Discopathy is referred to as discopathy when there is an alteration in the thickness or position of the intervertebral discs, small circular structures placed between one vertebra and another designed to cushion and distribute the stress resulting from body movements.
As Dr. Francesco Costa, neurosurgeon of Humanitas, explains, the alterations to discs can be due to various causes: traumas such as accidents or small repeated traumas linked to the intensive practice of sports activities such as running, basketball and volleyball; sedentary lifestyle and aging.
There are two discopathies: the disc protrusion and the disc herniation.
What is disc protrusion?
The protrusion is the most common discopathy and it is characterized by a release of the disc from its natural space and the invasion of the surrounding tissue, up to the contact with the nearby nerve roots. This can occur when the disc loses thickness or dehydrates. The protrusion causes a pain that can radiate along the sciatic nerve (in the posterior part of the leg), or along the crural nerve, involving the thigh in the anterior part and the groin.
The diagnosis is made during a specialist examination, which can also include magnetic resonance imaging.
What to do in case of protrusion?
The therapy is initially conservative by prescription; during the acute phase, pain and inflammation must be eliminated by taking analgesic drugs (such as paracetamol), anti-inflammatory drugs or cortisone. In general, your doctor will also prescribe a muscle relaxant to relax your muscles.
In the acute phase, relying on osteopathy or chiropractic can also help to alleviate symptoms and accelerate recovery; these practices alone, however, are not enough and do not replace gymnastics (postural gymnastics, Feldenkreis method, Pilates, yoga) needed in a second phase and fundamental to avoid relapses.
Among the options to combat pain, there is also ozone therapy: it is an infiltration of a mixture of oxygen and ozone that is injected into the muscular planes or near the vertebral foramen, the channel containing the spinal cord. Ozone therapy disinfects and reduces the volume of the disc, allowing it to return from protrusion. It is an effective treatment, but just like other percutaneous infiltrative techniques, it does not definitively solve the problem on the disc and at the moment there are no studies that prove its greater effectiveness compared to other treatments.
If the deterioration of the disc leads to the rupture of the disc, the pulpy core escapes and invades the surrounding space, compressing the nerve roots, causing inflammation and pain.
The treatment of the herniated disc depends on the situation: in some cases no operation is required, but it is sufficient to proceed as with a protrusion: drug therapy, manipulative treatments and gymnastics.
If the hernia is of medium size, a conservative approach is first chosen, but the results are closely monitored. If, after 6-7 months, the desired improvements have not been achieved and the hernia has not been resolved, the neurosurgeon may opt for its removal.
In other, more rare cases, an operation is necessary. These are the cases in which there is an interest in the motor nerve, which leads to disturbances in the sensitivity and strength of the feet. The procedure is carried out under general anesthesia and requires a short stay, usually one night in hospital. About a month after surgery, the patient must dedicate himself to gymnastics to strengthen the muscles of the central part of the body that give stability to the spine.