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Collapsed Disc

Collapsed Disc

Introduction

The spine is made up of vertebral bones that appear to be in a stack-like position. In between these individual vertebrae bodies are discs that act as cushions for the spine or “shock absorbers”. They are responsible for minimizing the friction in between the vertebral bones and allowing motion for the spine.

The disc appears to be like a jelly doughnut where there are two components: the inner core and outer core. The inner core is also known as nucleus pulposus, while the outer core is called annulus fibrosus. Both are made up of water, collagen and proteoglycans, but fluid content is much higher in the inner core.

Due to a variety of reasons – the natural process of aging being the most common one – the discs can degenerate. When axial load is applied to the spine, the inner core squeezes out toward the outer wall, but the tough exterior pushes the inner core back into place to re-establish the height and shape of the disc. Overtime, the elasticity of the disc decreases due to natural wear and tear until finally, the outer layer can no longer push the disc back into place. This can lead to a bulging disc condition or diminished height.

A collapsed disc condition is the loss of the spinal disc’s normal height due to deterioration. It is most common in the regions that involve more motion such as the cervical and lumbar region of the spine. Although it is often asymptotic, sometimes it can cause excruciating symptoms. This usually happens when the collapsed disc inflames a nearby spinal nerve root or the spinal cord.

Causes

There are several causes that can contribute to the development of a collapsed disc condition. The following are examples of these causes:

  • Aging

Just like every other degenerative spine condition, the natural process of aging is the most common cause for the development of a collapsed disc. Overtime, the discs loses water content – making it brittle and less flexible. They’re meant to absorb the shock, acting like cushions for the spine, but they tend to lose their elasticity overtime which increases their overall vulnerability. When this happens, the natural wear and tear from day-to-day activities can make it vulnerable to tears and bulging. Eventually, this can lead to diminished height or collapsed disc condition.

  • Weight

Another cause for a collapsed disc condition is over weight problems. Our spine is primarily responsible for support of our upper body weight. A heavier weight can increase the axial load exposed on the spine. As they are already more susceptible to damage with time, over weight increases its likelihood for the disc to collapse or to flatten out. This causes it lose its normal shape which can lead to different symptoms.

  • Sports

Although aging is the most common cause for a collapsed disc condition, participating in high-impact sports can also expose the spine to forceful blows that could potentially lead to a collapsed disc condition. Certain sports can also increase the axial load placed on the spine such as the impact from high-impact sports or repetitive motions such as twisting and swinging.

Symptoms

The symptoms experienced from a collapsed disc condition can vary widely depending on the location of the affected disc and severity of the condition. Although a collapsed disc condition can often be asymptotic – no symptoms can be experienced from the condition –, it can also result to excruciating symptoms if a nearby nerve root or the spinal cord is affected.

When a collapsed disc occurs, the disc diminishes in height and so does the space that lies in between the individual vertebrae bodies. When this happens, nerve roots that are located in between the vertebral bones can become trapped and the spinal cord can also be injured. These nerve roots are connected to a certain body part, and when they are impacted they usually result to a numbness, tingling sensation or muscle weakness to the body part to which it is connected. However, aside from the nerve root and spinal cord, the collapsed disc can also inflame the outer wall which in turn causes localized pain.

Risks

Aging

Overtime, our bodies will deteriorate, our spines with all the discs and vertebrae included. Aging is the most common cause for the development of a collapsed disc condition. The discs will eventually weaken with age. They tend to get dehydrated, brittle and thin. They’re meant to absorb the shock, acting like cushions for the spine, but they tend to lose their elasticity overtime which increases their overall vulnerability. With enough pressure in the spine, this could potentially lead to a collapsed disc where the outer layer can no longer push the disc back into its original shape causing it to diminish in height. Hence, the older a person is the more prone they are to developing this condition.

Overweight

Obesity is known to cause plenty of health problems. It specifically can contribute to degenerative spine conditions. Because the spine is primarily responsible for supporting some of our body weight particularly in the upper region, the added weight adds pressure on the spinal discs. This can potentially result to a collapsed disc condition.

With age, the discs in between the vertebrae in our spine wear out. They lose their elasticity and capability to minimize friction and absorb shock from the body’s motion and weight. Added weight can increase its susceptibility to incur damages. Hence, people who are heavier are more prone to developing this degenerative spine condition.

Smoking

Smoking is dangerous to one’s health. The diseases caused by smoking are usually related to the lungs. However, smoking can also have negative effects on the spine. The discs in the spine need certain essential nutrients to keep them healthy to keep them from deteriorating faster. However, the toxins released from smoking tend to interfere with the supply of these nutrients to the discs. Hence, with an already worn out disc the lack of essential nutrients can cause the development of a collapsed disc to come earlier in life.

Physical Demands

With an already deteriorating spine due to the natural process of aging, physically demanding activities in jobs or sports can increase the risk of developing a collapsed disc. The repetitive motions and overexertion can add to the pressure placed on the discs and accelerate the deteriorating process that may lead to a collapsed disc condition.

Prevention

Although the most common cause for collapsed disc is the natural process of aging, which is an inevitable process, there are still plenty of things that one can do to slow down the degeneration of the spinal components.

  • Healthy Diet

Keeping a well-balanced diet delays the development of the degenerating process. Being overweight is one of the risk factors of developing a collapsed disc. The added weight increases the axial load on the spine that can lead to collapsed disc. Hence, avoiding those unhealthy pounds by maintaining a balanced diet is key to delaying the development of it.

  • Stop Smoking

Smoking impedes the nutrient cycle of the discs in the spine because of the toxins it releases in the body. As the discs are already prone to deteriorate overtime, cutting off its nutrient supply will increase the vulnerability of the discs. Hence, stopping the habit allows the normal circulation to flow, providing the essential nutrients to the spine therefore strengthening the discs to avoid tears from occurring that can accelerate the degenerating process.

  • Low impact Exercises

Exercising strengthens the muscles to remove unwanted pressure from the spine. There are various stretches and exercises that decompress the spine. Therefore, loosen the pressure from the discs by allowing more space in between vertebrae. It is best to consult an expert to ensure that the exercises do not aggravate the pressure on the spine.

Treatment

Usually, before surgical treatment is considered patients are asked to focus on conservative treatments as these can be sufficient to alleviate the symptoms of a collapsed disc condition. Rarely, in extreme cases are surgical treatments immediately recommended. However, after several months of conservative treatments and symptoms still persist then surgical procedures are considered.

Conservative Treatment

The following are example of conservative treatment given to patients who suffer from a collapsed disc condition:

  • Medications

Nonsteroidal anti-inflammatory drugs (NSAIDs) and analgesics (pain relievers) are over-the-counter medicines usually prescribed by the physician to reduce pain and other symptoms such as burning sensations, numbness and muscle weakness. NSAIDs will fully or partially remove the inflammation to alleviate the excruciating symptoms. However, patient’s whose medical history involves cardiovascular or gastrointestinal conditions will not be advised to take these medicines.

Narcotics – mostly, codeine or an oxycodone-acetaminophen combination – are given once the over-the-counter medications do not relieve the patient from the pain and other symptoms. However, these medications are only administered at a certain period of time since they can be highly addictive and can cause drug abuse complications for the patient. It is important to strictly follow the physician’s instructions in taking these medications.

  • Physical Therapy

The purpose of physical therapy is to alleviate painful symptoms such as localized pain. It aims to strengthen core muscles, and restore mobility and flexibility to the spine. It involves stretches and exercises that should be developed by a licensed physical therapist. This helps remove pressure or axial load from the spine that’s causing a collapsed disc.

The treatment plan can then include, strengthening and stretching exercises, learning proper body mechanics, soft tissue massage and aerobic activities. The physical therapist can also assist a patient in adjusting certain ergonomic factors at work or at home and if needed, help the patient lose weight to improve overall spine health.

  • Heat/Ice therapy

Heat and Ice therapy is one of the conservative treatments patients do to relieve themselves of the symptoms of a collapsed disc condition.

  • Heat Therapy

It is also known as thermo therapy. It is especially helpful in treating localized pain caused by the herniated disc and muscle spasms. The heat helps blood flow and oxygen to relax the affected areas. It alleviates certain if not all discomforts caused by the disc herniation. One can use heat packs and hot towels.

  • Ice Therapy

It is also known as cryotherapy. It is especially helpful in reducing the inflammation caused by the affected nerve from the herniated disc. One can use ice or cold gel packs.

  • Heat-ice Therapy

Basically, it is a combination of both heat and ice therapies. It is reported that the combination of both is actually more effective in administering relief to the pain caused by the herniated discs. However, it is dependent on the individual as some can render more pain too since inflammation cannot be suited by heat and neither can muscle spasms.

  • Corticosteroid Injections

It is composed of steroid and anesthetic medications. It is injected near the site of the nerve that was compressed from the collapsed disc causing painful symptoms. The injection acts as a temporary numbing agent and can help reduce inflammation. It can provide relief from symptoms for weeks and even months. The situation can vary for every patient.

Other alternative treatments may involve:

  • Yoga or Pilates
  • Acupuncture
  • Herbal supplements
  • Chiropractic care
  • Heat Massage

Surgical Treatment

There are two kinds of surgery that a patient can choose from an open back surgery and minimally invasive surgery.

  • Open Spine Surgery

The traditional procedure performed for a collapsed disc condition is an open spine surgery. The surgery involves large incisions in the neck or back. It involves an incision that is about six to eight inches to reach the infected area of the spinal column. The following procedures can be done during the open spine surgery:

  • Laminectomy — this procedure involves the removal of the lamina of one or more vertebrae, to relieve pressure in the spinal canal and/or to gain access to the damaged disc.
  • Spinal fusion — this procedure involves the union of two or more vertebrae, in order to stabilize the spine and restrict spinal movement. This is done to reduce pain caused by movement. During which time, one or more discs are completely removed. After that, bone chips are placed in the space occupied by the removed disc. The vertebra is fixed in position using metal screws.
  • Open discectomy — this procedure involves removing the damaged disc tissue. After that, a spinal fusion or artificial disc replacement is performed.

The recovery process can take several months. This operation however has a high risk for infection, excessive bleeding, affected muscles from incision and failed back surgery syndrome (FBSS). FBSS is the continuing occurrence or worsening of symptoms after the surgery and may even require further surgery.

The pros for this kind of surgery that more surgeons are accustomed to performing it since it is the traditional treatment. The surgeon also has a clear visual of the spine and allows multiple operations on the spine. Therefore this procedure is recommended for those with multiple spine problems.

  • Minimally-invasive surgery

This is an outpatient procedure. Unlike the open spine surgery it only makes a small incision in the neck or back usually about an inch only. Multiple tubes are inserted carefully so not to affect the muscles and tissues. These tubes serve as funnel through which surgical tools and a camera are inserted.

During the procedure specifically discectomy, the collapsed disc is removed partially to remove pressure from the compressed nerve all the while maintaining the structure and stability of the spine. However, a disc severely damaged, will require a stabilization procedure to go with the discectomy procedure. In this procedure, the damaged disc is fully removed and replaced with an artificial disc or bone grafts. Proper height is restored, thus improving the stability of the spine while relieving compression from the nerve root.

Recovery

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