Spinal Discs are cushion that separate the vertebrae in your back. They are made up of a tough outer layer that is like a strong rubber which surrounds a softer center cartilage material.
Injuries from slip and falls, auto accidents, sports, degeneration from aging, poor postural habits, and lack of proper fitness can cause these discs to shift from their normal space between the vertebrae and into the spinal canal or spinal nerve space. When the disc shifts just a little bit it is defined as a disc bulge and is known to cause pain for a lot of people with or without pressure onto the nerve. Disc bulges can be seen on MRI. Disc bulges are common and according to researchers associated with low back (1.)
When the disc shifts more significantly, it is defined as a disc herniation or disc protrusion. A disc herniation or disc protrusion is sometimes referred to as a “slipped disc”. All of these terms describe the condition where the disc cushion material protrudes or pushes outward and into either the spinal canal that houses your spinal cord or into the space where your spinal nerve passes through on its way to the muscles, tendons and ligaments in the back and down the leg. In even a more severe scenario, a disc extrusion occurs when the central disc material breaks through that tough outer layer and into the spinal canal or spinal nerve space.
If you have a disc herniation or protrusion you may experience pain, numbness, tingling or even weakness in the back or down the leg. This condition associated with a disc herniation is known as sciatica.
The most common question that we hear from patients after we show them their confirmed disc herniation on an MRI is “Doctor, am I going to need surgery?” For the vast majority, you will not need surgery. To avoid surgery, research shows that it is important to take very deliberate steps to rehabilitate your back. This process begins with therapies like physical therapy and chiropractic. Other conservative treatments include injection therapies and even acupuncture.
Conservative treatment options for a herniated disc
Conservative treatment includes physical therapy, chiropractic, acupuncture and injection therapies. If you already have your MRI, chances are you have tried at least some of these conservative care modalities. However, not all conservative care is the same. For example, have you tried spinal decompression traction? Spinal decompression traction has shown to provide relief for sciatica and in some cases actually reduces the severity of the herniated disc. Spinal decompression traction is a specialized device that only select practices utilize and is administered most commonly by a skilled physical therapist or chiropractor.
Different forms of injection therapies performed by an interventional pain management specialist can work to reduce inflammation, swelling, and pain around the disc area which has been shown to provide many with significant relief. When effective pain management is combined with PT and/or chiropractic, this is often a recipe for success for your disc herniation.
In the circumstances where conservative treatment is not effective and your condition either has not changed or is getting worse, a consultation with an orthopedic or neurosurgical is appropriate. These surgeons will look first at the option of a minimally invasive surgery such as a microdiscectomy where a tiny incision is made and lasers or small instruments are used to shave off the damaged disc.
Our team of specialists at Monmouth Pain include physical therapists, chiropractors, acupuncturists, pain management specialists, and orthopedic and neurosurgeons to provide you a collaborative team working together under one roof. For over 20 years we have provided people with expert care in a friendly, compassionate setting. We are committed to getting you better.
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- MRI Findings of Disc Degeneration are More Prevalent in Adults with Low Back Pain than in Asymptomatic Controls: A Systematic Review and Meta-Analysis. W. Brinjikji, F.E. Diehn, J.G. Jarvik, C.M. Carr, D.F. Kallmes, M.H. Murad and P.H. Luetmer