Back pain presents itself in a variety of different ways: some patients experience sudden sharp pains in their lower back while others feel a constant low-level pain in their shoulders and arms. In both of these cases, the cause could be a herniated disc. Leading spinal surgeon Dr. Todd H. Lanman of Lanman Spinal Neurosurgery is an expert at diagnosing and treating these ruptured discs.
A herniated disc is when one of the cushions in between the vertebrae in your spine breaks through its protective shell. A herniated disc can also be referred to as a bulged, slipped, or ruptured disc. This spinal problem can occur at any point in your back and with varying levels of severity. The location and the pain you experience will determine your doctor’s treatment recommendations.
Herniated discs are often the result of disc degeneration. As you age, the cushions in between your vertebrae will start to wear and weaken. When you move, bend, twist, and lift objects, you place added strain on your back. The more the discs in your spine wear down, the more likely they are to rupture or split, causing back pain.
Everybody is different, which means you may be more or less prone to a herniated disc. Some people have weaker spinal cushions than others, which makes them more prone to back pain. Studies have found herniated discs are more common in individuals who have family members with similar spinal problems. Other people may never experience severe back pain.
Because herniated discs are caused by long-term wear, it doesn’t take much to cause them to slip or break. You don’t need to experience back trauma or have a sudden movement in your back in order to have a problem. Instead, you may experience a herniated disc while doing basic household chores, like emptying the dishwasher or sweeping the floor.
Many patients don’t know the exact cause of the herniated disc because the pain followed in the hours or days after the rupture.
The type of symptoms you experience will vary based on the location of the disc. If you have a herniated disc in the lower part of your spine (near the buttocks), the pain might radiate down your legs and into your feet. If you have a herniated disc in your upper back (closer to your neck), you may experience pain in your arms.
Additional symptoms of a herniated disc include numbness or tingling where the nerves are affected. You may also experience muscle weakness in that area that limits your ability to move or lift objects.
Some people have herniated discs without any symptoms. It’s not until something worsens the rupture that they start to feel pain.
The first thing to know about a herniated disc is the various body parts that make up your spine and the cushions that protect it. Your spine is made up of individual bones (vertebrae) that stack against each other. These multiple vertebrae allow you to bend over, twist, and move easily. Without them, human spines would be rigid, like a bar.
When your vertebrae move, they rub up against each other. This can cause wear and pain. As a result, each vertebra is protected by discs that work as shock absorbers cushioning the bones.
Discs have two key parts. The inner nucleus is jellylike and soft, this part is responsible for most of the cushioning. The exterior annulus is rubbery and protects the interior cushion.
A herniated disc occurs when there is a tear in the annulus that causes the nucleus to slip out. The nucleus can hit your nerves, causing pain, or lose its effectiveness as a shock absorber on the spine. The amount of pain you experience depends on how the nucleus slips out and where it is located.
Herniated discs can occur at any point in your spine. However, your doctor will likely categorize your herniated disc in one of two ways: cervical or lumbar.
The cervical spine is otherwise known as your neck. It refers to the collection of vertebrae that allow your head to turn in various directions. These bones also connect the head to the rest of the body, creating a communications superhighway with your nerves.
A cervical herniated disc may result in pain in your neck and upper back (between your shoulder blades). You may experience pain, numbness, or tingling in your arms down to your fingertips.
The lumbar spine refers to your back, including both your upper back and your lower back. Your upper back starts in your shoulder blades and works down your spine toward your beltline. Your lower back refers to the vertebrae near and above your buttocks. A lumbar herniated disc is more common than a cervical one.
A herniated disc in the lumbar spine can send shockwaves of pain down your legs. It can limit how long you can stand or walk. Some patients report that leg pain is worse than back pain for a lumbar herniated disc because the nucleus is hitting the nerves that control the lower body.
Many people live with herniated discs without realizing it. It’s not until there is additional trauma to the disc that the patient realizes there is a problem. However, most people experience back pain as a result of their ruptured or slipped discs.
If you are in pain, do not hesitate to seek medical help. While the pain might seem manageable now, it could get worse and limit your ability to move comfortably.
In emergencies, untreated herniated discs can lead to bladder and bowel dysfunction. This is where you cannot urinate even with a full bladder or you become incontinent. You may also experience numbness around your legs and thighs.
Even if you and your family members are prone to back problems (like herniated discs) there are still steps you can take to reduce the chances that you rupture the annulus in-between your vertebrae.
Even people who follow all of these guidelines may experience a herniated disc. However, you can decrease your chances of severe pain and lower your risk levels by practicing good spinal hygiene.
When a patient first presents with a herniated disc, the doctor will recommend non-surgical options to treat the pain. These can range from a period of low, painless activity levels to anti-inflammation medication. The doctor may recommend a series of herniated disc exercises or stretches to complete each day. They may also suggest physical therapy and massage. These treatment options work to reduce the pain levels caused by most herniated discs.
After testing multiple conservative and non-surgical options, your doctor may recommend more advanced treatments to reduce or eliminate your pain.
If your pain does not go away after practicing your herniated disc exercises and following your physical therapy appointments, your doctor may recommend herniated disc surgery.
The most effective form of surgery for the cervical spine would probably be an artificial disc replacement surgery. In the lumbar spine, the most effective form of surgery is either a microdiscectomy or an artificial disc replacement. Your doctor will remove the damaged disc and replace it with an artificial one. The new disc will be placed exactly where the old disc should have been. This surgical procedure will protect your range of motion and reduce your pain levels.
Artificial disc replacement surgery is more advanced than spinal fusion surgery. This occurs when the doctor removes the damaged disc and then fuses the spine together so the vertebrae cannot move against each other. While spinal fusion can reduce pain, it also negatively affects your range of motion and can lead to degeneration in adjacent discs.
If you have a herniated disc, you should avoid lifting heaving objects or placing added pressure on your back. You should also avoid repetitive, strenuous activities. Finally, try to eliminate the potential causes of your herniated disc. Replace your office chair with one that offers lumbar support and take steps to improve your posture.
An x-ray cannot detect a herniated disc. However, it can rule out other problems related to your spine. As your doctor looks to diagnose your herniated disc, they may recommend a series of x-rays to make sure your back is otherwise healthy.
Your doctor will likely run multiple tests to make sure your nerves and vertebrae are in good health in order to diagnose your herniated disc.
A large herniated disc is bigger than 3mm. A herniation of this size can cause the nucleus to slip out of the annulus and rub against your nerves. A herniated disc can keep growing into an 18mm extrusion.
In many cases, a herniated disc can heal on its own. The inflammation in your spine will decrease and pressure will be removed from your spine. However, you still need to follow the recommendations of your doctor to reduce your pain levels.
Not all herniated discs will improve on their own. Your disc tear may get progressively worse over time if you continue putting pressure on it. Even if you only have a small amount of pain, you should see your doctor in order to make sure your spine is in good health. Catching the rupture early and taking steps to help it heal can decrease the chances of it worsening.
Herniated discs are the leading cause of neck and back pain. Every year, up to two percent of people experience herniated discs. People ages 30 to 50 are most likely to get herniated discs and the problem affects men twice as often as women.
You don’t have to give up the activities you love or limit your ability to work just because you are in pain. If you suspect you have a herniated disc or are currently living with back and neck pain, seek medical help from a leading spinal expert. Dr. Lanman is one of the most sought-after spinal surgeons in Beverly Hills and has expanded his practice to the east coast. He works with Hollywood’s biggest stars, C-Suite executives, and patients around the globe. Contact Dr. Lanman to set up for a consultation and take the first step towards living pain-free.