HERNIATED DISC: EARLY DETECTION AND EFFECTIVE MANAGEMENT (2025)

Herniated disc cases are on the rise and showing a trend of affecting younger people. Currently, the condition is most commonly seen in people aged 30–50 years. Typical symptoms include numbness in the limbs, neck and shoulder pain, or lower back pain. The pain may radiate to the arms, hands, fingers, buttocks, thighs, lower legs, or feet. So, what are the treatment options for herniated discs? When should surgery be considered?

• Sitting in the same posture for an extended period of time

• Overweight

• Lifting heavy objects

• Repetitive movements such as twisting or rotating the torso, usually seen in certain works, sports or hobbies.

• Genetic predisposition

• Back pain

• Tingling or numbness in the lower limbs

• Muscle weakness in severe cases

• Pain between the shoulder blades

• Radiating pain to the shoulders, arms, sometimes hands, and fingers

• Neck pain, particularly at the back or on the sides of the neck

• Increasing pain with neck bending forward or rotating

• Paresthesia or numbness in the upper arms

• Magnetic Resonance Imaging (MRI): The most accurate and widely used diagnostic method to determine the location, shape, number of affected spinal levels, and degree of nerve compression caused by the herniated disc.

• X-ray: Helps identify spinal conditions such as degeneration, vertebral compression, slippage, or foraminal stenosis, etc.

• Computed Tomography (CT scan): Provides detailed images of the spinal structure and is an alternative for patients who cannot undergo an MRI.

• Electromyography (EMG): Measures the electrical activity of muscles and the nerves controlling them, helping diagnose muscle dysfunction and identifying which nerves are affected by the herniated disc.

► Treatment for herniated discs

• Medication: The doctor may prescribe painkillers, anti-inflammatory drugs, muscle relaxants, etc.

• Physical therapy: The physical therapist will guide patients through exercises to reduce pressure on the nerves, relax tight muscles and improve circulation.

• Selective root block injection: A medicine will be injected to the epidural space under C-arm guidance in an operation room. The injection helps reduce swelling and nerve inflammation as a result of disc hernia, promoting faster recovery and improved mobility.

• Surgery: The decision to proceed with herniated disc surgery will depend on the severity of the injury, location, complication as well as its impact on patient’s mobility, work and daily activities.

• No improvement after 6-8 weeks of medical treatment.

• Sudden pain in the herniated area, accompanied by severe pain that persists despite various conservative treatments.

• Loss of bladder control, also known as Cauda Equina Syndrome (CES) - a condition where the bundle of nerves at the base of the spine is compressed, affecting movement, bladder, rectum function or sensation to the lower limbs.

►Prevention of Herniated Discs

• Maintain proper posture when lifting heavy objects: Avoid bending at the waist; instead, bend at the knees while keeping your back straight. Use the leg muscles to support the weight.

• Keep a healthy weight: Excess weight places pressure on the spine.

• Maintain correct spinal posture in daily activities: Proper posture when walking, sitting, standing, and sleeping reduces stress on the spine.

• Avoid staying in one position for too long: Changing positions frequently like standing up and stretching can help relieve muscle tension after prolonged sitting.

• Avoid wearing high heels: High heels can increase muscle strain, spinal pressure, and the risk of disc herniation.

• Exercise regularly: Focus on strengthening the back and abdominal muscles to support the spine and enhance joint flexibility.

• Avoid smoking: Smoking can weaken spinal discs, making them more vulnerable to damage and herniation.