Lower back pain and symptoms caused by a herniated disc are quite common in adults. The cushion type tissue between the bones in your spine is called intervertebral discs. These discs are composed of a soft gel-like center and a tough outer lining and create a between the bones in the spine that allows them to move. A herniated disc occurs when the lining surrounding the disc tears and the soft center is pushed through the opening.
Herniated discs may be caused by numerous things. The most common of which is the simple process of aging. As we get older, the discs in our spines can lose their flexibility and elasticity while the ligaments surrounding the discs can become brittle and are more easily damaged or torn. Because this can put pressure on spinal nerves (radiculopathy) or on the spinal cord ( myelopathy), it can cause painful symptoms.
- Acute pain in the buttocks, thigh and leg below the knee, possibly into the foot.
- Pain that radiates or shoots into the leg when you cough or sneeze
- Numbness or tingling in the leg
- Weakness in the lower extremities if the herniation is pinching a nerve
Often a herniated disc can be diagnosed during a physical examination. By evaluating sensation, muscle strength, and reflexes, your doctor can often diagnosis a herniated disc.
As it is not possible to detect a herniated disc with an X-ray alone, an MRI is usually ordered to verify the diagnosis of a herniated disc especially if the doctor suspects another condition or needs to determine which nerves are affected. CT Scans may also be used to rule out other conditions. A Myelogram may be used in some cases, where a dye is injected into the spinal fluid, and then an X-ray is taken. This procedure can show pressure on your spinal cord or nerves due to multiple herniated discs. It can also assist in ruling out spinal cord tumors, abscesses and bony overgrowths.
Under normal circumstances, a herniated lumbar disc can be treated conservatively and our multidisciplinary approach at SCCNS provides patients options when dealing with pain associated with herniated discs. Before we consider surgery as an option we treat with conservative measures such as:
- Modified activities
- Physical therapy directed exercises
- Ultrasound or electrical stimulation
- Short-term bracing for the lower back
- Nerve pain medications
- Muscle relaxers
- Epidural steroid injections
- Oral medications (over the counter or prescribed) to relieve pain and inflammation
Unfortunately not all herniated discs can be treated conservatively. If it is found that conservative measures are not working and surgery is necessary, the experts at SCCNS will perform the most minimally invasive procedure required to treat the problem. Often our surgeons can remove just the protruding portion of the disc. In extreme cases, the entire disc may need to be removed. If the disc is removed, the vertebrae may need to be fused together with metal hardware to provide stability. Or the implantation of an artificial disc may be recommended.