Conditions

Herniated Disc

A herniated disc is a problem with one of the gel pads that act as shock absorbers between the individual spine bones (vertebrae). The discs in the lower back and neck can dehydrate, deteriorate, slip, collapse, protrude, rupture, or tear over time. The damaged disc(s) can irritate nearby nerves and cause pain, weakness, numbness, or radiating pain in the legs or arms.
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Symptoms

A herniated disc might have no symptoms, or result in leg or arm pain, tingling, numbness or weakness.

Leg or Arm Pain

Herniated discs in the lower back cause pain that radiates from the buttocks, to the thigh, and calf. If the herniation is in the neck, the pain will shoot into the shoulders and arms. Coughing, sneezing, lifting, bending, or twisting can result in radicular pain.

Tingling, Numbness or Weakness

Herniated discs can make the legs or arms go numb or tingle. The nearby muscles weaken and a patient’s balance and strength can deteriorate.

Causes

The main causes of pain are the result of direct compression from a nerve root, chemical irritation, disc degeneration, or a genetic predisposition.

Disc Degeneration

Over time, discs deteriorate and are more prone to tearing or rupturing. Herniated discs are often caused by lifting heavy objects incorrectly, or twisting, and turning awkwardly.

Genetics

For some patients, their genes have predisposed them to develop a herniated disc.

Treatments

Patients have a variety of treatments to choose from including self or alternative care, medications, therapies, procedures, and surgeries. 

Self Care

Physicians recommend avoiding nicotine, excess alcohol, and staying in one position for too long. Staying hydrated, and incorporating daily motion like stretching, walking or core strengthening exercises (stomach and back) can help reduce pain.

Alternative Care

Alternative or complementary medicine can provide pain relief for a herniated disc. Chiropractic manipulation and massages can provide temporary lower back pain relief. Acupuncture and yoga can help reduce pain and improve function in both the neck and back.

Medications

Patients can try over-the-counter (OTC) acetaminophen (Tylenol) or anti- inflammatory medication (ibuprofen or naproxen) to reduce mild to moderate pain. If the pain doesn’t improve, physicians can treat the nerve pain with opioids (OxyContin) or anticonvulsants (Gabapentin). Muscle spasms can be treated with relaxers (Valium), and antidepressants (amitriptyline) can help psychological conditions that make the perception of pain worse.

Therapies

Physicians might recommend physical therapy to improve posture, sleeping, ergonomics, stretching, and exercises that improve mobility and reduce pain. Psychotherapy and meditation can help cope with depression, anxiety or exhaustion that make the perception of pain worse.

Steroid Injections

A physician can inject anti-inflammatory medication directly on the nerve to reduce irritation and pain. 

Surgery

For some patients, surgery is a consideration if conservative treatments fail and activities of daily living are significantly disrupted. Surgery can repair, replace, or remove a damaged disc, and sometimes require a vertebrae fusion to provide spinal stability and protection.

Specialists

These doctors specialize in herniated discs and can help diagnose, treat, and manage your condition.

Anesthesiologist

A doctor that administers medicine to put patients asleep during surgery, renders them numb for local procedures, or reduces chronic pain through injections.

Physiatrist

A doctor specializing in physical medicine and rehabilitation that treats both acute and chronic pain with a variety of nonsurgical treatments.

Neurosurgeon

A surgeon that diagnoses and treats pain resulting from disorders of the spine, spinal cord, nerves, brain, intracranial, and intraspinal vasculature

Orthopedic Surgeon

A surgeon that diagnoses and treats pain resulting from spinal disorders, arthritis, sports injuries, trauma, and fractures.


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