Specialist for the Treatment of Disc Prolapse in Munich

The cushion between the bodies of each vertebra is known as an intervertebral disc. These discs might seem insignificant, but they play a major role in the way the human body functions. They are responsible for absorbing the pressure and impact that the body gets subjected to as a result of movement. This cushion helps to keep the vertebrae from rubbing against each other. Intervertebral discs are the biggest structures in the body that do not have a circulatory supply.

As spinal discs bear the weight and impact the body makes with every movement, they can get damaged over time. Depending on the type of damage, issues with spinal discs are known as Disc Prolapse, Herniated Disc, or Slipped Disc.

What is a disc prolapse?


Medical graphics: Protruded intervertebral disc

Any issue associated with one of the elastic pads known as spinal discs gets referred to as a disc prolapse or a herniated disc. Herniated discs can cause pain and other symptoms.

Every spinal disc has two main parts. The nucleus pulposus is the jelly-like interior of a spinal disc, while the annulus fibrosus is the stiff outer layer.

What happens in a spinal disc herniation?

Disc prolapses occur when a part of the disc’s nucleus pulposus protrudes via a rip in the annulus fibrosus. This issue is also known as spinal disc herniation or slipped disc. Moreover, when the tough outer fibers of an intervertebral disc are damaged, a condition known as a prolapse can develop.

The lower back is where a herniated disc is most likely to occur, even though it can happen anywhere along the spine. A prolapse of the disc can cause discomfort, numbness, or weakening in an arm or leg, but it will vary depending on the location of the spinal disc herniation.

The contents of a prolapsed disc or a ruptured disc can reach the spinal canal. This situation can happen when they compress the spinal cord or, more commonly, the spinal nerves, causing more pain to the individual.

What are the symptoms of spinal disc herniation or prolapse?

Schmerzen Lendenwirbelsäule

Lumbar spine pain

When excessive strain on the discs is present between the vertebrae, it might abruptly result in disc prolapse. A herniated disc can come from many factors, including twisting and turning while carrying large and heavy items or lifting with the back muscles rather than the leg and thigh muscles. Although infrequent, the condition can also occur due to a traumatic experience like a fall or a shock to the back. Disc degeneration is the steady damage to the discs that occurs naturally with aging.

As humans age, the discs become less elastic and are more likely to tear or rupture when subjected to a mild strain or torque. This issue increases the risk of back pain. It is also possible for intervertebral discs to burst as a consequence of the outer fibers of the disc weakening. The result makes a series of relatively minor injuries accumulated over time into one painful and potentially chronic problem. You can bring on this damage by getting older, genetics, or activities associated with work or leisure.

Disc prolapse can result in two main problems.

  • Direct compression: Direct compression happens when the fluid from the burst disc has made its way into the spinal canal or the intervertebral foramen, which can put the nerves under pressure.
  • Irritation caused by chemicals: After the disc ruptures, the substance at its center might irritate the nerve roots, which can cause discomfort.

Problems with the functioning of the nerve root can be caused by a combination of factors, including irritation from chemicals and stress on the nerve root.

The symptoms of a slipped disc

Behandlungsbeispiel Akupunktur

Treatment example: Patient acupuncture

The neck is another possible location for a herniated disc, although the lower back is where they are most common. While back and neck pain is a typical symptom, some people who have a herniated disc or a prolapse of the disc will not experience any discomfort in those areas. The symptoms of a slipped disc differ depending on the disc’s site and if the disc is pushing on a nerve.

  • Pain in the arms or legs if the herniated disc is in the lower back. The patient may, in addition to experiencing pain in the lower back, also experience discomfort in the buttocks, thighs, calves, and sometimes, even the foot.
  • Shoulder and arm discomfort are the most prominent symptoms associated with a herniated disc in the cervical region. This pain may shoot into the arm or leg when coughing, sneezing, or even moving in certain situations. Sharp or searing is a common way to describe the sensation of pain.
  • A sense of numbness or tingling in the area of the body that gets serviced by the nerves.
  • Weakness caused by damaged nerves. Damaged nerves typically cause a weakening in the muscles that they serve. This option may lead the individual to fall or impair their ability to lift or grasp objects, which could result in injury.
  • In serious conditions, sterility in men, numbness in the genital region, and loss of control of the bladder and bowels.
  • A herniated disc or a disc prolapse can exist without any associated symptoms. This diagnosis might not be detected until a spinal picture reveals its presence.

Expert advice:

<<In Germany there are too many operations for spinal conditions. This often occurs if a patient goes directly to a doctor who performs operations himself or if he refers the patient to a surgeon. In interdisciplinary centres, however, doctors of different specialist fields discuss the best treatment together. Colleagues of different specialist fields consider whether an intervention is actually necessary. We know that acute back pain often gets better spontaneously, or can be successfully treated with conservative or at the very least minimally-invasive treatment methods. >>  –  Dr. med. Reinhard Schneiderhan

Spinal catheter technique according to Dr Schneiderhan

Beweglicher Katheter - Kathetermethode nach Dr. Schneiderhan

Spinal cord endoscopy (elastic catheter)

Dr Schneiderhan further developed the spinal catheter technique according to Prof. Dr Racz. With this special stretchy catheter, we are able to treat precisely the affected nerve root, alleviating pain rapidly and in a targeted way. As pioneers in Germany of this minimally-invasive treatment method, which is now recognised worldwide, we offer our patients the highest level of expertise, as we have been performing most operations of this type in Europe for many years.


An imaging test called a discogram, often known as a discography, assesses back discomfort. The doctor may use a discogram to establish whether a particular problematic disc is causing you back pain in the spine.

A discogram involves injecting dye within one or more discs’ soft centers. Quite often, the injection causes the back discomfort to return. The dye also penetrates any external fissures on the disc, which are visible on an X-ray or CT scan.

Epidural Injections

A strong anti-inflammatory gets delivered to the location of the spinal nerve impingement via epidural steroid injections. Volume and concentration can change depending on the severity of the condition. In patients with a new disc herniation who respond well, epidural steroid injections can help to relieve pain permanently. The desired duration is three to six months for individuals with persistent pain or recurrent spinal disc herniations.

Periradicular Therapy or PRT

Periradicular therapy or PRT can alleviate the chronic pain brought on by degenerative disorders of the spine, particularly those that affect the cervical and lumbar regions. During the PRT procedure, a thin needle is moved near a nerve root in the spine while the patient gets monitored by computed tomography. After determining the region where the drug must get injected, the doctor inserts the needle to a predetermined depth to deliver the treatment to the affected nerves in the shortest feasible distance.


Physical therapy is largely successful for rehabilitating from a herniated disc or a disc prolapse. Its techniques provide instantaneous pain management and instruct on how to prepare the body to prevent future injuries.

Therefore, physical therapy can be useful to protect your body long after the injury subsides.

You can take a wide range of approaches to physical therapy. Deep tissue massage, thermal therapy using heat or cold, electrical stimulation using devices like TENS, and hydrotherapy are all passive treatments that calm the body. In most cases, the passive treatment component of the physical therapy program will come first. However, the next step will be active treatment once the body has healed.

When must the prolapse be treated surgically?

Physiotherapie am Patienten

Example of treatment: Physiotherapy on the patient

Surgery for a prolapsed disc has the potential to provide pain relief more quickly than non-surgical therapy. But, it is one of the last options most people and medical professionals undertake. Surgery usually gets scheduled when previous treatments have not successfully relieved continued symptoms and made it difficult to participate in daily activities.

  • With cervical disc herniation, surgery gets initiated after six months of non-responsive symptoms.
  • Failure of conservative therapy or worsening neurological symptoms is the reason for surgery in thoracic disc herniation. Even without neurological symptoms, surgery may benefit massive myelopathy signals on MRI.
  • Surgery for lumbar disc herniation gets initiated if MRI confirms the condition and conservative treatment fails after six weeks.



How to prevent spinal herniation

The best way to prevent spinal disc herniation is to develop strong back muscles. In doing so there are five important prevention measures. To avoid getting a herniated disc, be mindful of the following.

  1. Lift loads in a back-friendly way: Do not lift heavy objects with a bent back, but by bending the knees with a straight upper body
  2. Exercise: Strong back muscles relieve the spine. Cycling or swimming are particularly back-friendly sports
  3. The right mattress: A good and individually selected mattress helps you to stabilise the spine at night
  4. Ergonomic workplace: Those who need to sit for long periods in their job should make sure that their workplace is as back-friendly and adaptable as possible. This includes an ergonomic desk chair and standing up frequently
  5. Avoid excess weight: A healthy body weight relieves the spine


The spine and intervertebral discs are the body’s weight bearer and shock-absorber. It also contains the nerves that help in the body’s normal functioning. It is not a light task, but it is only right to take care of it.


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from Taufkirchen on jameda

jameda review from 12/2018

Wiltrud Rakel, OP spinal canal stenosis, 2018.

"A competent and very confident statement at diagnosis, "golden hands" at surgery WS canal stenosis. Thank you Dr. Hadi for a new pain free life.

Your Wiltrud Rakel"