Anyone who has ever had a herniated disc before knows how awful it can be. It can be worsened by movement and you will feel frustrated waiting for the disc to heal. You may feel fine one minute and be able to bend down to pick up something. One minute you feel a dull, shooting pain in your neck or back. It might seem like a herniated disc, but what does it actually mean?
What is disc herniation and how can it be prevented?
Disc herniation can be a broad term that describes specific changes in the lumbar disc.
A disc is a soft and rubbery structure between the vertebral bodies. The disc acts as a cushion or pad for the bones. The annulus fibrosus, which is the outer part of the disc, is composed of tough fibrocartilage. The nucleus pulposus, which is composed of water and collagen, has a jelly-like consistency. The disc structure is sometimes described as looking like a jelly donut. The disc allows movement of the vertebral body and buffers compression between bones. This system is very efficient in normal circumstances.
A disc herniates is caused by a tear in its annulus fibrosus. Some of the gelatinous middle comes out through this tear. The following are the types of herniations: protrusion (small), bulge (large), extrusion [bigger], and a sequestered fracture (when some material has been removed from the disc). The disc can cause pain if it is not in its original position. It may also cause irritation to nerves or contribute to narrowing the spinal canal.
A herniated disc is caused by:
The nucleus pulposus can be pushed through the annulus fibrosus by movement, injury, pressure, age, or simply bad luck. It’s just like a jellynut would push through a jellynut if it was pressed down. Sometimes, people are involved in an accident that causes a herniated disc. Other times, it is as simple as bending down and tying a shoe. Because the pain is usually felt immediately, most people will be able to pinpoint when and what it was.
Disc degeneration, genetics, or a combination of these factors can also cause a herniated disc. A herniation could also be caused by certain activities, such as lifting weights or participating in a sport.
How does a herniated disc feel?
When a disc herniation presses on a nerve, or the spinal cord, people experience symptoms. Radiculopathy is a condition that causes shooting pain, weakness or numbness. It can cause pain in many places, depending on the nerve pinched.
A herniated disc in your lumbar spine could cause pain down your leg, down your butt and down the leg. Your cervical spine nerve may be pinching your herniated disc, causing arm pain or weakness.
It depends on how severe the herniated disc is and which nerve is being pinched. When you experience symptoms, pressure on your spine cord can be more severe. This is often called myelopathy. It refers to loss of control or sensation in certain parts of the body.
The treatment for a herniated disc
There are many treatment options available that can be initiated right away.
- Ice and rest.
- Stretches and physical therapy.
- The nerve can be calmed down with medication (anti-inflammatory medicine, muscle relaxers).
- A dose pack of steroids.
- Some people may be able to have surgery if they meet the requirements.
Spinal surgery is dangerous and should be considered seriously. Schedule an appointment with your doctor if you suspect you have a severe herniated disc or are experiencing pain that won’t stop.
What is the average time it takes for a herniated disc to heal?
A herniated disc can heal in between four and six weeks. However, it can be healed within days depending on the severity of the herniation and where it happened. Time is the most important factor in healing a herniated disc. Most often, it will resolve itself on its own. The type of treatment and how you recover will also affect the healing time.
A MRI showed that my back is hurting and that a disc had herniated. Do I need surgery?
Surgery is a good option in four situations. These are the situations where surgery is most appropriate.
- cauda equina syndrome
- progressive strength loss
- intractable pain
- continued symptoms despite nonsurgical treatments
Cauda equina syndrome
This disorder affects a bundle or spinal nerve roots. It is rare and needs urgent surgery. This syndrome can cause back and leg pain, weakness, and numbness. It may also be associated with issues with bladder or bowel function.
Progressive strength loss
A lot of people experience some strength loss. However, if this is getting worse, it would be a sign that you need surgery.
Intractable pain
This is a sign that you need surgery if your pain is not controlled by medicine, injections or therapy.
Failure to provide conservative care
You might be eligible for surgery if a comprehensive program that includes medication, physical therapy, and/or injections fails.
What happens to my herniated disc if I don’t have surgery?
Study of patients with various sizes of herniations revealed that herniated disc material in many cases had disintegrated by the end of six months to one-year. The faster material was absorbed, the larger the herniation (extrusions).
Studies over a long period have shown that although surgery may result in a quicker initial recovery, nonsurgical outcomes are as effective for patients who return to work after five or ten years.
If the herniated disc is in my back, why do I feel pain in my legs?
Your spinal cord releases the nerves that run through your legs. They are released into the spinal canal, where they then exit between the two spinal vertebrae. The disc causes nerve irritation and sends pain down the leg. These nerves remain in the spinal canal and are named at the level of the disc (lumbar 5, or L5). After they leave the canal at their individual vertebrae levels they are grouped together and named nerves such as the sciatica nerve.
What options are available for treating herniated discs without surgery?
Low back pain can be treated non-surgically with many options. Physical therapy is the first. A good physical therapy can help the disc heal and improve biomechanics, strength and flexibility. Recent research has shown that physical therapy directed at the disc is more effective than other methods. This is often enough.
Epidural steroid injections are a great option for pain relief when physical therapy is not an option. Epidural injections can be safer than more invasive procedures. There are a few complications, including bleeding, headaches and infections. Very rarely, a nerve injury. But, there are ways to reduce pain. Epidural injections have been shown to reduce pain and improve function.
Combining these two methods can result in the most effective treatment. The epidural reduces pain and makes physical therapy more efficient.
Important points to keep in mind
- Common causes of leg and back pain are herniated discs in the lower back. Most people experience symptoms that improve over time with or without treatment.
- Many people can manage their symptoms by changing their lifestyle, taking pain medication, exercising, or getting steroid injections. You can combine these treatments or try another one if none of them work.
- Non-surgical treatments may not be as effective in relieving your pain. Surgery is an option for symptoms that last at least six weeks and make it difficult to perform your usual activities.
- Surgery and non-surgical treatments are similar in the long-term. They can reduce pain and other symptoms.
- There are risks associated with back surgery, such as nerve damage and infection. Also, there is a chance that your symptoms won’t improve after the surgery. Even if your symptoms improve after surgery, there’s always a possibility that you will experience new symptoms.
- You can always decide to have surgery later, if your symptoms don’t improve or worsen after you have tried other treatments.