Herniated Disc Treatment
A herniated intervertebral disc occurs when the soft nucleus pulposis, or the center part of the disc, ruptures though the outer wall or annular rings of the disc structure. It is also called a herniated disc, slipped disc, or ruptured disc. Disc herniations can occur in the neck, middle, and lower back. A classification system is in place to describe the degree of herniation of disc material.
Herniated discs are very common with the majority being asymptomatic, or the symptoms go away after a few days or weeks in 85% of the cases. Surgery is rarely needed unless severe and intractable pain is present and/or nerve damage is occurring (which happens in less than 1% of the time). The majority of the time in symptomatic disc herniations, we are treating pain.
Catching any condition in an early state is important to avoid it progressing into a more painful and more debilitating state. Most disc herniations occur between the Injury Phase and the Instability Phase of the Spine Degeneration Process. Therefore, most patients tend to be younger, however, they can occur in any age group. The predominant symptom or complaint involves “pinched nerve pain” in the upper or lower extremities which can be quite severe and disabling. Severe back pain may be also present. Numbness, weakness, balance or walking problems and even partial or complete paralysis can occur – especially if the spinal cord in the neck or middle back is involved. A serious condition known as “Cauda Equina Syndrome” can develop in the low back affecting bowel and bladder function as well as partial paralysis of the lower limbs.
The treatment for most disc herniations includes medication, physical therapy, and occasionally intervention pain blocks. Surgery may be required if these measures fail. The standard operation today is a microdiscectomy performed as an outpatient procedure in most cases and has a very good success rate. However, between 5 and 10% of disc herniations can recur since there is additional disc material that can come out of the disc space. Further, the disc structure will continue through the degenerative process and other conditions may occur such as disc space collapse, spondylolisthesis, spinal stenosis, and spinal instability. This same can also happen at any or multiple other spinal levels. Again, the key to successful treatment is to treat the patient, not the x-ray. Less is more. Since most of the spinal structures have little or no capacity to heal or replace themselves, it is likely that further and ongoing care for spine patients will be required in the future.
Remember that disc herniations are a symptom of another problem – the spine degeneration process. Be sure that your spine doctor discusses with you the entire nature of your problem when outlining a comprehensive and optimal treatment program. For this reason alone you may want to take advantage of having a free consultation with Dr. Delaney to help determine just where you are with your current condition and see if you are a candidate for spinal decompression.