Invertebral disks are the soft padlike cushioning between each vertebra that acts as a shock absorber for the spine and all of its different parts. Herniated disks are disks that rupture or bulge out between the vertebrae and begin to pinch the nerves in the spine and the spinal cord. It is possible for disks in the upper part of the spine to herniate, but it is most common in the lower, or lumbar, region. Sometimes called ruptured or slipped disk or pinched nerve, most doctors are referring to the same thing; the bulging disk between the vertebrae that is causing a person pain.
As people get older the soft, cushiony disks between the spine can lose their elasticity. As elasticity dissipates, the disk can tear or rupture. The disk can then bulge and put pressure on the nerves and cause tingling, numbness or other sensations. Sometimes, muscles spasms can occur because the affected area is trying to protect itself from further injury. Herniated disks can happen due to traumatic experience, like an accident or a fall, or from extreme overexertion, like lifting a very heavy weight. Herniations can also happen over time after normal wear and tear. There are also cases where a condition called Spinal Stenosis is narrowing the patient’s spinal canal and the herniated disk further aggravates and irritates the nerve.
Some symptoms of a herniated disk are tingling or numbness in the “saddle” region (any part of you that would touch while sitting in a saddle); electric shock type pains, which are unusual pains in the back and legs; weakening of the muscles; bowel or bladder problems. Bowel and bladder control issues can be very serious and the sign of an emergency, so a health care provider should be consulted immediately.
In diagnosing a herniate disk, the doctor will usually perform a physical exam and may possibly take an MRI or x-ray. (There is always normal wear and tear to a disk, so doctor has to determine what is normal and what might actually be causing the problem.)
To treat a herniated disk, doctors will often try non-surgical methods before considering surgery, depending, of course on the symptoms and the severity of the pain. The first step is always to try to reduce the pain and inflammation the patient is experiencing by having the patient rest (usually on a firm surface). Though complete rest might be necessary at the beginning until the pain is alleviated, it is necessary to get up and moving as soon as possible. Bed rest for more than a day or two can actually slow recovery, but avoiding excessive bending or lifting is advised. Other non-surgical methods are usually tried in addition to rest. Non-surgical methods can include:
- Alternating ice and heat and other compresses
- Anti-inflammatories or other medications such as muscle relaxants (if the muscles in the back are in spasm), corticosteroids, and a new class of medications called neuropathic pain medications
- Bracing the spine and hydrotherapy (to remove the pressure from the spine)
- Chiropractic care (or spinal manipulation) and/or traction
- Electrical stimulations (called TENS)
- Acupuncture
- Massage
The second step is to get the back moving again. Stretching exercises and mild activity is necessary. A doctor will probably recommend stretching along with some aerobic exercise along with core building exercises that will strengthen the stomach and back muscles.
Only one in 10 sufferers needs to have surgery. In most cases, if the person follows the healing regimen, the disk will shrink over time. Herniated disks tend to be very painful, and the pain usually eases up within one week, but it could take up to six months for the disk to fully shrink.
There are several surgical options if a person does decide on this route. Surgery is to reduce the pain, but also to get the protruding disk from causing nerve damage. Surgical methods include:
- Chemonucleolysis: An enzyme is injected directly into the disk to dissolve the portion of the disk that is protruding
- Diskectomy: Surgery under general anesthesia where a surgeon removes the protruding portions of the disk.
- Microdiskectomy: Similar to a Diskectomy, but it is less invasive, since the surgeon makes a smaller incision and the surgery is performed looking through a microscope, as opposed to the standard open surgery of a Diskectomy.
Recovery
Most herniated disks heal on their own with time and proper care. Of the people who need to opt for surgery, depending on the individual case and which surgical method, full relief from the pain and symptoms is possible. After the initial surgery, the doctor will prescribe an exercise regimen that will increase mobility and strengthen the muscle that will help to stabilize the back and spine.
Prevention
Back pain affects most American adults. There is no known, absolute prevention of back pain. However, the common belief is that staying physically fit to reduce the load on the spine and keeping the back and stomach muscles equally strong, so that the spine is able to keep in line, can reduce the chances of back pain and herniations.
This info was very helpful, I have suffered from low back pain for a while thanks
Has anyone had relief after removing fusion hardware?
I was wondering my first mri said I have deginertive disk dease and my right knee hurt I thought it was from all the stooping I did not being able to bend then I took my second mri and they said I have a tear but my doctor said I have two hernaited disk would it take three months after my injury before I started getting pain in my right knee and leg or could the knee thing be a separate injury
Memory foam Mattress beds are great relief when suffering with back pain and lumbar disc pain
Hi David,
I bought a Memory foam Mattress thinking that it was good for my back. However, I think this made my back worse as it was too soft. From speaking to my chiropractor he evaluated my back and said I required a Firm Matress and to avoid Memory Foam.
I came across your story about your back problem. I’ve been in 6 car accidents, 2 herniated disks and THOUSANDS of drs. and Chiros. I found THE BEST DR. SURGEON EVER! email me if you want his info. I swear this man SAVED my life and my pain is gone for the rest of my life. 10 years of pain and in one day it was gone! I was SCARED of surgery too but the dr. made me realize that he would NEVER give me surgery unless it was absolutely neccessary. In my case I had to or else I would have been paralyzed because the disk broke off and was cutting into my spine and nerves causing my pain. It can get worse over time and I only wish I caught it sooner. I just hope to help other people like me catch theirs in time :)The drs. told me I only had mild herniated disks but then ONE dr./surgeon I found saw my MRI and said, “Get in here tomorrow and you will need emergency surgery the next day” I was scared because this dr. was known for not doing surgery unless it’s VERY neccessary. But I was almost paralyzed because the other thousands of drs. didn’t catch it. I am SOOOO blessed. I am completely pain free because of this man and will be grateful to him forever.
Hope this helps anyone who needs it! I thought I would be on pain killers for the rest of my life but I’m not. 10 years people….10 years! Now pain free.
Kimmie
While I highly recommend exercise and physical therapy for back pain. It seems that most professional practitioners fail to realize that muscular imbalance is a leading cause of back pain and generic exercises are not going to help this condition. Our office worker society simply compounds this problem. When you sit for 6 to 8 hours a day, the hip flexors become shortened and weak and our posture just goes to hell. Talk to your medical provider and your PT and if they are not aware of this, it’s time to find another practitioner.
This information is very helpful. By going through the proper testing to KNOW that it is what you think it is. What if it’s stenosis, degenerated disc, sciatica, cervical brachial syndrome, a simple nerve compression or a facet syndrome. Once you know what is going on then it’s just a matter of using the right tools for the job. This type of pain is very serious.
I fell on a dripping pipe at my landlady’s and was told I have three herniated disks as well as 5 bulging disks in my neck. It is possible to get three herniated disks from one fall on water on the cement? I am in great pain at the present time, knees, back, legs and arms. I had two MRI’s one of the neck and one of the back. Marilyn Bloch
One of the best treatments for herniated disc is the spinal decompression therapy. I help patients with herniated disc everyday utilizing this therapy.
Surgeons never remove fusion hardware unless that is what is causing the pain.
There are so many factors that attribute to better back health:
Diet
Good Sleep
Excersize
Stretching
Educate yourself about your problem better
I see many people deal with these problems and say they are going to change one or more of the above. Most will try for a week or two and if they do not get immediate results they stop. Quicker results to consume a pain killer and give up.
Moving forward has to be a life changing experience and results take time. Granted if you have a severe structural problem that is causing you pain, you will not be perfect ever, but you can improve the way you feel over time if you can discipline yourself.
DDD in both my neck and lumbar
L5/S1 Fusion
Thankfully, only about 5% of disc herniations need surgery. The vast majority are stable (but chronic). There are home exercises, therapy, and other things that a person can do to reduce the injury and lead a very normal life. The surgery is very risky (and super expensive). If you don’t absolutely need the knife, then don’t go.
There are also other procedures that can be done prior to surgery. There are ways of performing microdiscectomy, RF neuroablations, and other things to reduce the pain.
Do some homework before they let a knife touch your skin. And certainly do not rely on the MRI. They are far too sensitive. About 30% of disc herniations seen on MRI are asymptomatic– meaning they are not causing pain. Just because you see a herniation on the MRI, it is not necessarily the smoking gun.
I have to agree with Dr. White. Surgery should always be the last resort unless there are red-flag symptoms (loss of bowel/bladder control, sudden onset of weakness in lower extremities, or cauda equina syndrome). Care should start with the least invasive, conservative care first and more invasive treatment should only be tried later if the conservative methods fail. Most cases respond favorably to conservative care such as spinal manipulation, traction, and PT. Surgical outcomes are poor in comparison, so I would give physical treatment a good chance before going under the knife.