Herniated disc: rheumatologist or neurosurgeon (which specialist to consult?)

You suffer from a herniated disc and you don't know which specialist to consult. This is a common problem, as there are many specialists who treat herniated discs.

In this article, we will discuss the two most common specialists: rheumatologists and neurosurgeons. We'll compare and contrast their specialties, so you can make an informed decision about which specialist to consult.

Spine Anatomy

La spine is a complex structure composed of bones, muscles, ligaments and connective tissues. It provides support to the body and protects the spinal cord. The bones of the spine are called vertebrae.

They are connected to each other by facet joints and held in place by ligaments. The muscles of the spine help move the vertebrae and protect the spinal cord.

La spinal cord is a bundle of nerves that starts from the brain and runs through the spine. It carries messages to and from the brain. The spine is an essential part of the human body and plays a vital role in protecting the nervous system.

A herniated disc what's this ? Definition

La herniated disc is a type of back injury that can be very painful. It happens when the soft, gelatinous material in the center of the disc comes out through a tear in the outer layer.

The resulting deformity can put pressure on nearby nerves, causing pain, numbness and weakness. In some extreme cases, a herniated disc can also make it difficult to urinate or pass stools.

Explanation of herniated disc

The discs in your spine are made up of two layers: a tough outer layer and a soft inner layer. The inner layer is filled with a gelatinous substance called the nucleus pulposus. This substance acts as a cushion that protects the vertebrae from shocks.

The outer layer, called the annulus fibrosis, is much stronger and helps hold the nucleus pulposus in place. When the disc is subjected to excessive stress (for example, when lifting a heavy object), the outer layer may tear.

This allows the inner layer to bulge out, forming a hernia.

A herniated disc can occur at any age, but is most common in people between the ages of 30 and 50. The risk of developing a herniated disc increases with age as the discs become less flexible and more susceptible to tearing.

Although most herniated discs heal on their own within weeks, some may require medication or surgery. By understanding how a herniated disc occurs, you can take steps to prevent this type of injury from happening in the first place.

Causes and symptoms of herniated disc

One of the causes of the herniated disc is the weakening of the center of the disc and its swelling outwards. This can be due to natural wear and tear over time or less common causes like an accident or injury.

Symptoms of a herniated disc vary depending on the location of the disc in the spine. For example, a herniated disc in the lower back can cause pain in the buttocks, legs and feet.

If the herniated disc is located in the neck, it can cause pain in the shoulder, arm and hand.

In some cases, a herniated disc can also cause numbness or weakness in those extremities. With proper care, a herniated disc usually heals within a few weeks or months.

Diagnosis: Which doctor to consult?

What does the rheumatologist ?

Le rheumatologist is responsible for the diagnosis, treatment and medical care of patients with rheumatic diseases, such as arthritis.

Its objective is to ensure the patient the best possible quality of life not only by prescribing medications, treatments or other specialized visits, but also by indicating to the patient and his family the best way to live with chronic diseases.

What are the diseases treated by the rheumatologist ?

The diseases most often treated by rheumatologist are:

• Inflammatory rheumatism, such as rheumatic fever and rheumatoid arthritis

• Connective tissue diseases, for example systemic lupus erythematosus, Sjögren's syndrome, poly myositis, dermatomyositis, scleroderma and vasculitis

• Arthritis caused by infectious agents, such as Lyme disease

• Arthropathies due to metabolic alterations, such as gout

• Spondyloarthropathies

• Degenerative diseases such as osteoarthritis (lumbar arthritis, cervical spondylosisEtc.).

• Extra-articular rheumatism, for example fibromyalgia, bursitis and periarthritis

• bone diseases, for example osteoporosis, osteomalacia and Paget's disease

• Raynaud's disease

• Rheumatic symptoms associated with other diseases

• Paraneoplastic syndromes and some tumors

What are the procedures most used by the rheumatologist ?

Le rheumatologist can use many different procedures to diagnose and treat rheumatism. Among the most used are:

• Blood tests
• Urinalysis
• Synovial fluid tests
• X-ray
• Joint ultrasound
• CT scan
• IRM
• Arthroscopy
• Capillaroscopy

He may prescribe medications and recommend rest, adequate physical activity, a balanced diet, stress reduction methods, the use of adequate sunscreen, and, if necessary, surgery.

What does the neurochirurgien ?

Le neurochirurgien is a physician specializing in the diagnosis and surgical treatment of problems affecting the central nervous system and peripheral nervous system.

What are the pathologies most often treated by the neurochirurgien ?

The pathologies to which the neurochirurgien must face are most often:

• Aneurysms

• Birth defects, e.g. vascular malformations

• Damage resulting from trauma, such as nerve damage

• Vascular disorders

• Cerebral hemorrhages

• Stroke

• Brain infections or spine

• Diseases of the nervous system such as Parkinson's disease, epilepsy, hydrocephalus

• trigeminal neuralgia

• Peripheral nerve problems, such as carpal tunnel syndrome

• Spine problems, such as degenerative diseases, vertebral fusions, injuries caused by trauma, problems caused by arthritis, fractures and intervertebral disc problems

• Central nervous system tumors, peripheral nerves and skull

What are the procedures most used by the neurochirurgien ?

There are several types of surgical approaches made by the neurochirurgien :

• Regarding neoplastic pathologies : ablation of benign and malignant cerebral neoplasms by traditional routes, minimally invasive routes;

• Vascular pathologies : microsurgical and endovascular approach (but also traditional) for the treatment of aneurysms and other vascular pathologies (cerebral hemorrhages, strokes, vascular malformations, cavernous angiomas);

• Spine pathologies: minimally invasive and percutaneous techniques (but also traditional) for the treatment of pathologies such as herniated disc, stenosis, vertebral instability, while for osteoporosis: arthrodesis of the vertebrae, discectomy, laminectomy, laminoplasty, revisions of previous arthrodeses, replacement of intervertebral discs, implantation of disc prostheses, insertion of screws and bars to improve the stability of the spine;

• Nerve pathologies : microsurgical decompression techniques for the treatment of neuropathies, rhizotomy, reconstruction and transplantation of traumatic lesions of the main nerve branches;

• Other pathologies : functional and stereotaxic neurosurgery for the surgical treatment of Parkinson's disease and movement disorders, chronic non-cancer pain, spasticity and epilepsies.

When to ask for a neurosurgical examination?

Typically, the patient is referred for a neurosurgical visit by other doctors to determine if the neurological problem requires surgery.

Other specialists involved in the management of herniated disc

The other specialists involved in the treatment of herniated discs are:

• General practitioner : for diagnosis and for the first therapeutic approach;

• Physiatrist: for the rehabilitation of patients suffering from herniated disc ;

• Radiologist: to carry out diagnostic imaging examinations such as x-rays, scanner, MRI;

• Orthopaedist: to rule out other spinal diseases such as degenerative disc disease, spondylolisthesis, spinal stenosis;

• An orthopedic surgeon which, in addition to herniated discs, treats other problems of the musculoskeletal system such as fractures, tears of ligaments and tendons, osteoarthritis;

• A physiotherapist that will help you regain your strength and range of motion through exercises and other methods;

• A chiropractor which uses manual manipulation to treat herniated discs and other musculoskeletal problems.

• Osteopath: he uses manual techniques to treat herniated discs and other musculoskeletal problems.

Choosing which specialist to see depends on the severity of your symptoms and the results of your tests. If you have severe pain or neurological deficits, you will likely be referred to a neurochirurgien.

What are the non-surgical treatments to relieve a herniated disc ?

The most common non-surgical treatments for herniated discs are:

• Rest : you may need to limit your activities for a few days or weeks;

• Ice cream : apply ice packs for 20 minutes several times a day to reduce swelling;

• Heat : apply heat packs for 20 minutes several times a day to reduce pain;

• pharmaceuticals : Over-the-counter or prescription medications such as ibuprofen, naproxen, and acetaminophen can help reduce pain and inflammation;

• Physiotherapy : exercises and other methods to help you regain your strength and mobility.