CONDITIONS
Herniated Disc
The discs in the spine, made up of soft tissue and cartilage, serve as a cushion between the bones of the spine. Discs consist of an outer annulus that holds the inner nucleus in place, which acts as a shock absorber. In the case of a herniated disc, the inner nucleus protrudes from the annulus and can lead to the compression of nerves, causing stenosis and associated symptoms. While it can happen anywhere in the spine, herniated discs are most frequently observed in the lumbar (lower back) and cervical (neck) regions.
Symptoms & Diagnosis
Disc herniations often cause leg pain, numbness, and weakness, commonly known as sciatica, accompanied by a varying degree of back pain. The symptoms of a disc herniation typically follow a predictable pattern, allowing for early identification. Symptoms will typically follow this pattern:
- When the herniation occurs, some individuals may experience immediate back pain, while others may notice it within a couple of days. At this stage of the injury, there are typically minimal or no leg symptoms.
- After about a week, the back pain subsides and leg pain begins. This leg pain typically presents as a burning sensation accompanied by numbness and occasional weakness. Although these symptoms typically affect only one side, both legs can be affected.
- Straightening the leg or sitting down tends to exacerbate the pain while standing often offers relief. Consequently, individuals often find it challenging to stand still and may resort to walking as a means to alleviate the discomfort.
A doctor will conduct a thorough examination to assess pain, muscle reflexes, sensation, and strength. An MRI is the most common and accurate imaging test for a suspected herniated disc. Additional tests like a myelogram or electromyogram (EMG) may be ordered to confirm the location of the herniated disc and/or which nerves the disc is affecting.
Treatment
Surgical intervention is typically not necessary for most disc herniations, but there are situations where surgery may be the best option. Depending on the severity of symptoms, especially if there is weakness in the legs, treatment with surgery may be expedited.
Conservative treatment
- Medication Non-steroidal anti-inflammatories, muscle relaxants, steroids, or nerve modulation medications may be recommended as the first level of treatment.
- Physical therapy Tailored exercises focused on the affected area aim to strengthen muscles and allow for nerve release or gliding.
- Pain management If there is no improvement in symptoms after 6 weeks of medication and/or physical therapy, the next level of treatment involves an MRI and epidural steroid injections based on the results of the MRI. If a series of 3 injections does not control symptoms, the last level of treatment is surgery.
Surgical intervention :
- Surgical treatment for a herniated disc involves removing the whole or part of the disc that has been damaged and is pressing on nerves, and addressing any instability.
- Discectomy Discectomy is performed when there are no signs of instability, and is often referred to as “shaving the disc.” During this procedure, the damaged part of the disc that is compressing nerves is removed. This is almost always done in a minimally invasive fashion.
- Laminectomy If the extent of the herniation is larger than normal, a laminectomy may be needed to fully decompress the nerves
- Fusion If the disc herniation is associated with or causes spinal instability then a fusion is often performed with the herniation removal and decompression for complete care of the spine.
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Contact
Our team at Avramis Spine & Scoliosis is here to help. To request an appointment or for any other inquiries, please fill out the form.
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HOURS
MONDAY - FRIDAY • 8:30AM - 4:30PM
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LOCATION
GET IN TOUCH
Contact
Our team at Avramis Spine & Scoliosis is here to help. To request an appointment or for any other inquiries, please fill out the form.
-
HOURS
MONDAY - FRIDAY • 8:30AM - 4:30PM
-
LOCATION