You probably know that the framework of the body is the spine. The spine is made up of 24 bones (vertebrae) that are connected by muscles and ligaments. Between each of the vertebrae is a spinal disc – a fluid-filled structure resembling a jelly donut that provides cushioning between the bones. Over time, a disc may bulge or break open, causing the fluid inside to leak out. This condition is known as a herniated disc.
WHAT ARE THE MOST COMMON SYMPTOMS OF A HERNIATED DISC?
Every individual is different; some people who experience a herniated disc have no pain or discomfort and have no idea anything abnormal has occurred. More commonly, people do experience symptoms when a disc ruptures. These symptoms include arm or leg pain (depending on the location of the affected disc), numbness or tingling due to nerve irritation, weakness in the muscles surrounding the affected disc, and back pain that can range from mild to severe.
Herniated discs can occur anywhere along the spine, including the neck, the upper back, and the lower back (which is the most common location.) When neck or back pain symptoms become severe, prevent you from performing daily functions, or interfere with your bowel or bladder function, you may need to seek emergency medical attention. When symptoms are bearable but worsen or last longer than a week, you should schedule an appointment with a spine doctor.
HOW DOES A BACK PAIN SPECIALIST DIAGNOSE A HERNIATED DISC?
Before your back specialist can treat you for a herniated disc, he or she must first take the following steps to make sure that a herniated disc is the reason your experiencing back pain or discomfort.
- Review your medical history to find out if anything else may be causing your back pain.
- Conduct a physical examination that may include tapping parts of your arms or legs to check your reflexes, conducting a neurological examination to test your muscle strength, and touching and moving parts of your body to identify where the pain is coming from.
- Review your symptoms by asking you how intense or dull your pain is, where your pain is, and whether your pain becomes better or worse in different circumstances, such as sitting in a certain position or performing a specific range of motion.
- Conduct various diagnostic tests, such as taking X-rays and using a computer processing system to closely view the structures in your body; conducting a magnetic resonance imaging (MRI) test that uses radio-wave energy to take pictures of your organs and body structures, and (very rarely) injecting dye into one or more discs to identify which may be herniated.
HOW DOES A SPINE SPECIALIST TREAT A HERNIATED DISC?
If your spine doctor determines you have a herniated disc, he or she has several options to treat you, depending on how severe your symptoms are. If you have no or very minor symptoms, you may need no treatment at all. Often, conservative (non-surgical) treatments provide relief from symptoms. These treatments may include:
- Physical therapy
- Pain medication
- Muscle relaxants
- Cortisone injections
If you’re still in pain two months after using one or a combination of these conservative treatments, your doctor may suggest discectomy surgery. This procedure relieves pain by removing all or a portion of the herniated disc. For discs located near the neck, the surgery involves making a small incision through the neck, removing the herniated disc, and replacing it with a small graft of bone (taken from another part of your body) that will permanently fuse with the surrounding vertebrae over time. The other common surgical procedure to relieve pain is called spinal laminectomy. This involves removing part of the spine called the lamina (a sheath that covers the disc and nerves) to give the herniated disc and surrounding nerves more room to expand.
In more severe herniated disc cases, patients may not respond to the most conservative approaches, and may require more involved surgical procedures. Regardless of how complex your herniated disc condition may be, a spine doctor has a wide variety of tools he or she can use to treat you. Finding the most effective treatment (or combination of treatments) may take some time, but you can be confident your spine specialist will eventually identify the back pain treatment regimen that will work for you.