Herniated Disc — What Is It and How Can I Treat It?
December 02, 2017
By Donny Bounds, MSN, RN, BC, CCRC, Director of Clinical Services, Millennium Pain Center
Many Americans with back pain, leg pain, or weakness of the leg muscles are diagnosed with a herniated disc. However, most herniated discs cause no symptoms at all! Herniated discs are actually a natural, normal, and gradual part of the aging process.
Your spine is made up of 26 bones (vertebrae) cushioned by small “discs.” These discs act as shock absorbers for the spine and help keep the vertebrae in place. The disc consists of two layers: a tough outer layer called the “annulus,” and a soft inner layer called the “nucleus.” As we get older, the disc loses some of its water content, causing it to be less flexible and more prone to tears, even with minor twists and bending. A herniated disc, sometimes thought of as a “bulging disc” or a “slipped disc,” occurs when a small portion of the inner portion pushes out through a tear in the outer part and leaks into the spinal canal. You can think of it as the jelly running out of the donut. This can sometimes irritate a nerve and result in pain, numbness, or weakness in your back, leg, or arm. However, many times it is painless!
Your physician can diagnose a herniated disc by examination, testing sensation, reflexes, and muscle strength. An MRI may also be needed to confirm the diagnosis, but you should be aware that it is normal for an MRI to show abnormalities, especially as we get older. Therefore, your physician may not be concerned about these findings. A recent study suggested 60 percent of individuals over 60 years of age reported no pain symptoms although their MRI showed some abnormalities, including herniated discs. Treatment of a herniated disc will depend on examination findings and symptoms experienced.
A disc herniation is rarely a result of trauma, such as a fall or injury, but is most often caused by improper lifting: lifting heavy objects using your back muscles instead of your leg muscles. A herniated disc caused by trauma or injury is usually painful. However, the pain will usually subside on its own as the healing takes place, although this process may not happen quickly.
There are many misconceptions regarding herniated discs and associated treatment:
- A herniated disc always causes pain — False
- All herniated discs are caused by trauma or injury — False
- Surgery is the only option to correct a herniated disc — False
- Surgery will “fix” a herniated disc and alleviate the pain — False
Approximately 10 percent of people with herniated discs may eventually need surgery. In most situations, an operation won't be considered unless conservative measures have failed, and even then, surgery is usually not indicated. Back surgery is usually reserved for times when spinal nerves are compressed, causing numbness along the back of your leg, bowel or bladder dysfunction, or weakness.
Conservative treatment may include the following methods:
- Resting your muscles if you have severe pain. Stay active if the pain is not severe. Extended inactivity could make your muscles weaker and cause more problems.
- A heating pad or cold packs may provide pain relief by decreasing inflammation and keeping muscles from tightening.
- Performing exercises that your doctor or physical therapist suggests will keep your back muscles strong and prevent further damage.
- Medication as suggested by your health care practitioner may help alleviate pain and inflammation.
- Epidural steroid injections can decrease inflammation around the disc and nerve.
- Disc material may be removed to relieve painful pressure of the disc on surrounding nerves. This procedure is called a percutaneous discectomy and should be performed by a specially trained physician.
It is vitally important to have a correct diagnosis for your back pain since the diagnosis determines the treatment plan. If the diagnosis is a herniated disc, conservative treatment will most often relieve the pain. You may be a good candidate for surgery if conservative treatment fails to improve your symptoms. Surgery also may be considered if a disc fragment lodges in your spinal canal, there is pressing on a nerve, or if you're having trouble standing or walking. If you experience chronic back pain, a pain specialist may help diagnose and treat your pain, without the need for surgery.
For more information on back pain or any type of pain, you may contact Millennium Pain Center at 309-662-4321 or www.millenniumpaincenter.com. Their new office is located at 2406 E. Empire in Bloomington. The practice provides the most advanced and comprehensive pain management for a wide variety of conditions. Drs. Benyamin and Vallejo have been selected among 70 of the Best Pain Physicians in America.
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