Herniated Disc

Overview
Back pain is a very common complaint in patients of all ages, and many studies suggest that 80% of people living in the United States will experience back pain at some point in their lives. Having said that, a common cause of back pain is a ruptured or herniated disc in the spine. A lumbar disc herniation is a ruptured disc that occurs in the low back, also known as the lumbar spine. Depending on the severity of the disc herniation, patients may experience mild or debilitating pain symptoms, such minor aches and pains or a complete loss of leg function and ability to control bowel movements. Herniated discs may not heal on their own, so it’s important for patients to seek medical care if they begin to experience worsening symptoms from the condition.  

Causes
Disc herniation occurs when the inner portion (nucleus pulposus) of a spinal disc breaks through the hard exterior of the disc, causing the nucleus pulposus to escape and irritate surrounding nerves, muscles, and ligaments. When the disc herniates, it puts immense pressure on vulnerable structures within the spine, including the spinal cord and spinal nerves. There are many risk factors that can lead to a lumbar disc herniation. The most common cause of a lumbar disc herniation is natural wear and tear from aging. As we age, our spinal discs begin to dry out, making them increasingly susceptible to damage. Other factors include lifestyle choices, such as smoking, lack of exercise, inadequate nutrition, and poor posture. An occupation that requires lots of heavy lifting and manual labor can also lead to a disc herniation.

Symptoms
Symptoms of a herniated disc vary depending on the cause and location of the condition. If the disc herniation is relatively new, patients may not experience any symptoms for several weeks or months. As the condition progresses, however, symptoms will likely develop in the back, upper extremities, and lower extremities. For lumbar disc herniations, the most common symptom includes pain in the lower back. Pain may be characterized as a dull ache or sharp, electric shock-like pain. Other symptoms may include muscle weakness, arm or leg numbness, tingling in the upper and lower extremities, muscle spasms, or overactive reflexes.

Treatments
Treatment for a lumbar disc herniation may require a multidisciplinary approach to ensure complete pain relief. Conservative therapies are often the first line of defense for this condition, especially if the pain is mild. These techniques often include rest, warm or cold compresses, massage therapy, physical therapy, and over-the-counter pain relievers. If the condition worsens, patients may benefit from interventional pain therapies such as steroid injections, nerve blocks, radiofrequency ablation, and nerve stimulation. If these treatment options fail to provide relief, a Southwest Spine and Pain Center physician may refer the patient to a spine surgeon to remove the herniated disc.