Herniated Disc

What is it?

Herniation describes an abnormality of the intervertebral disc that is also known as a “slipped,” “ruptured” or “bulging” disc. This process occurs when the inner core (nucleus pulposus) of the intervertebral disc bulges out through the outer layer of ligaments that surround the disc (annulus fibrosis). This tear in the annulus fibrosis causes pain in the back at the point of herniation. If the protruding disc presses on a spinal nerve, the pain may spread to the area of the body ( such as arms or legs ) that is served by that nerve.

What are the symptoms?

Usually, the main symptom is sharp, acute pain. In some cases, there may be a previous history of localized low back pain, with pain also extending down the corresponding arm or leg served by the affected nerve. This pain is usually described as a deep, sharp pain, which gets worse as it moves down the affected leg or arm. The onset of pain with a herniated disc may occur suddenly or it may be preceded by a tearing or snapping sensation in the spine, which may be attributed to a sudden rupture in the annulus fibrosis.  Patients will sometimes walk with a painful gait, flexing the affected leg so as not to put too much weight on the side of the body that hurts.

What is the treatment for a herniated disc?

Usually treatment will begin with a modification of activities. Sitting, bending, lifting and twisting are discouraged in a patient suffering from acute herniation because they put a large amount of stress and pressure on the lumbar spine, which may increase the pressure on the affected nerve root. The appropriate use of medication is an important part of conservative treatment. This can include anti-inflammatory drugs, analgesics and muscle relaxants. Referral to our pain management physician for an epidural steroid injection may also be recommended in hopes of lessening swelling and irritation caused by the damaged disc. Surgery is typically recommended only after physical therapy, rest, medications and or injections have failed to adequately relieve the symptoms of pain, numbness and weakness over a significant period of time.