What is a Herniated Disc?
Herniation describes an abnormality of the intervertebral disc that is also known as a "bulging," "ruptured," or "torn" disc. This process occurs when the inner core (nucleus pulposus) of the intervertebral disc bulges out through the outer layer of ligaments that surround the disc (annulus fibrosis). This tear in the annulus fibrosis causes pain in the back at the point of herniation. If the protruding disc presses on a spinal nerve, the pain may spread to the area of the body that is served by that nerve, causing radiculapathy.
What Are the Symptoms of a Herniated Disc?
Usually, a person’s main complaint is back pain. In some cases, there may be a previous history of episodes of localized lower back pain, which is present in the back and continues down the leg that is served by the affected nerve. This pain is usually described as a deep and sharp pain, which gets worse as it moves down the affected leg. The onset of pain with a herniated disc may occur out of the blue or it may be announced by a tearing or snapping sensation in the spine that is thought to be the result of a sudden tear of part of the annulus fibrosis.
A person with a herniated disc will usually complain of lower back or neck pain that may or may not radiate into different parts of the body. They will often have limited range of motion when asked to bend forward or lean backward, and they may lean to one side as they try to bend forward. Sometimes, they walk with a painful gait, flexing the affected leg so as not to put too much weight on the side of the body that hurts.
How is a Herniated Disc Diagnosed?
Our team at Modern Pain Consultants will perform a comprehensive spine and neurological exam. An MRI is the test of choice to diagnosis of herniated disc.
How is a Herniated Disc Treated?
The treatment for the vast majority of people with a herniated disc does not normally include surgery. Many patients will respond to non-surgical treatments. The primary element of non-surgical treatment is controlled physical activity. Usually, treatment will begin with avoidance of exacerbating activities followed by a gradual return to normal activities. Sitting is bad for this condition because the sitting posture puts a large amount of stress and pressure on the lumbar spine, which may increase the pressure on the affected nerve root.
The appropriate use of medications is an important part of non-surgical treatment. This can include anti-inflammatory drugs, analgesics, muscle relaxants, anti-seizure medication, and antidepressant medication. Physical therapy is also important. Surgical treatment are reserved for people who have not had success with non-surgical treatment options and a sufficient period of time has passed to indicate that they may need to have surgery in order to help them to get better.
Interventional Pain Management Treatments:
- Percutaneous Disc Decompression
- Epidural Steroid Injections
- Caudal Steroid Injections
- Trigger Point Injections