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Herniated Disc

The bones that form the spine in the back are cushioned by small spongy discs. When these discs are healthy, they act as shock absorbers for the spine and keep the spine flexible. But when the disc is damaged, it may bulge or break open. This is called a herniated disc. It may also be called a slipped or ruptured disc. You can have a herniated disc at any part of your spine, but most herniated discs are located in the lower back (lumbar spine) or neck (cervical spine) and rarely in the upper back (thoracic spine). A herniated disc may be caused by wear and tear of the disc. As we age, our discs dry out and are not as flexible. It can also be caused by an injury to the spine. This may cause tiny tears or cracks in the hard outer layer of the disc. When this happen, the gel inside of the disc can be forced out through the tears or cracks in the outer layer of the disc. This causes the disc to bulge, break, open or break into pieces.

Symptoms

Symptoms of herniated disc are most likely caused when a disc presses on a nerve root. This can cause pain, numbness, and weakness in the area of the body where the nerve travels. A herniated disc in the lower back can cause pain and numbness in the buttock and down the leg. This is often referred to as sciatica. You can get similar symptoms in either arm. This could be caused by a herniated disc in the neck region.

If a herniated disc is not pressing on a nerve, you may have a backache or no pain at all.

If you have weakness or numbness in both legs along with loss of bladder or bowel control, you need to seek medical care right away. This could be a sign of rare but serious problem called cauda equina syndrome.

Herniated discs are usually diagnosed via a qualified physical examination. However, often times, additional testing such as an MRI or a CT scan will help confirm the herniated disc or rule out other health issues that may be causing these symptoms.

Treatment

Treatment for disc herniations can vary. Symptoms from a herniated disc can actually resolve in a few weeks to a month on their own, most resolved within a month to six months. Bed rest can help recovery if you have severe pain, otherwise you should try to stay active. Staying in bed for more than one to two days can weaken your muscles and make the problem worse. Walking and other light activity may help.

Using a heating pad on low-to-medium setting for 15-20 minutes every two to three hours may be beneficial or warm shower in place of or in addition to this may be helpful as well.

Exercises that your physician, orthopaedic surgeon, or physical therapist suggest will help keep your back muscles strong and prevent other injury.

You can ask your doctor about medicine or other treatments that may be beneficial such as epidural steroid injections. Epidural steroid injections are a fluoroscopically guided injection that can significantly improve the symptoms of herniated disc and may allow your body to heal itself with much less or sometimes no pain.

Usually a herniated disc will heal on its own over time. About half of the people with herniated disc are better within one month, and most are better within six months. Only one person in ten eventually has surgery.

Epidural steroid injections are just one of the many treatments that are performed in our practice and can be very beneficial at treating herniated discs.

Epidural steroid injections are common treatment option from many forms of low back pain, leg pain, neck pain, and upper extremity pain. They have been used for lower back problems since 1952 and are still an integral part of nonsurgical management of sciatica, low back pain, neck pain, and upper extremity pain as well as sometimes upper back pain. The goal of the injection is pain relief. At times the injection alone is sufficient to provide relief, but commonly epidural steroid injection is used in combination with comprehensive rehabilitation program to provide additional benefit.

Most practitioners will agree that while the effects of the injection tend to be temporary providing relief from pain for one week up to one year and epidural can be very beneficial for patient during acute episode of back and/or leg pain. Importantly, an injection can provide sufficient pain relief to allow a patient to progress with a rehabilitative stretching and exercise program. If the initial injection is effective for a patient, he or she may have up to three in a 6-12 months period of time.

In addition to low back pain (the lumbar region), epidural steroid injections are used to ease pain experienced in the neck (cervical region) and in the midspine (thoracic) region.

Benefits of these injections is that they deliver medication directly (or very near) the source of the pain generator. In contrast oral steroids and pain killers have a dispersed, less focused impact and may have unacceptable side effects. Additionally, since the vast majority of pain stem from chemical inflammation, an epidural steroid injection can help control local inflammation while also “flushing out” inflammatory proteins and chemicals from the local area that may be contributing to an exacerbating pain.