Although the patient may feel some pain in the back, the major symptoms usually result from injury to the nerves. Think of the nerves like electrical wires that send signals from the brain to the muscles.
This can lead to significant pain down the nerve, often causing a burning sensation. Most herniated discs occur in the lower back, affecting nerves that run down the legs, such as the sciatic nerve. Some patients may experience symptoms such as numbness or weakness to the area, as well. It may be time to think about surgery as an option when:.
Surgery to repair a herniated disc is usually minimally invasive. The goal is to preserve the normal anatomy of the spine. I always operate by my philosophy of individually tailoring my treatment and approach to the patient. Whether a herniated disc appears small or very significant on an MRI is much less important to me than how a patient feels.
I treat the person, not the X-ray, and I try to help each patient get back to living an active and enjoyable life. Richard Kim, M. Born and raised in Southern California, Dr. Richard Kim earned his undergraduate degree in biochemistry from University of California, Riverside. This followed with a Master of Science in biochemistry and neurophysiology. The vertebrae are separated by cushiony discs, which act as shock absorbers preventing the vertebrae from rubbing together. The outer ring of the disc is called the annulus.
It has fibrous bands that attach between the bodies of each vertebra. Each disc has a gel-filled center called the nucleus.
At each disc level, a pair of spinal nerves exit from the spinal cord and branch out to your body. Your spinal cord and the spinal nerves act as a "telephone," allowing messages, or impulses, to travel back and forth between your brain and body to relay sensation and control movement see Anatomy of the Spine.
A herniated disc occurs when the gel-like center of your disc ruptures out through a tear in the tough disc wall annulus Fig. The gel material is irritating to your spinal nerves, causing something like a chemical irritation.
The pain is a result of spinal nerve inflammation and swelling caused by the pressure of the herniated disc.
Over time, the herniation tends to shrink and you may experience partial or complete pain relief. Different terms may be used to describe a herniated disc.
A bulging disc protrusion occurs when the disc annulus remains intact, but forms an outpouching that can press against the nerves. A true herniated disc also called a ruptured or slipped disc occurs when the disc annulus cracks or ruptures, allowing the gel-filled center to squeeze out. Sometimes the herniation is so severe that a free fragment occurs, meaning a piece has broken completely free from the disc and is in the spinal canal. Most herniated discs occur in the lumbar spine, where spinal nerves exit between the lumbar vertebrae, and then join together again to form the sciatic nerve, which runs down your leg.
Symptoms of a herniated disc vary greatly depending on the location of the herniation and your own response to pain. If you have a herniated lumbar disc, you may feel pain that radiates from your low back area, down one or both legs, and sometimes into your feet called sciatica. You may feel a pain like an electric shock that is severe whether you stand, walk, or sit. Activity such as bending, lifting, twisting, and sitting may increase the pain.
Lying flat on your back with knees bent may be the most comfortable because it relieves the downward pressure on the disc. Sometimes the pain is accompanied by numbness and tingling in your leg or foot. You may experience cramping or muscle spasms in your back or leg. In addition to pain, you may have leg muscle weakness, or knee or ankle reflex loss. In severe cases, you may experience foot drop your foot flops when you walk or loss of bowel or bladder control.
If you experience extreme leg weakness or difficulty controlling bladder or bowel function, you should seek medical help immediately. Discs can bulge or herniate because of injury and improper lifting or can occur spontaneously. Aging plays an important role.
As you get older, your discs dry out and become harder. The tough fibrous outer wall of the disc may weaken. The gel-like nucleus may bulge or rupture through a tear in the disc wall, causing pain when it touches a nerve. Genetics, smoking, and a number of occupational and recreational activities may lead to early disc degeneration. Herniated discs are most common in people in their 30s and 40s, although middle aged and older people are slightly more at risk if they're involved in strenuous physical activity.
Lumbar disc herniation is one of the most common causes of lower back pain associated with leg pain, and occurs 15 times more often than cervical neck disc herniation. When you first experience pain, consult your family doctor. Your doctor will take a complete medical history to understand your symptoms, any prior injuries or conditions, and determine if any lifestyle habits are causing the pain. But it is also the start of the healing process.
If this inflammatory reaction is appropriately managed early, then most disc injuries should heal, as with any other structure. If it is poorly managed it can lead to painful restriction to movement, and long-term disability. Early intensive treatment from the Doctor and Physiotherapist aimed at returning normal movement and function, and controlling the inflammatory response and pain, can have a dramatic impact on the fate of that injury.
For more information see your local LifeCare Practitioner, click here to find your closest LifeCare clinic. Back pain is probably the most widespread, common, and potentially disabling injury in modern society. It is also one of the most misunderstood.
Lifecare Close. For more information talk to a specialist at a Lifecare clinic near you.
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