Herniated Nucleus Pulposus (Herniated Disc)

Overview

Intervertebral discs are made of two parts: the soft, spongy center called the nucleus and the lining around the nucleus called the annulus. A herniated disc occurs when a small portion of the nucleus breaks off from the rest, oftentimes lodging itself towards where the nerves lie. This can result in neck/back pain, shooting pain into the arms or legs, tingling, and numbness.

Diagnosis

A diagnosis of herniated disc is first suspected based on a careful history and physical exam. Ultimately, MRI is the gold standard study for diagnosis a herniated disc and any nerve compression. A CT scan may also be used but is less sensitive than MRI.

Treatment

Fortunately, most herniated discs resolve on their own within 3 months as the body resorbs the disc material. As this process happens, pain is mainly managed through medications, activity modification, physical therapy, and injections. A small number of herniated discs do not heal on their own and may require surgical intervention (see microdiscectomy).

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