| Introduction to Herniated Disc |
 A disc is composed of two parts: an outer rim of fibrous (tough) tissue surrounding an inner loose material.
When there is a break in the outer rim, the inner material can leak out of the disc space and enter the spinal canal where the disc material can compress nerve roots or the spinal cord.
Disc herniation is a common cause of leg and back pain.
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| Symptoms of a Herniated Disc |
The first symptom is usually extreme, sudden pain. In most
cases the bottom two discs in the spinal column are the ones
that herniate, so the pain usually begins in the lower back.
When they bulge, these two discs exert pressure on the sciatic
nerve, causing sharp pain to shoot down the leg. Sciatica will
affect as much as 40% of the adult population at some point
in their lives.
Herniated discs higher up in the spine can cause
pain and weakness in the neck, shoulders, or arms. |
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| Olympic Athelete has Herniated
Disc Surgery (KCAL Ch9, Los Angeles, CA) (click on the image above to watch the video) |
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Numbness
and tingling in twoes and fingers, as well as a loss of movement
or strength in any part of the body are also symptoms of a herniated
disc and could be a sign of a serious problem. It's important
to note that pain is often not a matter of a single defect.
The pain associated with disc herniation usually improves with lying
down and worsens with prolonged sitting/standing or walking. Rarely,
bowel or bladder problems and progressive neurological deficits (such
as weakness) may develop; this type of situation requires urgent surgical
decompression of the nerves under pressure.
A magnetic resonance image (MRI) is an excellent tool to diagnose
a herniated disc. If previous surgery has been performed in the area,
however, a special MRI with contrast, or a CT myelogram is the most
effective way to evaluate the spine. X-rays are also routinely used
to determine the bony anatomy and alignment of the spine. |
| Treatment Options for Disc Herniation |
Because there are so many causes of a herniated disc (and
all back pain for that matter), each patient commands a different
treatment plan. The first approach we take with all our patients
is conservative, with treatment consisting of exercise, physical
therapy or medication (or a combination therof). The majority
of back problems go away in four to six weeks with moderate
medical attention and pain medication. For those who fail conservative
treatment there are now new microsurgical techniques that can
offer appreciable relief.
Most people have full recovery from episodes of sciatica within the
first few weeks. If the symptoms continue past 6 weeks, however, one
should consider undergoing an evaluation which includes MRI studies.
If symptoms continue and conservative management has not been helpful,
surgical decompression of the disc (microdiscectomy) may be helpful
in relieving the symptoms. The only absolute indications for surgery,
however, are progressive neurological symptoms, bowel or bladder problems,
and severe, unremitting pain.
| Frequently Asked Questions about Disc Herniation |
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| Q: |
What is a herniated disc? |
| A: |
A disc is a small pad of elastic tissue located between each
vertebra in the spinal column. Discs act as shock absorbers
for the vertebrae and prevent them from rubbing against each
other. Discs are held in place by thick ligaments attached to
the vertebrae. Often, these discs break down, and bulge into
the spinal canal, or the thick jellylike material inside them
seeps out to press against a nerve. The result is what we commonly
call a herniated or slipped disc. |
Q: |
What are the symptoms of a herniated disc? |
| A: |
The first symptom is usually extreme, sudden pain. In most
cases the bottom two discs in the spinal column are the ones
that herniate, so the pain usually begins in the lower back.
When they bulge, these two discs exert pressure on the sciatic
nerve, causing sharp pain to shoot down the leg. Sciatica will
affect as much as 40% of the adult population at some point
in their lives. Herniated discs higher up in the spine can cause
pain and weakness in the neck, shoulders, or arms. Numbness
and tingling in twoes and fingers, as well as a loss of movement
or strength in any part of the body are also symptoms of a herniated
disc and could be a sign of a serious problem. It's important
to note that pain is often not a matter of a single defect. |
Q: |
How does age affect a disc? |
| A: |
The pulpy disc tissue degenerates naturally as we age. And,
the supporting ligaments begin to weaken. At a younger age,
a single excessive strain is usually the cause of injury to
the disc. But as we get older and the wear and tear progresses,
a relatively minor strain or twisting movement can cause a disc
herniate. Although there are many causes for this wear and tear,
the primary factor is genetics. Research has shown that there
may be a hereditary predispoition for slipped discs, often with
may members of a family being affected. |
Q: |
What other factors contribute to the degeneration process? |
| A: |
Stress, tension, overweight, lack of exercise, poor sitting
and working posture may aggravate an already existing back condition.
The wear and tear of the disc is also spurred by disease such
as cancer, rheumatoid arthritis, diabetes and certain medications. |
Q: |
When should people see a doctor? |
| A: |
They should see a doctor if they suffer from back pain that
is accompanied by pain that radiates down their leg or pain
that does not seem to go away after a few days of rest. |
Q: |
When is surgery a good option for treating herniated discs? |
| A: |
The human body has an amazing ability to heal even when battered
by wear and tear. For most people, back pain can usually be
eased with a few changes in lifestyle, mild physical therapy,
back-strengthening exercises, behavior modification, and a little
patience. The majority of back problems go away in four to six
weeks with moderate medical attention and pain medication. In
a few cases, when the pain is severe and does not respond to
nonsurgical treatment, surgery to remove the bulging disc parts
may be a good option. New microsurgery techniques now offer
patients quicker recovery and more complete recovery than traditional
surgery methods. |
Q: |
How are herniated discs treated? |
| A: |
Because there are so many causes of a herniated disc (and
all back pain for that matter), each patient commands a different
treatment plan. The first approach we take with all our patients
is conservative, with treatment consisting of exercise, physical
therapy or medication (or a combination therof). The majority
of back problems go away in four to six weeks with moderate
medical attention and pain medication. For those who fail conservative
treatment there are now new microsurgical techniques that can
offer appreciable relief. |
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Look for the book to access our animated conditions, procedures, and anatomy via our patient education system!