If you’re looking for relief from herniated disc pain and sciatica, you’ve come to the right place. Here at our blog, we’ll give you the latest information on the best treatments for these conditions. Whether you’re looking for natural remedies or want to know what the latest surgical options are, we’ve got you covered.
What Is Herniated Disc
The spinal column is made up of smaller bones called vertebrae. These bones form a canal in which the spinal cord runs. The vertebrae are also separated by small pillows of cartilage called discs. The discs act as shock absorbers for the spine and keep the vertebrae from rubbing against each other.
A herniated disc occurs when a disc is damaged and a fragment of it bulges out of the spinal canal. This can put pressure on the spinal cord or nerves, which can cause pain. Herniated discs are more common in the cervical spine (neck) and lumbar spine (lower back), but they can occur in any part of the spine.
There are two main types of herniated discs:
These occur when there is a small tear in the outer layer of the disc. This can cause some of the inner gel-like material to leak out.
Nucleus pulposus prolapse
This happens when the inner gel-like material bulges out through a tear in the outer layer.
Herniated discs can happen due to normal wear and tear, but they can also be caused by traumatic injuries or lifting heavy objects improperly. Most herniated discs occur in people over the age of 40, but they can happen at any age.
What Causes a Herniated Disc
There are several members in your spine that work together to keep you moving and pain-free. When one of these discs experiences problems, it can put pressure on the spinal cord or the spinal nerves and cause pain.
Discs act as cushions between the vertebrae, and they absorb shocks to the spine. The outer layer of the disc is tough and fibrous, but the inner layer is softer and more jelly-like. If the outer layer cracks or tears, the inner layer can bulge out from the crack. This is called a herniated disc.
Herniated discs are more common as you age because discs degenerate over time and become less flexible. They’re also more vulnerable to injury from a twisting movement or excessive strain. A herniated disc can occur in several places along your spine, but it’s most likely to happen in your lower back or neck.
Most herniated discs occur with relatively minor damage to the outer layer of the disc. However, in certain individuals, a herniated disc can cause severe pain because it presses on a nerve root that leads to your arm or leg.
What Are the Symptoms
Cervical radiculopathy is often characterized by a sharp pain in the neck that radiates down the arm to the fingers. This is caused by a compression of the nerves in the cervical spine and can be made worse by certain positions or movements of the neck.
Low backache is a more common, but less severe, form of radiculopathy which affects the lumbar spine. Sciatica is another form of radiculopathy which affects the sciatic nerve, which runs from the pelvis to the feet. Sciatica is often worse on one side of the body and can cause leg pain and weakness.
There are many possible causes of radiculopathy, including degenerative diseases such as osteoarthritis, herniated discs, spondylolisthesis, and spinal stenosis. Radiculopathy can also be caused by acute injuries, such as car accidents or falls. In some cases, there is no clear cause of the condition.
Radiating pain is often worse at night or when you are lying down. You may also experience intermittent episodes of sharp pain when you move into certain positions or when you cough or sneeze. The pain may be accompanied by numbness, tingling, or weakness in the affected arm or leg.
If you have a long history of low back pain with intermittent episodes of sciatica, your symptoms are likely to be caused by a degenerative condition such as spinal stenosis or degenerative disc disease. If you have sudden onset of severe leg pain after an injury such as a car accident, your symptoms are more likely to be caused by a herniated disc or another acute injury.
Treatment for radiculopathy depends on the underlying Cause Of your condition. If your symptoms are mild and not causing significant interference with your daily activities, your doctor may recommend over-the-counter pain relievers and anti-inflammatory medications.
If your symptoms are more severe, your doctor may recommend physical therapy to help improve your range of motion and strength. In some cases, surgery may be necessary to relieve pressure on the nerves or to stabilize the spine.”
When To Seek Medical Care
If you have either low back pain or leg pain that does not go away, is severe, or keeps coming back, you should see a doctor. Seek medical care if you develop any of the following:
- Radiographic imaging is indicated when there are red flags for serious conditions such as infection, metastatic cancer, progressive neurological deficit, or uncontrolled pain despite conservative measures.
- Advanced imaging with MRI is generally not required in the initial evaluation of simple herniated discs without radiculopathy.
- If you have a loss of bowel or bladder function, seek urgent medical evaluation.
- If you develop progressive weakness in your legs or an inability to walk, seek immediate medical attention.
The majority of people with herniated discs and sciatica will improve with time and conservative measures. However, there are some general guidelines for when to see a spine specialist or other medical provider:
- If your pain lasts for more than a few days or significantly interferes with your activities of daily living, you should see a doctor.
- If over-the-counter medications provide only partial relief, you should see a doctor.
- If self-care measures such as rest and ice/heat don’t help, you should see a doctor.
- If your leg pain is severe and/or accompanied by numbness or tingling in the rectal region (saddle anesthesia), you should see a doctor. These symptoms may indicate cauda equina syndrome which is a medical emergency.
Depending on your individual situation, your doctor may refer you to a spine specialist or other medical provider for further evaluation and treatment. The American College of Surgeons provides some guidance on when to seek surgical treatments for herniated discs and sciatica.
Testing Modalities And Diagnosis
There are a few testing modalities and diagnoses that can be used to help determine if you have a herniated disc and sciatica. The first is looking at your past injury. If you’ve had powerful magnets or bone spurs in the affected region, it’s more likely you have a herniated disc.
The next is computed tomography, which can show the nerve roots and the spinal cord. Next is an electromyogram, which can measure the electrical impulse in the muscle tissue. Finally, magnetic resonance imaging (MRI) can create 3D images of the body structures and show if there is nerve compression. If you have any of these symptoms, it’s important to see a doctor to get a proper diagnosis.
Most herniated disc cases are treated conservatively, without surgery. This is because most discs heal on their own over time, and surgery is only needed in severe cases.
If you have a herniated disc, your doctor will likely recommend conservative, nonsurgical treatments at first. These can usually help relieve your symptoms If you have pain that’s only mild or moderate, for example, your doctor might suggest muscle relaxants, physical therapy, or electrical muscle stimulation.
For more moderate to severe pain, your doctor might recommend an epidural steroid injection. This involves numbing the area around your spinal cord with a local anesthetic and then injecting a steroid medication into the epidural space. The steroid helps reduce inflammation and pain.
The injection is given through a spinal needle that’s inserted into the epidural space. You might feel a brief sensation of pressure when the needle goes in. The whole procedure usually takes less than 30 minutes and you can go home the same day.
The effects of an epidural steroid injection can be immediate or could take a few days to kick in. Once they do, you should be able to move around with less pain and be able to do a more painless activity level. If the initial treatment doesn’t work, you might need repeat injections.
In some cases, your doctor might also recommend pelvic traction. This involves wearing a special harness that pulls on your pelvis to take pressure off the affected nerve root. Pelvic traction is usually done in a hospital or physical therapy office and can provide short-term relief from pain while you’re being treated with other methods such as physical therapy.
After diagnostic testing such as an MRI or CT scan to get an image of the depth evaluation of herniation, if required treatment will be given accordingly which may include resting for several weeks followed by gradual increases in activity level as tolerated, spinal nerve inflammation due to herniation may require initial treatment with corticosteroids ( anti-inflammatory medication) given either orally or by epidural ( spinal) injection under ray guidance and heat therapy, gentle massage.
Depending on the location of the herniated disc and the severity of your sciatica, your doctor might recommend other issues before considering surgery. If your pain is manageable and not disabling, you might try conservative treatment options first, such as medication, physical therapy, and injections.
Surgery should be reserved for people who have reasonably good overall health and who haven’t found significant pain relief from other treatments. Sciatica can sometimes improve on its own, so you might wait to see if conservative treatment options work before considering surgery.
There are two main types of surgical options for treating a herniated disc: open-spine surgery and minimally invasive spine surgery.
Open spine surgery involves a large incision in your back so that the surgeon can access your spine. Minimally invasive spine surgery uses small incisions and technology to visualize and treat your spine without harming the surrounding tissues. Recovery time is often shorter with minimally invasive procedures, but they might not be an option for everyone.
Your doctor will consider many factors when deciding whether surgery is the best option for you, including the type of herniated disc you have, your age, your overall health, and your preference.
Lumbar Spine Surgery
Lumbar spine surgery is generally performed when other methods of treatment have failed to relieve a person’s leg pain and other symptoms associated with a herniated disc in the low back. If you have a herniated disc, you know how debilitating the pain can be. You may have tried physical therapy, pain medication, and a back brace, but still, find that the pain interferes with your quality of life.
Spinal fusion is the most common type of lumbar spine surgery. In this procedure, the surgeon removes the affected disc and any bone spurs. The adjacent vertebrae are then joined together using metal rods and screws. This stabilizes the spine and relieves pressure on the nerve root.
Lumbar laminotomy is another common type of lumbar spine surgery. In this procedure, a small incision is made in the back and a small opening is created in the lamina (roof) of the vertebrae. This gives the surgeon access to the herniated disc so it can be removed. The opening in the lamina is then closed with sutures or metal screws and rods.
Laminectomy is similar to laminotomy, but more bone is removed from the vertebrae. This gives the surgeon more room to work and access to sophisticated instruments that can remove herniated discs with less risk of damage to surrounding tissue.
Artificial disc surgery is a newer procedure that is being used with increasing frequency as an alternative to spinal fusion surgery. In this procedure, a small incision is made in the front of the lower spine and a small opening is created around the affected disc.
The damaged disc is removed and replaced with an artificial disc made of metal or plastic. The artificial disc preserves motion between the two vertebrae while simultaneously relieving pressure on nerves or other surrounding structures.
The sacral vertebrae are another option for patients who have severe leg pain due to degeneration of their discs but who do not want to undergo spinal fusion surgery. In this procedure, metal rods are inserted into the sacral vertebra (the large bones at the base of your spine).
The rods are connected at each end by pedicle screws (metal fasteners). This strengthens and stabilizes your lower spine without removing any discs or bones
Cervical Spine Surgery
A herniated disc in the cervical spine can cause pain and other symptoms. Treatment options include conservative measures such as medication, physical therapy, and steroid injections. In a small select group of patients, surgery may be recommended.
The type of surgery performed depends on the location of the herniated disc. Anterior cervical surgery is performed through an incision in the front of the neck. A cervical plate is placed over the affected disc and screwed into place. This stabilizes the spine and relieves pressure on the nerve root.
Posterior cervical surgery is performed through an incision in the back of the neck. The surgeon will remove a small portion of the bone to access the disc. The herniated material is removed and a surgical fusion is performed using bone grafts and/or metal rods and screws. In some cases, an interbody device may be used to support the fusion.
Complete recovery from cervical spine surgery takes several months. During this time, it is important to follow your surgeon’s instructions for activity and rehabilitation.
Frequently Asked Questions
There is no one answer that fits all cases when it comes to healing a herniated disc naturally. Some people may find relief from treatments such as chiropractic care, acupuncture, or massage therapy. Others may need to take a more hands-on approach, such as physical therapy or exercises designed to strengthen the muscles around the spine. It is important to speak with a healthcare professional to determine the best course of action for your individual case.
A herniated disk can cause sciatica, which is a pain in the sciatic nerve that runs from the lower back down the leg.
A herniated disc does not always heal on its own, although most cases of mild to moderate herniated discs will improve over time. If you have a herniated disc, you can help speed your recovery by maintaining good posture, exercising regularly, and avoiding activities that put a strain on your back.
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Your mental attitude is very important. It is best if you try to remain cheerful and not let pain get you down. Studies have shown that patients with a positive mental attitude recover more quickly.
Regular activity is also very important. You should not stay in bed for more than two days unless your physician tells you to. When you get up, do so slowly and carefully. Avoid sudden twists or movements. A prompt return to your regular job or activity is in your best interest.
If such activity is not possible, begin some other form of exercise such as walking, swimming, or riding a stationary bicycle. Do these activities for limited periods only at first, gradually increasing the time as tolerated.
This program of medical treatment and exercise often results in the successful treatment of herniated discs and sciatica pain. However, if pain persists despite treatment, surgery may be necessary to relieve the pressure on the nerve root. Your physician can advise you on whether surgery is indicated in your particular case.
Alan Walker is an author, researcher, and contributing writer at Spine Institute NY. He is a typical introvert, coffee fanatic, and freelancer.”