Expert Insights on Disc Herniations

What is Disc Herniation?

The human spine is able to bend and flex due to the soft compressible cushion between the vertebrae known as the intervertebral disc. Discs are located in the neck region (cervical), upper back (thoracic) and lower back (lumbar). The disc itself has a soft center (nucleus) that is contained by layers of thick connective tissue called the annulus. As the spine ages, regrettably beginning in our 20’s, the annulus naturally develops fraying and fissuring and the nucleus can bulge or protrude or even herniate through these weak spots in the containing annulus layers of tissue. It is common and in fact normal to find annular fissures, disc protrusions and herniations in the asymptomatic adult spine. Many research studies have shown these sorts of disc abnormalities in people with no back or leg pain at all. Only 30% of disc herniations are due to a particular injury. Most occur as a matter of bad luck, genetics, and normal aging.

When the disc herniation presses against a spinal nerve or the spinal cord, radiating arm or leg symptoms can occur. This is called “radiculopathy”, and can feel like burning, shooting, or aching pain. Compression or pinching of spinal nerve roots can cause numbness along the distribution of the pinched nerve, weakness of the affected muscles, and loss of muscle reflexes. When the spinal cord itself is compressed, serious neurologic symptoms such as paralysis and loss of bowel and bladder control can occur.

How is a Disc Herniation Diagnosed?

Your doctor will perform a history and a physical exam, including a neurological exam to check your reflexes, skin sensation, muscle strength, and walking ability. These can provide clues as to whether and where a disc herniation might exist. X-rays are usually performed to determine the extent of any spinal arthritis or disc settling that may have occurred. When radiating arm or leg pain is present for more than 6 weeks, an MRI scan is often indicated to precisely diagnose the problem. When spinal deformity such as scoliosis is present, or in cases involving prior spinal fusion surgery, other imaging tests may also be needed to reach a clear diagnosis.

How are Disc Herniations Treated?

Fortunately, conservative treatment options are usually enough to remedy pain and mobility issues associated with herniated discs. In fact, around 70% - 80% of people with a new disc herniation and new symptoms will notice that their symptoms drastically improve or even resolve within 6 – 8 weeks, even when there is no treatment. Your doctor will likely recommend modifying your daily activities for a few days short time and may prescribe medication for the pain.

Nonprescription drugs like acetaminophen, ibuprofen, or naproxen may be the only medication necessary, but doctors may prescribe drugs like opioids, neuropathic drugs, or muscle relaxers if nonprescription drugs are ineffective. If the pain does not subside by 6 weeks, even after taking medication, your doctor may recommend cortisone injections. In rare cases, surgery may be necessary to remove the protruding portion of the disk and relieve the pain caused by the compressed nerve.

The best way to describe my experience is to say that when I first went to Sonoran spine in August, my lower back pain was between a six and an eight. After the treatment that I finished last week, it is now between 0 and 2. That speaks volumes for this place, and I would recommend them to anybody who has suffered with lower back pain for years as I have.
– Barbara P.

What Can I Expect After Treatment?

In the nonsurgical treatment of herniated discs, your doctor may recommend physical therapy, stretching, and muscle-strengthening exercises to help heal the affected area and prevent future injury. Additionally, heat and ice treatment can reduce pain and inflammation. If your doctor performed surgery to alleviate pain from the herniated disc, recovery may take a few to several weeks and typically has a better than 90% success rate.