What is a herniated disc?
The spine is made up of vertebrae stacked on top of each other, with soft discs in between. The muscles of the back attach to the spine with tendons and ligaments, and there is a spinal cord in the middle of the spine made up of nerves that branch out to various parts of the body. The discs can sometimes become compressed due to injury, or long term degeneration, which caused them to bulge and rupture. When a disc extends outwards and the inner nucleus breaks through the outer wall it becomes a herniated disc and can be very painful. They’re most common in the lower back and neck area of the spine, and happen frequently after sudden impacts like car accidents and sports injuries.
Symptoms of a Herniated Disc
Herniated discs symptoms will depend on the affected part of the body. If it’s in the neck the numbness or tingling might go down to the shoulders, arms and hands, but if it’s in the lower back it would radiate down to the legs and feet. Generally though the symptoms are:
- Dull ache on one side or the other
- Numbness, tingling or burning sensation
- Trouble with balance
- Weakness in extremities
- Slower reflexes
- Bowel or bladder control issues
What happens if a herniated disc goes untreated?
The problem with delaying getting a herniated disc looked at or treated is that there is a risk of the herniated disc getting worse. A herniated disc can start out as just a mild pain and progressively grow into numbness and partial paralysis of the legs if a serious herniation goes untreated. Some patients won’t need treatment, but there’s no reason to risk the condition getting to that point.
Can a herniated disc heal completely?
Herniated disc treatment will initially begin as conservatively as possible and simply over the counter medication and some rest will probably be a viable option for recovery. However, it may take up to 6 months for a herniated disc to heal with this approach. There’s also a chance it can get worse. Physical therapy might also help, and a steroid injection at the disc area will help reduce inflammation as well as control pain while the disc heals. The ways your body can resolve a herniated disc are by utilizing an immune response to reduce the herniated disc size and remove any inflammatory proteins, or the body absorbing water from the herniated disc which will cause it to shrink and no longer exhibit symptoms.
Do you need surgery for a herniated disc?
Most of the time people suffering from a herniated disc do not require surgery, and at home remedy or mild pain management by a doctor will be all that’s needed to get back to normal. If the symptoms are particularly painful or affecting daily life you will likely undergo further testing and imaging such as MRI’s or CT scans to determine whether or not surgery is a viable option. An MRI is well suited to observe the spine and any problems happening within and will help guide your doctor when creating a treatment plan. X-ray’s are good at showing bone structure, but aren’t the best at detecting non-bony parts like spinal discs. However, they’ll still be a good complementary scan to see if it may be a problem with bones or bone structure.
Many factors go into deciding if surgery is an option such a patient’s health, age, medications, and other things that might impact surgery and the recovery process. If your doctor determines that surgery is appropriate for your condition they will discuss the process with you and what approach woks. There are a few different types of surgery such as a lumbar laminectomy, micro discectomy and laser spine surgery.
Types of Surgery for Herniated Discs
The location of a herniated disc determines the surgical approach. Herniated discs most often happen in the lumbar spine, or the cervical spine. This is the lower back (lumbar) and neck (cervical), and it just so happens these are also the locations people experience pain the most frequently. Different procedures can be performed on these locations like the laminotomy. The laminotomy removes a portion of the lamina to make room for the herniated disc and thus the nerve will no longer be pinched. Many times a discectomy is also performed with a laminotomy, wherein a surgeon will also remove the portion of the herniated disc that is extending outwards. If the spine needs to be stabilizing a spinal fusion could also be performed, which involves fusing two vertebrae together with a bone graft and metal plates and screws to keep the fusing bones in place.
Another surgery that is minimally invasive that also treats herniated discs is laser spine surgery. This type of surgery doesn’t even require cutting at all, and can be done by inserting a needle directly at the herniated disc site and shrinking it using heat. There are many benefits to this approach since recovery time will be much shorter than a traditional open surgery. There will also be little to no scarring in a laser spine procedure as compared to an open surgery, and less risks of complications.
Herniated Disc Complications
There are some serious complications of untreated herniated discs that can be alarming. It’s important to get a herniated disc checked out even if it seems mild so that you can have any serious complications ruled out by a doctor, or treated if need be. Potential complications from a herniated disc are:
- Loss of bladder control
- Permanent disability
- Permanent nerve damage
- Loss of muscle function
- Progressive pain
- Loss of sensation around the thighs
Preventing a Herniated Disc
The best way to avoid any pain from a herniated disc is avoiding the herniated disc itself. If you had a herniated disc in the past and want to prevent getting another one there are definitely a few things you can do to reduce the risk further herniations. Bend with the knees might be something your mom always told you, but it will truly help if you are used to lifting at the waist. It’s much better to use leg muscles to lift than putting the extra strain on your back that could, over time, cause an injury. Maintaining a healthy weight will also help relieve pressure on your back every day, as well as keeping your posture upright and in an ideal position to relieve back pain. Stretching and exercising regularly are integral if you sit for a long period of time. Strengthening the back and abdomen muscles will help support the spine. If you smoke then stopping smoking is something beneficial to the spine since it weakens discs and increases the risk of experiencing a pinched nerve.