Herniated Disc

A Common Source of Pain That Often Has Non-Surgical Solutions

*Medical Illustration by Nucleus Medical Art

This prevalent source of neck, arm, back, and leg pain is typically seen in adults between 30 and 50 years of age. Also referred to as a slipped disc or ruptured disc, a herniated disc can occur anywhere in the spine. Most often, it occurs in the cervical spine (neck) or lumbar spine (lower back), typically causing "a pinched nerve." If you are experiencing pain or numbness in the neck, arm, lower back, or leg, you could be suffering from a herniated disc. At Capitol Spine & Pain Centers, we can help you alleviate your pain with accurate diagnosis and effective non-surgical therapy.

Discs are soft, rubbery pads located between the bony vertebrae that make up the spinal column. Composed of a thick outer ring of cartilage (annulus) and an inner gel-like substance (nucleus), discs allow the back to bend and also act as shock absorbers. The spinal column surrounds and protects the spinal cord and nerves. When the cartilage develops a defect or tear, the nucleus can break through. Much like toothpaste, the nucleus bulges out or herniates, putting pressure on the nerves. Even slight amounts of pressure can cause pain, numbness, or weakness.

A herniated disc in the lower spine can put pressure on the sciatic nerve (sciatica). The sciatic nerve is comprised of several spinal nerve branches as they travel from the spine down the length of the leg. When pinched, sciatic pain may be experienced anywhere along these branches, radiating from the buttocks down the back of the leg and sometimes through the shin and foot. Often, leg pain occurs without any back pain.

Why a herniated disc occurs
When we are young, our discs have a high water content (almost 80 percent). As we age, the water content decreases, causing the discs to become less pliable and more susceptible to wear and tear. Conditions that can further weaken or damage the discs include:
– Heavy or incorrect lifting
– Repetitive twisting movements
– High impact athletic activities
– Smoking
– Excessive body weight
– Traumatic injury.

The symptoms of a herniated disc
A herniated disc causes different symptoms, depending on where the injured disc is located.

Low back pain and/or leg pain (sciatica) are the most common symptoms of a herniated disc in the lumbar (lower) spine. Pain may vary from mild to severe. Symptoms may be experienced suddenly or gradually and may also include:
– Pain in both legs
– Burning, tingling (a "pins–and–needles" sensation), or numbness in the buttock, leg, or foot
– Pain with specific movements, usually bending forward or twisting
– Intensified pain with prolonged sitting, bending, sneezing, or coughing
– Weakness in one or both legs
– Loss of bladder or bowel control (This is rare.)

Neck and arm pain occurs when the herniated disc is in the cervical (neck) vertebrae. In addition to pain in the muscles between your neck and shoulder, other symptoms may include:

– Shooting pain down the arm
– Pain when turning/twisting the neck
– Tingling, numbness, or weakness, usually in only one arm

The importance of accurate diagnosis
At Capitol Spine & Pain Centers, we complete a thorough clinical evaluation to determine if the pain is generated from a herniated disc or other conditions that share similar symptoms (such as piriformis syndrome, sacroiliac joint dysfunction*, and discogenic pain*). We begin with a complete medical history, analysis of specific symptoms, and a physical examination, followed by specialized tests which may include MRI, CT scan, and EMG studies.

Effective pain relief without surgery
Up to 90 percent of patients can be treated without surgery. Often, the symptoms of a herniated disc will resolve gradually with simple measures such as a modification of activity, analgesic and anti-inflammatory medications, and physical therapy. However, when the pain and discomfort of a herniated disc persist, many people successfully gain relief with epidural steroid injections known as epidural nerve blocks*.

An epidural nerve block is an office-based procedure that effectively treats the pain of a herniated disc with little to no down time. Anti-inflammatory medication (corticosteroid) is injected around the inflamed disc and nerves, significantly decreasing the irritation and relieving pain. Up to three injections may be given, usually two to three weeks apart. Many patients gain considerable to complete relief with the first or second injection.

Epidural nerve blocks may be accompanied by physical therapy to strengthen muscles and prevent recurrence. Other preventative measures include an appropriately firm mattress, proper seating with support, good body mechanics and lifting techniques, and core stabilization exercises.

Stop pain from interfering with your life.
Resolve your symptoms with help from the board-certified pain specialists at Capitol Spine & Pain Centers.