Have a Herniated Disc?

Have a Herniated Disc?

A herniated disc occurs when one of the discs in the spine ruptures or slips out of place. The discs are tough exterior encasings around softer gel-like centers and act as rubbery cushions between each of the bones (vertebrae) of the spine. When a disc is herniated, it is either out of place or the soft center is pushing out through a crack in the tough exterior. Most herniated discs occur in the lower back, though it is also possible to occur in the neck. If left untreated, a herniated disc can lead to intense pain, numbness, permanent weakness or even paralysis.

Symptoms

Many people do not even know they have a herniated disc because they experience no symptoms. Still, it is not uncommon for herniated disc to irritate nearby nerves, resulting in pain, numbness or weakness in an arm or leg.

If the herniated disc is in the lower back, pain will usually be felt most intensely in the buttocks, thigh and calf. This pain is also known as sciatica because it is caused by the disc irritating the sciatic nerve. Pain may also radiate down to parts of the foot. Numbness, tingling and weakness may also affect the same areas.

If the herniated disc is in the neck, pain will be most intense in the shoulder and arm.

The pain may shoot down the arm or leg, especially when you cough, sneeze or move your spine into certain positions.

You should seek medical attention if pain, numbness or weakness increase to the point that they hinder your normal daily activities. You should also seek medical attention is you have bladder dysfunction, bowel dysfunction, or saddle anesthesiathe progressive loss of sensation in the inner thighs, back of the legs and the area around the rectum.

Causes

Herniated discs are usually the result of disc degenerationa gradual, aging-related wear-and-tear of the discs. Over time, spinal discs lose some water content, making them less flexible and more susceptible to tearing or rupturing. Though many people cannot determine the exact moment they herniated their disc, twisting the back too much or overexerting while lifting a heavy object incorrectly are common ways for weakened discs to rupture or shift out of place. In some rare cases, herniated discs are caused by a traumatic event such as a fall or a blow to the back.

Factors that increase your risk of a herniated disc may include being overweight, having a physically demanding job that requires repetitive lifting and twisting, and inheriting certain genetic traits.

Diagnosis

In the majority of cases, a physical examination and medical history are all that is necessary for a diagnosis. During the exam, your doctor may test your body’s reflexes, strength, sensitivity and flexibility to determine the exact nature and cause of your pain. Your doctor may also order an x-ray, CT scan, MRI, myelogram or electromyogram to help determine the exact location of the herniated disc. 

Treatment

If the pain you feel is only mild to moderate, you may be prescribed an over-the-counter pain medication, such as ibuprofen or naproxen. If this does not alleviate the pain, narcotics, such as codeine or an oxycodone-acetaminophen combination, may be prescribed for a short time.

You may also be prescribed a nerve pain medication that helps to relieve nerve-damage pain. Nerve pain medications tend to have milder side effects than narcotics, and are being used more and more by doctors as a first line prescription.

Other medications may include muscle relaxants (if you have muscle spasms), oral steroids, or cortisone injections. Cortisone injections are injected directly into the area around the spinal nerves, sometimes with the help of spinal imaging to guide the needle more safely.

In addition to medication physical therapy can help to manage the pain of herniated discs. Physical therapists can teach you stretches and exercises that will minimize your pain. They may also use heat packs, ice packs, ultrasound, electrical stimulation or short term bracing.

Surgery is only required in severe cases such as when other treatments show no progress after six weeks and there is continued numbness, weakness, difficulty standing or walking, or loss of bladder or bowel control. In most surgical cases, it is only necessary to remove the portion of the disc that is protruding. In rare cases, the entire disc is removed and the vertebrae are fused together with metal pins to provide spinal stability. In some cases artificial disc implants are recommended.

If you are suffering from sciatica or other pain from a herniated disc, contact us immediately for a consultation.

Dr. Root and Dr. Villanueva are physicians based in Burbank, CA, and are focused on the multi-disciplinary approach of treating pain. They approach each case from a variety of disease processes including neck and back spinal conditions, complex regional pain syndrome, joint disease, and chronic pain from spinal cord injuries, neurological disorders, cancer, and other medical conditions. Call us at 818-875-5501 so we can create a comprehensive treatment plan to restore you back to full health.

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