Herniated disc is a painful condition that affects the spongy cushion that sits between the vertebrae. It can occur in the back or neck and can pinch or irritate nerves causing pain, numbness and tingling, tenderness, or weakness radiating into the arms or legs, depending on where the herniated disc is located. Sneezing, coughing, and certain body movements can cause more pain.
Other terms for herniated disc include bulging, slipped, or ruptured disc. They are interchangeable terms that have the same meaning. If left untreated, the condition can worsen over time, increasing pain and decreasing mobility.
A spinal disc is likened to a jelly donut. The annulus fibrosis is the tough outer layer of the disc and inside is the nucleus pulposus, a softer jelly-like layer. The most common cause of a herniated disc is age degeneration. Over time, normal wear and tear occurs to the discs which leave them vulnerable. A wrong movement, such as twisting or lifting a heavy object with your back instead of your legs can cause a disc to rupture.
In rare occasions a disc can rupture due to a physical trauma such as a car accident. When the disc is damaged, the inner jelly leaks out, putting pressure on and irritating the nerves running through the spinal column. Risk factors for herniated disc include age-related degeneration and obesity.
Before treatment can begin, your doctor must diagnose your condition. Tests to determine a herniated disc include:
There are a number of treatment options available. Rest, the application ice and heat, and over-the-counter pain medications are recommended for the first day or two. Prescription pain drugs and muscle relaxants may be given for more severe pain, as well as referral to a physical therapist.
If there is any nerve damage as a result of the herniated disc, nerve-pain medications may be prescribed. Another treatment that you may receive from a Seattle pain management doctor is epidural steroid injections. These are performed as a series of injections.
Successful pain relief from an epidural injection is typically between 75 and 90%. That has been shown in several studies, with the vast majority of patients being able to avoid the need for surgery.
Spinal decompression therapy may help as well, along with TENS units and acupuncture.
Most patients improve over time with treatment, but there may be some lingering pain. A landmark study published in JAMA in 2006 compared nonoperatively treated herniated discs with surgical outcomes. At the one year point, outcomes were no different.