By Alexander Germanis
In any ecosystem, there is a delicate balance necessary to maintain the proper balance. When one species dies off, it can negatively affect another species, which will in turn affect another, and so on. This is what is known as a cascade effect.
The human body is an ecosystem of its own. When one part of the anatomy has issues, especially something in the spine, the resultant cascade effect can be detrimental.
When lumbar disc herniations cause pain and nerve malfunctions in other parts of the body, orthopaedic surgeons like Dr. Michael Dolphin of Orthopaedic Specialists in the Quad Cities have a number of ways in which to treat the cascade effect.
Neck, arm, back, or leg pain are often indications of a herniated disc in the lower back – the lumbar portion of the spine. This pain, known as sciatica, is most common in the lower back or the neck. Disc herniation can also result, says Dr. Dolphin, “in pain on one side of the body, numbness or weakness in the arms or legs, muscle spasms, overreactive reflexes, pins and needles, tingling and burning sensations, and even foot or hand numbness.”
Although only two percent of the population get a herniated disc each year, the likelihood of a herniation increases with age. “Age is a risk factor because the discs in the spine are going to naturally degenerate over time,” explains Dr. Dolphin. “As people age, the discs become less flexible and more prone to tearing or rupturing even with minor movements or twists. The ligaments that support the disc to hold it in place also weaken as people get older, making disc herniations a bigger risk.”
Although age is the most common risk factor, herniations can result from excessive weight, repetitive motions, or as a sudden injury from lifting heavy weights improperly. Men more than women and those aged 30 to 50 are most often affected by disc herniation.
The pain of sciatic is not necessarily a sign of a herniated disc, however. “Sciatica can be reflective of a condition known as piriformis syndrome,” the doctor warns. “In this case, the actual sciatic nerve can be compressed within the buttocks, causing radiating pain down an extremity, mimicking the radiating pain associated with a disc herniation. A hamstring strain can also cause pain similar to that associated with disc herniations.” Should sciatica be caused by either of these issues, physical therapy often resolves the condition.
Regardless of the cause of pain, Dr. Dolphin and his colleagues approach treatment conservatively, prescribing NSAIDS, activity modification, physical therapy, and sometimes an epidural steroid injection from a referred interventional pain clinic. Surgery, specifically an outpatient minimally invasive microdiscectomy, is the last course of action.
“Currently, advances in treating herniated discs are focused on endoscopic approaches,” Dr. Dolphin says. “There are more long-term outcome studies being published supporting the endoscopic approach as one that is safe and effective. Advances in treating other causes of sciatica include platelet rich plasma injections to help promote healing of soft tissue injuries that may be causing the symptoms of sciatica that mimic those of a herniation disc.”
Of course, preventing the cascade of pain resulting from sciatica is the best approach. Maintaining a healthy lifestyle by managing one’s weight, getting the proper nutrition, and maintaining joint and spine flexibility with consistent stretching and core strengthening are paramount in preventing spinal issues like lumbar herniation and sciatica.
“These aspects of one’s health are not quick fixes,” Dr. Dolphin states. “They take time and effort but are proven to prevent injury and provide individuals with the greatest opportunity to avoid having to seek the services of a spinal specialist.”
Should preventative efforts fail, however, orthopaedic specialists like Dr. Dolphin are there to slow the cascade of pain to a trickle or shut it down altogether.
Orthopaedic Specialists have locations at 3385 Dexter Court, Suite 300, in Davenport, Iowa, and at 2635 Lincoln Way, #D, in Clinton, Iowa. If you would like to request an appointment, please call us at (563) 344-9292. And visit us on the web at www.osquadcities.com.