Many different terms are used to describe a disc herniation. Sometimes they are called a bulging disc, protruding disc, torn disc, slipped disc, ruptured disc, or collapsed disc. The list goes on. So one can understand how there might be confusion surrounding this type of injury
A disc herniation injury occurs when the outer wall of the soft cushion between the spinal vertebrae (the spinal disc) ruptures. A portion of the disc’s inner gel then herniates—which means to push outwards—against the spinal cord or the spinal nerves. It is this pressure on the spinal nerves that causes symptoms typical of a disc herniation.
All types of disc injuries can occur during an automobile collision, or after other traumatic events like a slip and fall. These injuries create varying problems and varying degrees of pain in each person. However, most people with a herniated disc or some other type of disc injury can all agree that they are painful. This is due to the fact that the spinal cord and the spinal nerves are very sensitive. They have to be, in order to carry all the information to and from your body. Every time you rub your fingers across suede, stub your toe, or wave goodbye, your spinal cord and nerves are responsible. They transmit and receive everything from big muscle movements to tiny, minute feeling.
One of the problems with diagnosing and trying a personal injury case involving a herniated disc is how subjective the idea of pain can be. Each person is affected differently. On a pain scale from 1 to 10, one person could be experiencing a level 4 and the other a level 9, even when they appear to have the same level of disc herniation.
Sadly, injuries to the disc and other soft tissues in the musculoskeletal system are often a permanent-type injury. While treatment is available which may be very effective at mitigating the pain symptoms, oftentimes the injured party is never exactly as they were prior to the acute injury. Following a traumatic injury like this, it’s best to seek the advice of a qualified medical provider and to speak to a personal injury attorney. This way, you get the care you need and you are not stuck with the financial responsibility of someone else’s negligence.
When a disc herniates, it can do so in two different ways. The difference is minor, but it is still worth noting which is which. The basic idea is that a protrusion is the first step towards extrusion. As the inner gel of the spinal disc starts to herniate through the outer wall, it protrudes. If it continues to push through the wall until a good portion has leaked out, then it becomes an extrusion.
Disc protrusions are commonly called disc bulges. Disc protrusion occurs when the spinal disc and associated ligaments remain intact, but form an out-pouching that presses against the spinal nerves. This protrusion of the disc may push against the damaged fibers of the outer ring, but it mostly stays within its confines.
The pain from a protrusion can sometimes disguise itself as other sources, since the nerves (and the pain) radiates out to other areas. The most common nerve pain associated with these conditions is sciatica. Pressure from the damaged disc on the sciatic nerve can often cause an ache or sharp, shooting pain into the buttocks and down the back of the leg. Numbness, tingling, or generalized weakness in these areas can also occur. Paresthesia is another common side effect of disc protrusion. This is when a tingling, pricking, or numbing sensation is present because the abnormal disc is pressing on a nerve. In severe cases, the sufferer can experience symptoms in other areas, such as lack of bladder control or the inability to raise the foot. A disc protrusion is one of the most common causes of back pain.
A disc extrusion occurs when the outer part of the spinal disc ruptures, allowing the inner, gelatinous part of the vertebral disc to squeeze out of the annulus enclosure. It then breaks away from the fibrous enclosure and pushes out beyond the disc and the supporting ligaments. In other words, a disc extrusion occurs when the nucleus leaks out. [See the image below]
The reason for the pain is really quite simple, both in protrusions and in extrusions. As the inner material causes a bulge or actually leaks out, it comes in contact with one or several of the surrounding spinal nerves. This bulging or extruding then places a slight amount of pressure on these nerves, causing the pain. As mentioned above, these nerves are extremely sensitive; so, it does not take much contact to cause a patient excruciating pain.
However, both disc protrusions and disc extrusions can occur without symptoms. If the gelatinous material does not press on any soft tissue or nerves that are nearby, there may be no indication of a problem, nor any pain.
A sequestrated disc—also referred to as a free disc fragment—corresponds to extruded disc material that has broken away from the parent disc and has begun to move away from the site of extrusion. By definition, it is considered a subtype of disc extrusion.
In a disc sequestration, the inner gel extrudes so far through the outer wall of the disc that it breaks off and begins to float freely around the spinal area. Like a protrusion and a extrusion, this can be extremely painful if the freed piece comes in contact with soft tissue or a spinal nerve.
Disc sequestration almost always requires surgery to find and remove to the floating piece.
An X-ray, CT scan, or MRI is needed in order to properly diagnosis whether the pain is from a disc protrusion, disc extrusion, or disc sequestration. These imaging devices create a clear image of the spinal disc, which can be extremely helpful is identifying the shape of the injury.
If pain persists, the use of Electromyography (EMG) may be able to pinpoint the exact nerve being irritated. An EMG assesses the electrical activity of a nerve root, which can pinpoint pain, even when a scan does not reveal an exact issue. These tests are not very effective at detecting compression or herniation, but they can be helpful in finding other nerve damage causing pain in the spine. Bone scans can reveal any abnormal bone activity if the problem cannot be found in scans or using an EMG.
Conservative treatment options involve rest, anti-inflammatory medications, ice and/or heat, and physical therapy. If pain continues, epidural or nerve block injections may be useful in treating and diagnosing the cause of pain. Alternative methods such as massage therapy, acupuncture, and chiropractics may also valuable tools to gain relief.
The most important factor to stop pain from protruded or extruded discs is in the diagnosis. Just because an individual has back pain does not mean there is a problem with the disc. Conversely, just because there is a problem with the disc does not mean there will be back pain. If you have been injured in a collision or slip and fall accident, seek quality medical treatment through qualified medical health care providers.
At Dolman Law Group, we will fight on behalf of our clients to hold the negligent party responsible for your injury. Call us today to schedule a free consultation with an experienced personal injury attorney at 727-451-6900.