As a disc degenerates, the soft inner gel in the disc can leak back into the spinal canal. This is known as disc herniation, or herniated disc. Once inside the spinal canal, the herniated disc material then puts pressure on the nerve, causing pain to radiate down the nerve leading to sciatica or leg pain (from a lumbar herniated disc) or arm pain (from a cervical herniated disc).
It’s critical that a highly trained physician accurately diagnoses the underlying cause of your back pain and other symptoms since the diagnosis dictates the treatment options.
For example, treating a lumbar herniated disc will not do you much good if a muscle strain or other soft tissue injury is the actual cause of your pain. This point is particularly important if you might be considering surgery. Surgery may be considered when non-surgical treatments, such as pain medications, epidural steroid injections, chiropractic care and physical therapy have not provided adequate pain relief.
Most studies report that more than 50% of patients find measurable pain relief with epidural steroid injections. They also underscore the need for patients to enlist the services of professionals with extensive experience administering injections, and who always use fluoroscopy to ensure accurate placement.
Disc herniations can result from general wear and tear, such as when performing jobs that require constant sitting. However, herniations often result from jobs that require lifting. Traumatic (quick) injury to lumbar discs commonly occurs when lifting while bent at the waist, rather than lifting with the legs while the back is straight.
There is also a strong genetic component. Mutation in genes coding for proteins involved in the regulation of the extracellular matrix, such as MMP2 and THBS2, has been demonstrated to contribute to lumbar disc herniation.
Symptoms of a herniated disc can vary depending on the location of the herniation and the types of soft tissue that become involved. They can range from little or no pain if the disc is the only tissue injured, to severe and unrelenting neck or low back pain that will radiate into the regions served by affected nerve roots that are irritated or impinged by the herniated material.
Other symptoms may include sensory changes such as numbness, tingling, muscular weakness, paralysis, paresthesia, and affection of reflexes. If the herniated disc is in the lumbar region you may also experience sciatica due to irritation of one of the nerve roots of the sciatic nerve. Unlike a pulsating pain or pain that comes and goes, which can be caused by muscle spasm, pain from a herniated disc is usually continuous or at least is continuous in a specific position of the body.
It is possible to have a herniated disc without any pain or noticeable symptoms, depending on its location. If the extruded nucleus pulposus material doesn’t press on soft tissues or nerves, it may not cause any symptoms. Typically, symptoms are experienced only on one side of the body. If the prolapse is very large and presses on the spinal cord or the cauda equina in the lumbar region, affection of both sides of the body may occur, often with serious consequences.
The medical diagnosis identifies the actual cause of your pain. Our physicians determine the cause of your pain through a combination of the following:
Because of the complexities of understanding pain from a herniated disc, you should not attempt to make your own diagnosis. An inaccurate self-diagnosis may lead to further damage to spinal structures or to more severe episodes of back pain or leg pain if the condition is left untreated or treated incorrectly. Working with a spine specialist helps ensure that the correct location of a herniated disc, extent of the problem, and source of pain are identified early on.
Most insurance carriers do cover this procedure. Your out of pocket cost depends on the plan you have but our staff will be happy to contact your insurance carrier to get the details and answer any other questions you may have.
Or get a free symptom review over the phone with one of our highly experienced clinical staff