Common Injuries: What is a Herniated Disc?

This post is part of our ongoing series to educate our patients about common injuries and how they can be treated with our nonsurgical techniques. It’s all part of our commitment to helping you live pain free.

Herniated discs affect millions of Americans and is one of the leading causes of low back pain. A disc is the cushion between the bones in the back. Normally there is a tough outer part (the annulus) that keeps the softer inner part (the nuclues) inside. It is very similar to a jelly doughnut where, under normal conditions, the jelly remains inside the doughnut. A disc herniation is when the nucleus (the jelly) pushes through the annulus (the doughnut).

WHAT ARE THE SYMPTOMS OF A HERNIATED DISC?

Symptoms can vary for each patient. Many people have disc herniations without knowing it. Herniated discs can occur anywhere in the spine, but is most common in the low back and can cause any of the following:

• Neck or back pain
• Pain radiating to the arm or leg
• Numbness or tingling
• Weakness
• Difficulty with urinating or having a bowel movement

WHAT CAUSES A HERNIATED DISC?

Most disc herniations occur between the ages of 30 and 50. There are two main reasons herniations occur in this age group. The first is that the discs loss some of their water content as a person ages. This causes them to be more susceptible to tearing, which allows for the inside disc material (the nucleus) to herniate. The second reason is that the posterior longitudinal ligament, which is the ligament in the back of the discs that helps to keep the discs intact, begins to generate and makes the discs more likely to herniate.

It is more common to not know exactly when the disc was herniated, but some patients can feel a disc herniated when lifting and twisting or from trauma, like a car accident.

HOW IS A HERNIATED DISC DIAGNOSED?

Our pain management doctors in Ramsey, NJ can easily diagnose a herniated disc. You will be asked questions about your pain including when it started, what it feels like, and what makes it better or worse. Your doctor will examine you and will focus on feeling your neck or back while also checking your strength, sensation, and reflexes. The history and physical exam is usually enough to make the diagnosis of a herniated disc, but other testing may some times be required, especially if your pain doesn’t improve with appropriate conservative treatment.

• X-ray – A herniated disc can not be seen on x-ray, but an x-ray is a valuable tool in helping to assess other causes of pain incluiding a fracture or arthritis.
• MRI – An MRI is the gold standard for assessing a herniated disc. The detail in an MRI allows your doctor to see which disc is involved and which nerve may be affected.
• EMG/NCS – Electromyography and nerve conduction studies are examinations of your body’s muscles and nerves. The advantage of this exam is that it assesses the actual function of the nerves that can be affected.

HOW IS A HERNIATED DISC TREATED?

Most patients improve with conservative treatment and very few require surgery. Medications that have been proven to be effective include anti-inflammatories and muscle relaxants. The most important aspect of treatment for a herniated disc is physical therapy. The initial focus of physical therapy is on pain relief. Once that is accomplished, the patient will progress to working on range of motion and strengthening the core muscles in the low back, hips, and abdomen.

If conservative treatment does not result in improvement in your pain, an epidural injection may be recommended. Epidural injections deliver potent anti-inflammatory medication directly to the site of the disc herniation and irritated nerve. These injections are done with live spinal imaging to help guide the needle safely to the site of the disc herniation.

At Progressive Spine and Sports Medicine, we specialize in nonsurgical pain management, and a herniated disc is just one of the many injuries we diagnose and treat in our Ramsey, NJ medical center. For more information, please see our full list of our nonsurgical services, or to schedule a consultation, contact us today.

We look forward to being your #1 solution for nonsurgical pain treatment.