will never fully recover increasing the likelihood of additional injury or further degeneration as a person ages.
A herniated disc can push on or irritate nearby nerves that can result in pain and radiculopathy (pain, numbness or weakness that radiates into the arms or legs).
Herniated discs can result in several different conditions:
Radiculopathy is a condition caused by compression, inflammation and/or injury to a spinal nerve root. Pressure on the nerve root results in pain, numbness, or a tingling sensation that travels or radiates to other areas of the body that are served by that nerve, including the arms and legs. Radiculopathy may occur when spinal stenosis or a herniated or ruptured disc compresses the nerve root.
Sciatica is a form of radiculopathy caused by compression of the sciatic nerve, the large nerve that travels through the buttocks and extends down the back of the leg. This compression causes shock-like or burning low back pain combined with pain through the buttocks and down one leg, occasionally reaching the foot. In the most extreme cases, when the nerve is pinched between the disc and the adjacent bone, the symptoms may involve not only pain but numbness and muscle weakness in the leg because of interrupted nerve signaling.
Spondylolisthesis is a condition in which a vertebra of the lower spine slips out of place, pinching the nerves exiting the spinal column.
Spinal stenosis is a narrowing of the spinal column that puts pressure on the spinal cord and nerves that can cause pain or numbness with walking and over time leads to leg weakness and sensory loss.
Disc Herniation Diagnosis
MRI is the most commonly used imaging for this condition. Plain x-rays of the affected region are frequently used to round out the vertebral evaluation. Please keep in mind that a disc herniation cannot be seen on standard x-rays. Before MRI, CT scans and myelograms were more commonly used, but they are now rarely ordered as the initial diagnostic imaging, unless special circumstances warrant their use. An electromyogram is rarely used.
X-ray: The use of radiation to create a film or picture of a body part can reveal the structure of the vertebrae and the outline of the joints. X-rays of the spine are taken to look for other potential causes of pain, such as tumors, infections, fractures, and so on.
Magnetic resonance imaging (MRI): A diagnostic test that uses powerful magnets and computer technology to create 3D images of body structures; can show the spinal cord, nerve roots, and surrounding areas, as well as enlargement, degeneration, and tumors.
CT or CAT scan: A diagnostic image created after a computer reads X-rays; can show the shape and size of the spinal canal, its contents, and the structures surrounding it.
Myelogram: An X-ray of the spinal canal after a contrast material is injected into the surrounding cerebrospinal fluid spaces; can show pressure on the spinal cord or nerves caused by herniated discs, bone spurs, or tumors.
EMG and Nerve Conduction Studies (EMG/NCS): These tests measure the electrical impulses that travel along nerve roots, peripheral nerves, and muscle tissue. This will show whether there is ongoing nerve damage, if the nerves are healing from a previous injury, or if there is another site of nerve compression. This test is rarely ordered.
Dealing with Insurance Companies After a Back Injury
Insurance companies know that neck and back injuries can easily become complicated and expensive as they often require substantial medical treatment, including extensive physical therapy and potentially multiple surgeries to correct. They are also aware that many of these injuries progress into lifelong injuries that can destroy your quality of life and prevent you from working or enjoying your hobbies. Unfortunately, a lot of personal injury lawyers settle these types of cases for far less then they should, buying in to the insurance refrain it’s “only a sprain strain”! At Phillips Personal Injury, we have the knowledge, and fight hard to make sure our clients receive full and fair compensation for their back injury.
Please don’t let the insurance companies harass you or pressure you into taking less than you deserve. If you or a loved one has suffered neck or back injury due to the negligence of another, we are committed to helping you receive the medical treatment that you need and seek the compensation you deserve. We are driven to seek the maximum compensation for our clients and to help you to overcome the challenges created by the wrongful acts of others. If you believe your neck or back injury was caused by the carelessness of another, please contact Phillips Personal Injury immediately for your free consultation.
Phillips Personal Injury helps clients from Sacramento to the Oregon border. We invite you to call us for a free consultation with any questions you may have.