Herniated disc: How radiology helps with diagnosis and treatment

A herniated disc is often perceived as a sudden occurrence, but is usually the result of a gradual process of wear and tear on the spine. An accurate diagnosis is essential to finding the best possible treatment. This is where modern imaging techniques such as MRI come into play, providing precise information and enabling targeted treatment.

Find out what a herniated disc is, how radiology helps with diagnosis, and what treatment options are available.

Intervertebral discs act as ‘shock absorbers’ between the vertebrae of the spine. In the case of a slipped disc (medical term: disc prolapse), the soft centre of the disc pushes through the protective fibrous ring and may press on surrounding nerves.

The main cause is wear and tear on the annulus fibrosus, which loses elasticity and water content with age. This leads to tears in the annulus fibrosus, allowing the nucleus to protrude. Strenuous activities such as sitting for long periods, heavy lifting,

The signs of a slipped disc vary depending on the severity and location. Common symptoms include:

• Back pain, which may also radiate to other parts of the body.
• Reduced mobility or muscle stiffness.
• Numbness or tingling, particularly in the arms or legs.
• Loss of strength in the affected limbs.

Magnetic resonance imaging (MRI) is regarded as the standard method for diagnosing a herniated disc. It provides a precise image of the spine, including the intervertebral discs, nerves and surrounding structures.

MRI vs. X-ray and CT

• MRI: Uses magnetic fields instead of radiation and provides particularly detailed images of soft tissues.

• X-ray: Primarily shows changes in bone, but is less effective at visualising the intervertebral discs.

• CT: Uses X-rays but provides sharper images of bones and, to some extent, intervertebral discs.

Thanks to this imaging, it is possible to determine the extent to which the intervertebral disc has shifted, which nerves are affected and which treatment options are most appropriate.

An effective method of pain relief for a herniated disc is periradicular therapy (PRT). This minimally invasive pain treatment is carried out under CT guidance to target the affected nerve tissue.

The PRT procedure

1. Precise localisation: CT is used to identify the affected nerve exactly.

2. Local anaesthesia: The affected area is numbed with a local anaesthetic.

3. Medication injection: A pain-relieving and anti-inflammatory medication is injected directly into the affected area.

PRT not only reduces acute pain, but also combats inflammation and improves mobility. Several sessions are often necessary to achieve a lasting effect.

PRT at our clinics

We offer periradicular therapy at our radiology practices at MVZ Dr Neumaier in Regensburg and Amberg. Please note that a doctor’s referral specifying ‘pain therapy’ is required for the treatment costs to be covered by statutory health insurance schemes.

Thanks to modern diagnostic techniques such as MRI, we can accurately diagnose herniated discs and treat them on a case-by-case basis. Whether for imaging or to carry out a PRT, our experienced radiologists are here to support you.