AllSpine

COULD YOUR BACK PAIN BE A HERNIATED DISC? TREATMENT, SYMPTOMS AND FACTS!

Back pain due to a herniated disc is so common that it is now considered a worldwide health problem! In the United States, nearly 2% to 3% of the adult population suffers from the condition. And, it’s not an age-related problem.

In fact, you are more likely to suffer from a herniated disc between 30 to 50 years of age than after your 70th birthday. Also, men have it worse than women when it comes to a herniated disc, as they are twice as likely to suffer from the condition.

But, back and neck pain are not always a result of disc herniation nor does the condition always lead to the immediate onset of pain. So, continue reading to know if the back pain that’s giving you sleepless nights is a result of a herniated disc.

BUT FIRST, WHAT EXACTLY IS AN INTERVERTEBRAL DISC?

Your vertebral column or the skeletal structure that surrounds the spinal cord comprises of discs and vertebrae. The discs are placed in between the bony vertebrae and act as shock absorbers. These tiny pillows:

• Prevent friction and impact injuries.
• Offer stability to the spine.
• Provide the spine the ability to bear weight.
• Distribute the weight throughout the spine.

Simply put, 23 of these tiny, one-half inch protectors work relentlessly to keep all of your spine healthy and safe. Typically, you won’t have a problem with the 12 discs in the thoracic region (behind your chest). In fact, the disc in the lumbar area (5 in the lower back) are the most at risk of herniation. Those in the cervical region (6 discs in the neck) have the second-highest risk rate.

WHAT IS A HERNIATED DISC?

These intervertebral disc are made of a tough, rubber-like outer shell (Annulus fibrosus) that surrounds a jelly-like center or nucleus. No matter where the herniation occurs, the premise is that for some reason the nucleus starts pressing against the annulus, causing it to protrude into the spinal canal.

Because there isn’t a lot of space in the spinal canal, the bulging annulus eventually starts pressing against the nerve root causing pain in the back. If the issue is not corrected in time, the nucleus can tear right through the annulus and leak the jelly-like matter into the spinal canal.

NO, VERTEBRAL DISCS DON’T JUST SLIP OUT OF PLACE!

Yes, those disc are like tiny pillows, but they are not just casually thrown in between the vertebrae. They are firmly attached by two strong and thick ligaments to the bony structures above and below. So, it is impossible for a disc to simply slip out from in between the bony structures. In other words, it takes either one big shock or a series of repetitive insults to herniate the disc.

DISC HERNIATION RUNS THROUGH 4 STAGES!

1. DISC DEGENERATION: Repeated stress or age-related chemical changes cause the annulus to weaken and thin out, making it susceptible to bulging.
2. PROTRUSION/PROLAPSE: The nucleus presses against the annulus causing it to bulge.
3. EXTRUSION: The nucleus ruptures the annulus but the jelly-like center does not separate.
4. SEQUESTRATION: The jelly-like center separates from the annulus and flows into the epidural space, causing nerve irritation and inflammation.

Stages 1 and 2 are referred to as incomplete herniation, and you are likely to experience mild pain during these stages. Stages 3 and 4 are called complete herniation.

In the extrusion stage, you will experience extensive pain as well as numbness or tingling in the extremities. If the condition reaches stage 4, it can cause intense pain and possibly the loss of mobility.

HERNIATED DISC SYMPTOMS

How a disc herniation announces its presence depends on the location and the stage of herniation. If the bulge does not touch a nerve, you may only feel light and intermittent pain. If the protrusion presses on a nerve, you will feel pain and numbness /tingling in the area of the body that the irritated nerve travels through.

While the intensity and location of the pain vary, typically, a herniated disc will be preceded by a long history of chronic back pain. Depending on the position of the herniation you are likely to experience the following symptoms:

A. IN CASE OF LUMBAR DISC HERNIATION:

• Lower back pain that can start of as a dull ache but quick progress.
• Pain intensifies with movement that involves the lower back.
• Weakness in one or both legs.
• Burning, pricking pain that travels from the buttocks into the leg and the foot.
• Numbness and tingling in one or both legs.
• Loss of function in the affected leg.

B. IN CASE OF THORACIC DISC HERNIATION

• Abdominal pain.
• Radiating chest pain.
• Nausea.
• Gait disturbances.
• Sensory changes.
• Bowel and bladder dysfunction.

C. IN CASE OF CERVICAL DISC HERNIATION

• Nerve pain that radiates into the arm and the fingers.
• Radiating pain in between the shoulder blades.
• Weakness of the hand and arm.
• Tingling and numbness in the shoulder, arm and/or hand.
• Motor skill problems.
• Gait and balance issues.

THE CAUSES OF DISC HERNIATION

A SINGLE EXCESSIVE INJURY: Although a single intense shock can cause the disc to rupture, this is rare unless the injury results from significant impact such as what you’d experience in a car crash or due to a nasty fall.

AGING: After 30, the spinal discs start drying out, which causes the annulus to become brittle, thin and weak. This can eventually lead to cracks in the tough outer ring.

OBESITY: Piling on the pounds can open up the pathway for a range of health conditions and vertebral disc issues are among them. Obesity puts additional pressure on the discs, increasing the risk of disc damage and rupture.

REPETITIVE MOTION: Any activity (such as baseball, golf, etc) that causes repetitive stress  or spine trauma to a particular area of the spine can gradually cause the discs to wear out.

STRAINING THE SPINE WHEN LIFTING: If you have improper form when lifting, you exert intense strain on the vertebral column, including the discs.

GENETICS: People with a family history of disc herniation are more likely to suffer from the condition

HOW IS A HERNIATED DISC DIAGNOSED?

When you visit a doctor complaining of back pain, he/she will follow a 3-step process to determine if a herniated disc is to be blamed for the discomfort.

STEP 1: MEDICAL HISTORY AND SYMPTOMS: This is done to understand if there is a genetic element or an existing/past condition that may have caused disc herniation.

STEP 2: PHYSICAL EXAMINATION: The aim is to determine if you suffer from loss of sensation and/or muscle weakness.

STEP 3: DIAGNOSTIC TESTS: These are done to ascertain a diagnosis and to rule out other conditions that cause similar symptoms. Typically, the imaging tests recommended for a herniated disc include: CT Scan, Myelogram, Open MRI and/or Electromyogram.

HERNIATED DISC TREATMENT

1. SPONTANEOUS RECOVERY: In some cases, disc herniation may improve on its own over a period of 3 to 4 months.

2. NON-SURGICAL TREATMENT: However, you may need help with pain management while you recover. Typically, the following are prescribed for pain relief:

• Rest and slowing down or a break from activities that caused the problem.
• Conscious effort to control activities that can aggravate the problem like bending and lifting.
• Nonsteroidal anti-inflammatory medications (NSAIDs), usually naproxen or ibuprofen are prescribed to control pain.
• Specific exercises that will help to strengthen and tone the muscles in the lower back and the abdomen.
• Epidural steroid injections may be recommended in case of intense pain that prevents you from going through physical therapy.

3. SURGICAL INTERVENTIONS: Surgical treatment for disc herniation is only considered after all other forms of treatment have failed to yield results and the symptoms continue to worsen. Surgical treatment options include:

DISCECTOMY: Removal of the part of the disc that is pressing on the nerve (least invasive).

LAMINECTOMY: Removing the vertebral roof to access the disc from behind.

INSTRUMENTATION AND FUSION: Only needed in case of severe disc damage and spinal instability.

LASER SPINE SURGERY: This minimally invasive technique uses heat from a small laser to evaporate part of the disc in order to relieve pressure.

A HERNIATED DISC IS NOT A CONDITION YOU SHOULD IGNORE!

While a herniated disc does not always herniate more over time, it will end up degenerating, which will eventually lead to the same outcome. Also, the pain linked to the condition does go away over time but the disc herniation will not resolve on its own. So, you will need medical help to treat this condition.

At AllSpine Laser and Surgery Center, our surgeons have the experience and expertise to provide the best and most effective back and neck pain management interventions. Whatever the stage of disc herniation, our doctors are fully qualified to offer a wide variety of treatment options that will provide the shortest recovery time and the maximum pain relief.