Herniated Disc

Spine herniated disc at a glance

  • Herniated discs are common and can often go undetected.
  • Herniated disc symptoms often disappear after a few days or weeks, while some people may experience disabling or severe pain.
  • Herniated discs tend to occur in patients who are 20 to 50 years old.
  • Most treatments initially focus on reducing pain.
  • Surgery is sometimes needed when severe pain is present or nerve damage is occurring.

Causes of herniated disc

Herniated discs are often caused by gradual, aging-related wear and tear. With age, the spinal disks lose some of their water content, making them less flexible and more prone to tearing or rupturing with even a minor strain, twist, or physical injury.

Lifting a heavy object can also sometimes lead to a herniated disc. Other times, people can’t pinpoint when the exact injury occurred.

Some factors increase your risk, including being between the ages of 35 and 45, overweight and in a physically demanding occupation that involves lifting, pushing or pulling.

Symptoms of herniated disc

In many cases, herniated discs cause few problems. However, some can lead to severe and disabling back pain. In addition, herniated discs may lead to numbness, weakness, and balance or walking problems. Other symptoms may include muscle spasms and deep muscle pain.

Herniated discs in the neck or upper back can cause pain in the upper arms, neck, and shoulders. When herniated discs are lower in the back they may also cause shooting pain and numbness in the buttock and down the leg. This is called sciatica and is the most common symptom when the problem is located in the lower back. Lower back pain may also occur, although it is usually less intense than leg pain.

A rare, but serious condition known as Cauda Equina Syndrome can develop in the lower back, affecting bowel and bladder function as well as leading to partial paralysis of the lower limbs if left untreated.

See your medical provider if your neck or back pain travels down your leg or arm, or if it is accompanied by numbness, tingling or weakness.

Treatment for herniated disc

In many cases, herniated disc treatment will include medication, physical therapy, and occasionally injections for pain management. Back surgery may be required if these measures fail.

Non-surgical treatments

Many patients can be helped with minimally-invasive treatments that may include non-prescription medicine and an exercise plan designed to improve strength and flexibility. Be sure to talk to your pharmacist before purchasing anti-inflammatories as these medications may be contraindicated as they may interact with other medications and medical conditions.

Non-surgical treatment options include:

  • Non-prescription medicine
  • Prescription medication
  • Physical therapy

Pain management treatments

Strategies often include a nerve block or various types of epidurals, a procedure where medicine is placed directly into the spinal area to block pain. The most common approach to treating a herniated disc is addressing the pain caused by the condition.

Pain Management options include:

  • Caudal-epidural
  • Epidural
  • Transforaminal epidural
  • Selective nerve block

Surgical treatment

For herniated discs that require surgery, the standard operation is a microdiscectomy, an operation to remove the herniated part of a disc. The surgeon performs a microdiscectomy with a microscope or similar device, often as an outpatient procedure. Microdiscectomies have a very good success rate. Disc herniation can recur in up to 10 percent of cases.

Other surgical options range from nucleus replacement, a new form of surgery still under investigation in which a surgeon replaces the center part of the disc with an artificial implant to a percutaneous laser discectomy, in which the surgeon makes a small incision, inserts a tiny probe and operates with the aid of x-rays.

Surgical options for herniated disc include:

  • Laminotomy
  • Laminectomy
  • Microdiscectomy
  • Percutaneous laser discectomy
  • Percutaneous nucleoplasty coblation
  • Transforaminal microdiscectomy
  • Nucleus replacement disc stabilization arthroplasty

If you are experiencing back pain and symptoms of a herniated disc, contact us to request an appointment with our spine specialists to learn about your treatment options.