• August 21st, 2024

Herniated disk: risk factors and prevention

Dr. Ana Maria Ioniță, neurosurgeon, answers the most frequently asked questions about herniated disks; its causes and prevention. If you have any questions related to herniated disk, you can discuss them with Dr. Ioniță in an onlineconsultation.

"The spine is formed by the overlap of vertebrae which are made up of the vertebral body (the front cylindrical part) and the back part, made up of a circular arc. By overlapping the arcs of the posterior/back, the spinal canal is formed through which the spinal cord passes. In the front/anterior part, the vertebral bodies have between them vertebral discs (cartilaginous formations) that give mobility to the spine. Sometimes, it can happen that one of these intervertebral discs breaks and fragments of it migrate posteriorly towards the spinal cord or to the side of the canal where the spinal nerves are located (they have the role of controlling the whole body from a motor and sensory point of view ). If something like this happens, it means that the disc fragment that has reached this posterior area compresses the spinal nerve or even the spinal cord, which translates into motor and sensory impairment of a part of the body or the whole body", explains dr Ioniță.

Risk factors of herniated disk

1. Mechanical factors – lifting very heavy weights can lead to increased compression of the intervertebral discs and the migration of some fragments to the spinal nerves.

2. Dehydration – discs are made up mostly of water; intervertebral discs are made up of collagen proteoglycans that hold water. 

3. Aging - can cause collagen levels to drop resulting in a decrease of water levels and the core of these discs to break down.

4. Smoking influences the degree of hydration of the intervertebral discs, as tobacco causes the constriction of blood vessels, and the body gives more water to the intervertebral discs.

5. Prolonged sitting, sedentarism. Herniated disk is quite common in those who sit a lot at their office desk, those who do not exercise, and professional drivers. The spine is loaded with weight and compression occurs that limits mobility and over time can lead to a ruptured intervertebral disc.

6. Genetic factors. Patients who have genetic diseases that affect the quality of collagen may have more or less laxity of the spine and damage to the intervertebral discs, for example patients with Ehlers-Danlos disease are likely to experience disc herniation more quickly.

Symptoms of herniated disk

a. Cervical hernias give pain in the posterior neck, with migration to the hands.

 b. Thoracic hernias hurt in the belt, the pain migrating intercostal; the pain starts in the back and goes in the front between the ribs.

 c. Lumbar hernias hurt in the back area, the lower part, the pain usually migrates to one of the legs or even to both.

 d. Any type of hernia causes tingling and numbness along the path of the affected nerve.

 e. Hernias also cause motor deficits, the nerve segment compressed by the hernia no longer does its job affecting the adjacent muscles, the patient no longer has strength in the hand/hands or in the leg/feet, etc.

Clinical investigations should be done as soon as the pain appears. The more the medical appointment is delayed the more difficult the treatment could be. "Usually, when a motor deficit also sets in, once it has set in, the possibility of returning to a healthy form, postoperatively, is quite small, the recovery can be quite difficult, and the patient can even remain paralyzed for the rest of his/her life ”, says dr Ioniță.

Prevention is much better than intervention

• Avoid lifting very heavy weights

• Lift weights correctly. Do not lean forward with all your body to lift a weight from the bottom, but squat down slightly, grab the weight and lift it by contracting the abdominal muscles very well to protect the spine as much as possible.

• If you have no training, do not lift more than 5 kg at a time.

• If you sit at your desk a lot, do you get up from time to time and do a little movements to relax your spine muscles.

• People who are overweight should lose weight, because the extra pounds lead to axial loading and damage to the spine.

• Hydrate properly and quit smoking!

If you want to know more about herniated disk you can quickly get an answer through an online consultation without the need to go to a doctor's office. The doctor can assess your symptoms and recommend what investigations are needed (CT or MRI) and could also look at the investigations that you have already done, may refer you to the emergency room or recommend that you go to a neurologist or neurosurgeon for a full neurosurgical evaluation. So, instead of searching on Google when you have a minor accident, it is better to ask a doctor online in the first place.

Keep in mind

• Herniated disk target any segment of the spine (neck/cervical, thoracic or lumbar).

• The most common herniated disk are at the lumbar level. All hernias, in addition to pain, are accompanied by numbness and tingling along the path of the affected nerve, so the patient may have numb fingers or toes.

• If you want to have a second opinion of a diagnosis you already have, you are just a click away from an online consultation with a neurosurgeon.

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