Treatment of a Herniated Disc

Often referred to as a ruptured or slipped disc, a herniated disc occurs most often in the lower back region. Around 70% of people will have low back pain at some time during their lives, and a herniated disc condition often results in leg pain.

The spine is made up of 24 vertebrae, and these bones connect together to create a canal that protects the spinal cord and nerves. The nerves travel along the spinal canal, and the intervertebral disc cushions between the vertebrae. A disc herniates when the gel-like material inside pushes against the outer ring.

What causes a herniated disc?

If a disc is worn or injured, the gel material inside squeezes through the outer ring that encloses it. If the structure herniates, it can produce back pain and sciatic leg pain. For children and young adults, the disc contain plenty of fluid, but with age, these discs dry out and start to weaken. With weakening and shrinkage of the disc, the vertebrae narrow producing disc degeneration.

What are the risk factors for a herniated disc?

• Aging – This is the most common risk factor for a herniated disc.
• Male gender – Men between the ages of 30 and 50 are more likely to suffer a herniated disc.
• Weight – Overweight and obesity puts strain on the lower back.
• Improper lifting – Lifting heavy objects can cause a herniated disc of the lower back.
• Physically demanding jobs – Repetitive activities put strain on the spine. Many jobs require constant pulling, twisting, lifting, and bending, and this puts a person at risk for a herniated disc.
• Frequent driving – People who drive for a living are at risk for a herniated disc because sitting for long periods puts pressure on the discs and spine.
• Sedentary lifestyle – Lack of exercise is a risk factor.

What are the symptoms of a herniated disc?

The back pain associated with a herniated disc is often associated with leg pain, weakness, and numbness. The leg pain will go below the knee, and for many patients, extend into the foot and ankle. Symptoms include:

• Persistent back pain
• Leg and foot pain (sciatica)
• Leg and foot weakness
• Leg and foot tingling
• Loss of bowel and/or bladder control (cauda equine syndrome)

How does the Chicago pain doctor diagnose a herniated disc?

To diagnose a herniated disc, the doctor will take a medical history and conduct a comprehensive physical examination. The most useful diagnostic test is a magnetic resonance imaging (MRI) scan. This test creates clear images of the disc so the doctor can visualize the exact area that is herniated.

How does the pain management doctor in Chicago treat a herniated disc?

For many patients, a herniated disc will gradually improve over several days to weeks. Most people report being symptom-free by four months. However, many people continue to have symptoms. The nonsurgical treatment for a herniated disc includes:

• Rest – Bed rest for the first couple of days, followed by restriction of activities for two to three weeks. Also, the patient should avoid prolonged sitting, heavy lifting, and make slow, controlled movements.

• Non-steroidal anti-inflammatory medications (NSAIDs) – Medications like naproxen and ibuprofen are often prescribed to reduce inflammation and relieve pain.

• Physical therapy – Special exercises are taught to the patient to strengthen the muscles of the back.

• Epidural steroid injection – This involves the injection of steroids and/or anesthetic medications into the back.

Is surgery used to treat a herniated disc?

For a small percentage of patients, a herniated disc requires surgical correction. Spinal surgery is usually used only when conservative measures fail. The microdiscectomy is the most common procedure for a herniated disc.

This involves removing the herniated portion of the disc and any other fragments that exert pressure on the nerve. Following surgery, the doctor will order a rehabilitation program, which involves flexibility exercises, walking, and working with a physical therapist.