What is a Disc Herniation (Herniated Disc)?
Dr. Greg Khounganian, Spine Surgeon February 15, 2020
Between the vertebral bodies in the spine are discs which act as cushions, to minimize impact between the bones of your spinal column. A disc can be thought of as a jelly donut type of cushion, with a soft central component called the nucleus pulposus. The outer part of the disc is tougher, and quite rubbery. When that soft center part of the disc pushes out because of a tear in the rubbery part of the disc (known as the annulus), the condition is known as a disc herniation, herniated disc, ruptured disc, or slipped disc. All names refer to a similar condition, although the disc that has slipped may be located anywhere in the spine.
What Causes a Herniated Disc?
Two things happen when you have a herniated disc. First, the tougher outer portion of the disc becomes worn, and/or tears due to injury or trauma. Then the nucleus pulposus of the disc slips out through the tear. Disc herniation happens frequently due to the aging process. However, certain motions can cause a disc to slip. Lifting something very heavy can cause a herniated disc, overuse can cause a slipped disc, and so can trauma, such as a sports injury, or an auto accident. In addition, individuals who are overweight are more prone to a slipped disc, as the discs must support extra weight, which causes greater strain and stress on the disc.
Does a Herniated Disc Hurt?
Many men and women in Los Angeles live with a slipped disc, without knowing it. However, for others, a slipped disc can cause significant pain. Although a disc herniation may occur anywhere from your neck, to your lower back, disc herniations are most common in the lumbar (lower) spine. When pain—which may be debilitating—does arise, it is due to the disc pressing on nerves. When the nerves become irritated as the result of this pressure, it is not uncommon to have pain in the location of the disc, but it may also spread to your buttocks, thighs, or calves. For others, numbness may occur, or you may experience unexplained muscle weakness. Likewise, some individuals suffering from a slipped disc may feel tingling or burning sensations as the result of a herniated disc.
Pain from a disc herniation often gets worse while you're active and subsides a bit when you're at rest. However, for some individuals even sneezing or coughing can cause significant pain, as it causes addition pressure on the nerves.
How Do I Know If I Have a Herniated Disc?
Pain in the back should always be taken seriously, particularly if you experience sharp shooting pain, or if the pain doesn't go away within a few weeks. If the pain persists, you'll need to have special imaging tests run to diagnose the source of your pain. If a herniated disc is to blame, it won't show on a standard X-ray, although it is very common to have an X-ray first, to rule out a bone fracture and other conditions. Typically to diagnose a herniated disc, you will undergo tests including an MRI, CT scan, or a discogram.
Please note, it is crucial see a top Los Angeles spine surgeon immediately if you notice numbness, tingling, or any inability to control your bladder or bowels.
How Are Herniated Discs Treated?
Like most neck, back and spine conditions, there are multiple methods of treating a herniated disc. Treatments range from nonsurgical (conservative treatments) to surgery, if necessary. Dr. Khounganian always recommends the most conservative treatments first, and surgery will only be considered after all nonsurgical treatments have failed to provide pain relief.
That said, there is no one size fits all treatment plan for a herniated disc. The severity of the herniation must be considered. Your level of pain will be considered, as will your overall health and wellness. In some cases, you'll just need to rest, take it easy, and use some over the counter medication, to help with the pain until the problem improves on its own, in a few weeks.
In other cases, you may benefit from physical therapy, massage, ultrasound therapy, muscle stimulation, or other noninvasive treatments. For others, an epidural injection may help to alleviate the pain. Epidural injections deliver anti-inflammatory steroid medication into the epidural space of the spinal column to bring down swelling and irritation that is responsible for your pain.
Surgery is also a possible solution to a ruptured disc. If your pain cannot be resolved through non-surgical treatments, Dr. Khounganian will discuss whether or not surgery may help you. There are multiple types of surgeries, many of which are minimally invasive, that may be considered if your pain is disrupting your quality of life.
If you've experienced pain in your back and spine that will not resolve, it's very important to seek out a top spine surgeon. Contact Dr. Khounganian today for a consultation by calling 818-343-4430