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A Guide to Herniated Discs: Symptoms, Diagnosis, and Treatment Options

  • Feb 18 2022

One of the most common reasons for lower back pain is a herniated disc. In fact, the Cleveland Clinic estimates that as many as 2% of all adults get a herniated disc every year. 

An illustrated diagram of a herniated spinal disc.

Although this spinal injury can cause a great deal of pain and discomfort for some people, herniated disc treatments tend to be conservative. Very few people need surgery for herniated discs, and some may not even realize they have the condition. If you have ongoing back pain, though, that doesn’t seem to get better within a few weeks, make an appointment to see an orthopedic specialist to uncover the cause of the pain. 

At South Island Orthopedics, our board-certified surgeons are experts in diagnosing and treating herniated discs with surgical and non-surgical options. We are committed to providing patients throughout Long Island with the highest quality care from diagnosis through recovery. Whether your back pain is due to a chronic condition or a sudden injury, we’re here to help you get back to doing what you love as soon as possible.

What is a Herniated Disc?

In between each spinal vertebrae is a rubbery, flexible disc that serves as a cushion and shock absorber. These discs help you bend and move comfortably, and keep the spinal bones from rubbing against each other. 

 A woman has back pain while working from home.

Spinal discs have two layers: a firm, rubber-like outer layer called the annulus and a gel-like inner layer called the nucleus. The disc is herniated if the nucleus shifts and creates a bulge or if the annulus cracks and lets the fluid leak out. 

A bulging disc can put pressure on the nerves in the spinal cord. This can cause pain in the back as well as pain, weakness, numbness, or tingling in an arm or leg, depending on the affected nerves. A disc that is leaking fluid, also known as a ruptured disc, can also irritate and inflame surrounding nerves, contributing to discomfort. 

What Causes a Herniated Disc? 

By far, the most common cause of a herniated disc is age. Getting older causes wear and tear on the discs that increase the risk that the annulus will weaken. Younger people also have more water in their spinal discs, which keeps them supple and flexible.

However, other factors that increase the risk of a herniated disc include:

  • Carrying excess weight, which puts more pressure on the spine
  • Genetics — some people are simply more prone to back problems than others
  • Lifting a heavy item using your back instead of your legs, which cause a weakened disc to bulge or rupture
  • Heavy physical labor that puts extra strain on your back or work that requires repetitive motions
  • Frequent driving that requires you to sit for long periods, as engine vibrations can put pressure on your spine
  • Trauma, like a hard fall, an auto accident, or a hard blow (such as while playing contact sports)
  • Smoking, which reduces the oxygen available to the discs and speeds degeneration

Again, though, age is the leading cause of the injury. The majority of people who have a herniated disc are between ages 30 and 50, and men are more susceptible than women. 

Symptoms of a Herniated Disc

Herniated discs are most common in the lower, or lumbar, spine, but they can occur anywhere in the back. The location of your pain usually indicates the location of the affected disc, and the severity of the pain is closely related to the severity of the hernia. 

An older woman has lower back pain.

In the more common lumbar spine injury, you’re likely to feel sharp, burning pain in the lower back, which may radiate through the buttocks, legs, and feet. Some people report that the pain worsens when they cough, sneeze, or change positions.

It is possible to have a herniated disc in the upper, or cervical, spine as well. In this case, you may feel pain in the upper back that radiates into the shoulders and arms. 

In many cases, a herniated disc only causes temporary discomfort that can be managed with conservative measures. The condition can worsen, though, and cause complications that require more aggressive treatments. For example, the pain can worsen to the point that it interrupts daily activities, leads to a loss of sensation in the lower body, or causes bladder and/or bowel dysfunction. 

Diagnosing Herniated Discs

Determining the best herniated disc treatment begins with an accurate diagnosis to determine the location and severity of the condition. Again, for many people, the pain subsides after a few days of rest, over-the-counter medication, and applying heat and ice to the affected area. But if the pain persists for several weeks, make an appointment with a doctor. 

Diagnosing a herniated disc typically includes:

  • A review of symptoms, including location, intensity, duration, and triggers 
  • A neurological exam to assess feeling, reflexes, and stability in the limbs
  • Imaging tests, including X-rays, MRI (most common), CT scans, and myelograms
  • Nerve tests to determine how well signals travel along the nerves

Your doctor will develop a treatment plan based on the location and severity of the injury.

Treating Herniated Discs

In most cases, herniated disc treatment begins conservatively. Most people are advised to rest and take over-the-counter pain relievers until they feel better.

If your symptoms do not improve, your doctor may:

  • Prescribe pain medication 
  • Administer steroid injections (also known as nerve blocks) in the spine to relieve inflammation and reduce pain
  • Recommend physical therapy to improve strength and reduce pain

Typically, these treatments ease pain and discomfort and prevent the need for surgery.

Surgery for Herniated Discs 

If conservative herniated disc treatments are not effective, surgical treatment is an option. It’s reserved for those patients who have extreme, unbearable pain, difficulty walking, bladder and bowel instability, or extreme numbness or weakness in their limbs. Surgical procedures for herniated discs cannot “fix” the disc, but rather remove the affected disc (discectomy), remove some of the bone surrounding the disc to make more room for it (laminectomy), or remove the disc and fuse two vertebrae to make the spine more stable (spinal fusion). 

Herniated Disc Treatment at South Island Orthopedics

If you have back pain and suspect you have a herniated disc, we encourage you to make an appointment with an orthopedic specialist at South Island Orthopedics. Our offices are equipped with the latest imaging technology, ensuring you can receive an accurate diagnosis quickly and start working toward pain relief right away. Click here to schedule a visit now. 

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Posted in: Neck/Back & Shoulder, Spine