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Disc Herniation

Sometimes called a slipped or ruptured disc, a herniated disc most often occurs in your lower back. It is one of the most common causes of lower back pain. Between 60 and 80 percent of individuals will experience lower back pain at some point in their lives. A high percentage of people will have lower back pain caused by a herniated disc.

Although a herniated disc can sometimes be very painful, most people feel much better with just a few months of non-surgical treatment. In many cases, a herniated disc is related to the natural aging of your spine and result from risk factors such as gender, lifting technique, weight, frequent driving, smoking and an inactive lifestyle.

In children and young adults, discs have a high water content. As we age, our discs begin to dry out and weaken. The discs begin to shrink and the spaces between the vertebrae get narrower. This normal aging process is called disc degeneration, which is a contributing factor to the eventual herniation of discs.

Disc Herniation Symptoms
Pain may last for a few days and then improve. It is often followed by the eventual onset of leg pain, numbness or weakness. This leg pain typically involves the leg below the knee, and foot and ankle. Pain related to disc herniation is described as moving from the back or buttocks down the leg into the foot or as a radiating or shooting pain.

Major symptoms may include one or all of the following: back pain, leg and/or foot pain, numbness in the leg and/or foot, weakness in the leg and/or foot and loss of bladder or bowel control, though this is extremely rare. The loss of bladder or bowel control may indicate a more serious problem and is caused by the spinal nerve roots being compressed. If you have this symptom, you should seek immediate medical attention.

Disc Herniation Diagnosis
To determine whether you have a herniated lumbar disc, your doctor will ask you for a complete medical history and conduct a physical examination. The diagnosis is usually confirmed by an MRI scan. This scan can create clear images of soft tissues such as intervertebral discs.

A physical examination should include a neurological examination to detect weakness or sensory loss in lower limbs. To test muscle weakness, the doctor will assess how you walk, your leg strength and any loss of sensation.

Non-surgical Treatment of Disc Herniation
Unless there are neurological deficits, conservative, non-surgical care is the first course of treatment. Here are a few recommended ways to deal with a herniated disc.

  • Usually one to two days of bed rest will calm severe back pain.
  • Take rest breaks throughout the day, but avoid sitting for long periods of time.
  • Make all your movements slow and controlled.
  • Avoid movements that can cause further pain, especially bending forward and lifting.
  • Medicines like ibuprofen or naproxen can relieve pain.
  • Physical therapy and specific exercises can strengthen your lower back and abdominal muscles.
  • Epidural steroid injections can be used to reduce inflammation.

In the majority of cases, a herniated lumbar disc will slowly improve within six to eight weeks. By three to four months, most patients are free of symptoms.

Surgical Treatment of Disc Herniation
Surgery for a herniated lumbar disc is controversial. Research shows that results for patients who have had surgery are similar to those for patients treated non-surgically. Patients with significant sciatica who have surgery, however, have better and more rapid pain relief. Surgery resolves symptoms faster for those with motor weakness or numbness, as well.

If you think you have a herniated disc, let the Gwinnett Medical Center–Duluth help. For a free physician referral to one of Atlanta’s top sports medicine doctors, please call 678-312-5000.