My doctor said I herniated a disc, what does that mean?
The common metaphor used by practitioners to explain a disc herniation is the jelly donut. Imagine your spine with each vertebrae stacked on top of each other. Now imagine that in between each vertebrae is a jelly donut. Your disc is the space in between each vertebrae. Your disc is like a jelly donut in that it has a harder exterior shell and a soft, squishy center. Sometimes, because of injury or simply from aging, the exterior shell can weaken and the soft center can push through. When this happens,we call it a herniation, meaning what belongs inside has now ruptured to the outside.
If it doesn’t hurt do I have to fix it?
Many people live with disc herniations and never have symptoms. Many times the herniation is found by accident after diagnostic imaging is performed for other reasons. If the herniation is not painful and does not affect you in your day to day activities, it is not necessary to treat it, however, it is important to maintain good body mechanics to prevent it from worsening or becoming irritated.
The pain is unbearable, now what?
Patients who have a sudden onset of symptoms tend to know the moment that the herniation occurred. Patients who have a gradual onset may or may not know the cause of the pain. Symptoms can include sciatic nerve irritation such as sharp, shooting pain down one or both legs, numbness and tingling in the buttocks and legs, and weakness in the lower back. This is common with lumbar spine herniation. Similar symptoms in the neck and arm can occur from cervical spine herniations. In addition to these telltale indicators, patients with herniations in the base of the spine may experience bowel and bladder incontinence. You need to inform your healthcare provider immediately if you are experiencing incontinence along with your pain.
If you are experiencing pain related to a disc herniation, your Commonwealth Pain Specialists physician will likely recommend fluoroscopic steroid injections. Fluoroscopy is a three-dimensional x-ray that allows your doctor to administer cortisone directly to the inflamed tissue to provide you with immediate pain relief. This treatment is so effective that many patients’ pain is completely resolved and they are able to resume their regular activities without needing to consider surgical options.
Despite the effectiveness of fluoroscopic therapy, a select few patients will still require surgical intervention to restore mobility and treat the source of the pain. A microdiscectomy is the surgical removal of the protruding “jelly,” allowing the rest of the disc to remain in place. In extreme situations, more invasive surgeries such as spinal fusion (the joining of vertebrae) or internal fixation (the mechanical stabilization of the spine) may be necessary. Upon evaluation of your condition your practitioner will decide what type of surgery will be required.
If you have questions about disc herniation or want to know if you are at risk for developing a herniation, speak with your practitioner. Simple lifestyle changes can help reduce your risk factors and keep your back strong and healthy for years to come. Commonwealth Pain Specialists is here to help. Make an appointment with us today (804) 288-7246.