A herniated or bulging disc is a condition that affects the rubbery cushions between the individual vertebrae bones. A spinal disc has a soft doughnut-like shape with a softer center (nucleus pulposus) encased in a much tougher exterior (annulus fibrosus).
When the spinal disc ruptures, the disc may push out of the normal boundary, and it bulges out between the vertebrae. The most common location of herniated disc is at the level of the 4th and 5th lumbar vertebra. This is because the area receives much of the pressure from the upper body weight.
A large disc herniation seen on MRI.
What are the causes and risk factors of a herniated disc?
As described above, the spinal disc has a softer central portion and tough periphery. With age, the jelly central portion becomes hardened, as the disc loses its water content. Thus, it is easier for a disc injury to occur. The major causes of a herniated disc include:
• Wear and tear of the disc: This is usually due to the rigid nature of the disc with age
• Spinal disease
• Trauma to the spine that can cause tears or cracks to the outer portion of the disc. Hence, the central gel can force through the tears to the peripheral surface causing the disc to bulge.
The common factors resulting in spinal disc herniation include:
• Age: The elderly are at a higher risk of developing disc bulging due to age-related degeneration of the disc.
• Weight: Excess body weight exerts more pressure to the supporting disc in the lower back hence high susceptibility to disc herniation.
• Occupational hazard: People who are in physically involved jobs are at a high risk of injuring their back and hence, disc injury.
Symptoms of spinal disc herniation
Pain symptoms attributed to disc herniation are as a result of compression of spinal nerves by the bulging spinal disc.
The common symptoms include:
• Electric shock pain: This is due to compression of nerves. If the disc herniation occurs on the cervical area, the sensation is felt on all limbs. If the disc herniation occurs in the lower back, the pain is felt in the lower limbs. This is termed sciatica.
• Numbness and tingling sensation: These sensations are felt distal to the position of disc herniation.
• Muscle weakness: This is as a result of nerve irritation at the point of disc herniation, hence, interrupting signals from the brain.
• Bowel and bladder problems: This is a medical emergency and is caused by the irritation of nerves innervating the organs. It’s called cauda equina syndrome and should be operated on immediately.
Diagnosing a herniated disc
In many cases, proper history and physical exam such as the neurological exam and straight leg raise (SLR) test are sufficient for diagnosis, but the San Antonio pain management doctor may carry out further diagnostic investigation.
Some of the imaging tests include X-rays, CT scan, MRI, or myelogram. Other studies include electromyograms and nerve conduction tests to pinpoint the location of the nerve injury if necessary.
Treatment options of herniated disc
There are four options of disc herniation treatment:
Medications: These are mainly used to relieve the pain and prevent inflammation. These include OTC pain medications such as ibuprofen, narcotics for severe pain such as codeine, nerve pain medications such as gabapentin, muscle relaxers, and corticosteroids to reduce inflammation.
Epidural Steroid Injections – these are outpatient procedures that have been performed for over 50 years. The treatments may be necessary as a series of injections (three of them) and work well between 75-90% of the time.
Spinal Decompression Therapy – has been shown to work well in over 85% of patients. Treatments are outpatient, typically painless, and cost effective.
Chiropractic and Physical therapy: This is done to reduce the pain and help stabilize the back and return to normal function. These include heat or ice, traction, electrical stimulation, or short-term bracing for the neck or lower back.
Thankfully, over 95% of those with a symptomatic herniated disc are able to avoid surgery. With treatment from a comprehensive San Antonio pain center, this may include a combination of chiropractic, PT, spinal decompression, medications and epidural steroid injections.
If you or a loved one is suffering from a Herniated Disc with sciatica and would like pain management San Antonio trusts, contact Premier Pain Consultants today. The practice has a Double Board Certified pain management doctor accepting over 50 insurance plans at multiple locations.
Call (210) 202-4030 for more information and scheduling!