All About Ruptured Discs. Causes, Symptoms, Treatments, And More

Most people are familiar with what doctors call a  herniated disc or bulging disc. But there is another diagnosis- ruptured disc. The term “ruptured” disc is sometimes used interchangeably with herniated or bulging disc, while some doctors believe it is a subtype of a herniated disc. Regardless of being labeled in different ways, a ruptured disc can cause a lot of symptoms and requires treatment. This article is all about ruptured discs including the causes, symptoms, treatment, and outlook of this condition.  

Herniated  disc vs ruptured disc 

Some health experts like radiologists or chiropractors recognize that a ruptured disc is in fact, a special form of a herniated disc. Here is the difference between a ruptured disc and a regular herniated disc.

Herniated discs develop when the soft,  inner part of the disc called the nucleus pushes through a weak spot in the tougher outer layer called the annulus. 

A ruptured disc occurs when there is a full tear in the annulus and the central material is pushed out in the spinal column. 


Ruptured disc symptoms

Herniated discs may not cause any symptoms and the problem and resolve on their own.  In other cases, the herniated or ruptured discs can compress the nearby nerves and cause symptoms that limit day-to-day activities and overall quality of life. Symptoms such as pain, weakness, numbness, and tingling. Most herniated and ruptured discs develop in the low back. The neck is another part of the spine that is mobile, and thus more prone to disc herniation. 

If the affected disc is in the lower spine, the pain is experienced in the buttocks and may be irradiated to the thigh, calf, and parts of the foot. If the neck is affected, the pain is in the shoulder and arm. The pain may worsen with coughing, sneezing, and moving in certain positions and can be very intense, described as having a sharp shooting quality. 

Numbness and tingling are felt in the parts of the body served by the affected nerves and the weakness will have a similar pattern. If the ruptured disc is in the low back, a person may have weakness in the legs and stumble. If the ruptured disc is in the neck, it can make a person unable to hold or lift a heavy item. 


Why do ruptured discs develop? 

Age-related degenerative changes are often involved in the development of ruptured discs. The discs also degenerate,  dry out, lose elasticity, and are more likely to crack and develop small tears. In time, these small tears can get bigger and rupture. Lifting heavy objects, twisting, and turning the spine regularly are also common causes of ruptured discs. Major trauma and injuries such as car accidents can lead to ruptured discs as well. 

Excess weight, having a job that involves a lot of lifting or twisting of the spine, smoking and certain genetic variants are considered risk factors for herniated discs.

Doctors perform a physical and neurological examination and may order X-rays, MRI, CT scans, or nerve tests like EMG (electromyography) to diagnose rupture discs. 

Ruptured discs treatment 

Most individuals with ruptured treatment can manage this condition with conservative measures and fully recover within a few weeks. Conservative treatment includes rest,  home remedies such as cold or hot applications, physiotherapy, massage therapy, and spinal manipulation. A variety of medications is available from over-the-counter acetaminophen or ibuprofen to muscle relaxers and steroid injections. Opioids are very effective but not prescribed routinely due to the risk of addiction. If opioids are recommended,  codeine or oxycodone-acetaminophen combination can be used for the short term only.  The goal of these conservative measures is to provide symptom relief and function while allowing the body to heal. 

Surgery is used as a last resort, if conservative measures do not provide enough relief, symptoms worsen and persist beyond six weeks, and the quality of life is affected due to loss of bladder or bowel control or difficulty standing or walking. Decompression surgeries like discectomy are the first choice. During this procedure, the part of the discs that irritates the nerve is removed. Full removal of the disc and spinal fusion is needed if the disc is severely damaged. In the case of spinal fusion, it takes many months to recover. Artificial disc implants are used rarely, in selected cases of ruptured discs. 

Ruptured disc outlook  

The prognosis is good in mild cases of ruptured discs, as conservative therapies lead to full recovery. Surgery is rarely needed, and the doctor will discuss both benefits and risks of various procedures. 

 In some cases ruptured discs can cause complications like bladder or bowel incontinence, saddle anesthesia (progressive loss of sensation in the rectum area,  thighs, and back of the legs), or the life-threatening condition called cauda equina which requires treatment right away to prevent paralysis. 

A healthy lifestyle including diet and exercise, weight management, avoiding smoking, and maintaining proper posture can all prevent future episodes.