Herniated disc, also known as a slipped disc, is a condition in which the cushion-like disc between the vertebrae in the spine bulges out of its normal position and puts pressure on the nerves and spinal cord. It is most commonly found in the lower back and is referred to by the affected vertebrae. For example, if the disc between the 4th and 5th vertebrae slips out of place, it is known as an L4-5 herniated disc. If the pain extends to the right leg, it is referred to as a right L4-5 herniated disc, and if it extends to the left leg, it is referred to as a left L4-5 herniated disc.

Treatment for herniated discs can be divided into two categories:

a) Early-stage herniated discs b) Advanced-stage herniated discs

The treatment for each stage is different, so an accurate diagnosis is crucial for proper treatment.

EARLY-STAGE HERNIATED DISCS

In the early stage of herniated discs, the disc has not yet ruptured the surrounding capsule. Therefore, it presses against the nerve like a balloon (see image 3). The patient experiences only back and leg pain, with no reflex loss or leg weakness. In this stage, it is not appropriate to immediately perform open surgery without trying other treatment methods first.

Our first choice of treatment is MANUAL THERAPY, in which lumbar traction, or spinal decompression therapy, is performed. If this method is insufficient, we recommend laser-assisted minimally invasive herniated disc surgery for our patients.

We have observed that Turkish people tend to consult doctors less frequently in the early stage of herniated discs. Instead, they often use home remedies or seek help from traditional “back pullers” in their neighborhoods. As a result, they tend to consult doctors only when the condition has progressed to an advanced stage.

ADVANCED-STAGE HERNIATED DISCS

In the advanced stage of herniated discs, the disc has ruptured the surrounding capsule and protruded into the spinal canal. The displaced piece presses against the nerve and causes severe pain. At this stage, the condition is irreversible because we cannot eliminate the displaced piece of disc in the spinal canal with medication or manual therapy. Especially if there is leg weakness, we recommend microsurgery, which involves only two stitches, without delay.

In advanced cases of herniated discs, we can see the displaced piece of disc pressing against the nerve in the spinal canal. This is called an extruded disc herniation in medical terms. If the word “extruded” appears in your MRI report, it means that your condition has reached an advanced stage.

DIAGNOSIS:

Symptoms:

Patients with herniated discs experience pain that radiates from their lower back to their buttocks and legs. The pain may extend all the way to the heel and toes. The pain tends to increase when the patient coughs or strains. This is an important sign for diagnosing herniated discs.

Some patients report feeling as though their leg is being pulled by a rope from the back. The patient may lean to one side due to pain.

Numbness may occur while standing. In some cases, the patient may begin to experience weakness in the ankle. Patients may complain of their ankles turning when walking over small obstacles.

In advanced cases, patients may experience difficulty with urination or incontinence. Sexual function can also be negatively affected, particularly in men, who may experience difficulty achieving an erection.

IMPORTANT NOTE: If a patient experiences a sudden onset of ankle paralysis or urinary retention (inability to urinate), they should be operated on within the first 6 hours. This 6-hour period is called the GOLDEN PERIOD,