Herniated Disc - Pain Management
A herniated disc, also called a “ruptured” disc, is a common source of neck or lower back pain. Discs are cushion-like pads that are located between the series of small bones that make up the spine. A herniated disc occurs when the outer disc layer tears and it’s gel-like interior comes out. The contents can irritate nerves. A herniated disc can cause pressure on the nerves or spinal cord. Fortunately, for the vast majority of people, pain related to a herniated disc can be relieved without surgery.
The opening in the center of each vertebra forms the spinal canal. Your spinal cord is inside of the protective spinal canal. Nerves extending from the spinal cord exit the spine and travel throughout your body, sending messages between your body and brain.
Intervertebral discs are located between the vertebrae. A disc and two facet joints connect one vertebra to the next, allow movement, and provide stability. The discs are made of strong connective tissue. Their tough outer layer is called the annulus fibrosis and their gel-like center is called the nucleus pulposus. A healthy disc contains about 80% water, which allows it to act as a shock-absorbing cushion between the bones.
In addition to the natural aging process, herniated discs can result after sudden pressure. Impacts from trauma, violence, and motor-vehicle crashes can cause a herniated disc. Abrupt forces during sports, such as football or surfing, can cause a herniated disc, as well.
Neck pain is a common symptom of a herniated cervical disc. You may feel shooting pain in your arms. You may experience pain or burning pain in your shoulders, neck, and arms. Your arm(s) may feel weak, numb, or have a tingling sensation. You may experience a headache at the back part of your head.
Low back pain is a symptom of a herniated disc in the lumbar spine. Sciatica is the most frequent symptom of a herniated disc in the lower back. Sciatica is shooting pain that travels through the buttocks and down the back of one leg. One of your legs or buttocks may feel weak, numb, or have a tingling sensation.
Your doctor will order X-rays to see the condition of the vertebrae in your spine. Dye may be used to enhance the X-ray procedures in a procedure called a myelogram. A myelogram is used to help determine if there is pressure on your spinal cord or nerves from a herniated disc.
An electromyography (EMG) test is often performed at the same time as the NCV test. An EMG measures the nerve impulses within a muscle. Healthy muscles need nerve impulses to perform movements. Your doctor will place fine needles into the select muscles that a spinal nerve controls. The EMG allows your doctor to determine the amount of nerve impulses that are conducted when your muscle contracts. An EMG may be uncomfortable, and your muscles may remain a bit sore following the test.
A short period of rest may be recommended. Your doctor may initially restrict your activity level and body positioning. You should avoid lifting, bending forwards, and quick abrupt movements. You may wear a back or neck brace for support. It can help to take brief walks and avoid sitting for prolonged periods.
Am I at Risk
Herniated discs are more common among people that are middle-aged. Older adults are at the greatest risk for herniated discs because of the decreased disc water content.
Risk factors for herniated disc include:
• Being overweight
• Using poor body posture when lifting
• Performing repetitive strenuous activities