Back pain that radiates into the leg or arm can indicate a herniated disc. The intervertebral discs are located between the vertebral bodies of the spine. They consist of an elastic outer layer of fibrous cartilage and a gel-like core (nucleus pulposus). In a herniated disc, disc tissue protrudes out from between the vertebral bodies. This “herniated” tissue can press on nerves in the spinal canal that supply the arms or legs (sciatic pain). With stronger compression of the nerves, sensory disturbances (tingling, numbness) or paralysis (for example, weakness in lifting the foot, causing the foot to “drop”) can occur in the affected leg or arm. However, not every herniated disc needs to be treated or even operated on. MRI studies in older adults show that about a quarter of those examined have disc damage without any symptoms.
Acute treatment of herniated discs is usually conservative: medications administered orally, intravenously, or in a targeted manner at the affected nerve (X-ray-guided PRT, periradicular therapy), usually combined with physical measures such as physiotherapy. Surgery is indicated in the case of weakness in the affected limb caused by nerve compression, but can also be advisable for chronic pain that has not sufficiently improved with conservative treatment. Removal of the herniated disc tissue is performed microsurgically and minimally invasively, meaning that through a focused surgical access route, usually only a few centimeters in size, the compressed nerve is specifically freed while maximally preserving the bone, muscles, and ligaments of the spine.