What is a Spinal or Intervertebral disc?

 
Spinal Disc; Intervertebral Disc
 

It is a rubbery cushion (disc) between individual bones of the spine (vertebrae). A spinal disc is somewhat like a jelly donut with a soft center (nucleus pulposus) within a soft exterior (annulus fibrosus).


What is Spinal Disc Herniation?

 
Herniated Disc
 

Spinal disc herniation occurs when some of the softer "jelly" present in the center of the disc pushes out through a crack in the tough exterior. A herniated disc can irritate nearby nerves and result in pain, numbness or weakness in an arm or leg. Herniated disc is also referred to as a slipped disc or a ruptured disc.


What are symptoms of herniated disc?

 
Spinal Herniated DIsc
 

Your symptoms may vary based on the location of your herniated disc. Most herniated discs occur in the lower back (lumbar spine) or neck (cervical spine). Every bulging or a herniated disc does not cause symptoms. The common symptoms associated with herniated disc are:

  • Back or neck pain
  • Pain going down yours arms or legs
  • Weakness or numbness in your arms or legs
  • Sciatica

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What are the risk factors associated with spinal disc herniation?

 
Risk Factors of Herniated Disc Disease
 

Most people are unable to pinpoint the exact cause of disc herniation. Risk factors associated with disc herniation include:

  • Aging: Aging related wear & tear can cause disc degeneration. This makes the spinal disc more to prone to tearing or rupture even with a minor strain or twist. 
  • Injury or traumatic events: A fall, a blow to the back or a motor vehicle accident.
  • Obesity: Excess body weight can cause extra stress on your discs
  • Physically demanding jobs/ Lifting heavy objects: Using back muscles instead of your leg muscles to lift objects or turning or twisting when lifting heavy objects can result in disc herniation

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How is herniated disc disease diagnosed?

 
MRI Herniated Disc
 
  • Medical history and physical examination are important factors in diagnosing spinal disc herniation

Sometimes we might order additional test to confirm the diagnoses. The tests ordered for diagnosing herniated disc include:

  • Magnetic Resonance Imaging (MRI)
  • Computerized tomography (CT Scan)
  • Myelograms 
  • Discography 

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How does you treat herniated disc disease?

 
Treatment of Herniated Disc Disease
 

Functional Rehabilitation

The goal of our treatment is functional rehabilitation. Eliminating chronic back or neck pain is extremely hard, our program seeks to return patients to levels of activity that they were able to perform prior to suffering from back or neck pain. We have a multimodal approach to treatment, where we use many different approaches to treat pain. 

Our multimodal approach includes: 

Physical therapy or Muscle strengthening regimen

Medication

Medication such as anticonvulsants or antidepressants

Minimally Invasive Treatment

Epidural Steroid Injection - ESI

Epidural Steroid Injection →

This injection is an integral part of nonsurgical management of radicular pain from spinal disorders. A small amount of corticosteroid is injected into the epidural space around the spinal cord and spinal nerves. Epidural space is a potential space that surrounds the outermost covering of the spinal cord and contains nerve roots, blood vessels & fatty tissue. The anti-inflammatory effects of the corticosteroid is responsible for providing pain relief. This injection can help patients suffering from disc herniation, disc bulges, degenartive disc disease, sciatica & spinal stenosis. 

Endoscopic Discectomy

Endoscopic Discectomy →

Endoscopic Discectomy is a procedure used to remove damaged disc material in the spine. It is a minimally invasive technique that unlike the conventional procedure does not involve major tissue injury. Instead, a small metal tube, the size of a pencil, is inserted into the herniated disc space under x-ray and camera guidance and the fragment of the disc pinching the nerve is removed. You might benefit from discectomy if your presentation includes: pain, numbness or weakness in arms or legs.

Surgery

Surgery is usually reserved for very few patients with pain from structural problems that have not responded to medical or interventional therapy.

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When do I need to see a doctor?

You should seek immediate medical attention if you experience worsening symptoms, such as:  

  • Inability to perform activities of daily living 
  • Increasing back or neck pain 
  • Increasing weakness or numbness of arms or legs
  • Radiating pain
  • Back or neck pain traveling down your arm or leg
  • Bowel or bladder dysfunction

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