WHEN SHOULD I WORRY ABOUT...

Could a Herniated Disc Be Causing Your Neck or Back Pain?

Feb. 21, 2020

You pick up a package on your doorstep — and you're surprised by how heavy it is — but you manage it anyway. The next thing you know, the dull ache in your lower back suddenly turns into a sharp pain running down the back of your leg.

Could it be a herniated disc?

"Disc pain is often the result of a gradual, age-related wear and tear called disc degeneration," explains Dr. Karl Vega-Lelkes, orthopedic spine surgeon at Houston Methodist. "A herniated disc in the lumbar or lower back is common, but discs in the neck can also slip or herniate. The thoracic or mid-back discs are rarely affected."

What are the symptoms of a herniated disc?

The spinal column consists of vertebrae separated by softer, cushiony discs. A herniated disc occurs when that softer material slips outside the vertebral column and presses against nerves causing pain.

Symptoms of a herniated disc include:

  • Arm or leg pain, depending on the location of the affected disc, that can radiate from the buttock to the foot or through the shoulder and arm
  • Numbness or tingling in the limb that is served by the nerve the disc is pressing against
  • Weakness in the muscles served by the affected nerve, causing you to stumble or have difficulty lifting or holding items

 

How is a herniated disc treated?

"Treatment varies based on your overall health, age, activity level and severity of the symptoms. Initially a short period of rest and pain medications, such as anti-inflammatory drugs or painkillers, may be followed by physical therapy," explains Dr. Vega-Lelkes.

Taking into consideration your condition, physical therapists may combine exercise with:

  • Bracing of the neck or lower back
  • Electrical stimulation
  • Heat or ice treatment
  • Traction (a mechanism to pull a vertebrae back into place and hold it there)

 

As the pain improves, physical therapists will teach you core-strengthening exercises to help avoid a recurrence. Generally, most people's symptoms improve within a month of nonsurgical treatment.

"If physical therapy doesn't provide relief, steroid injections may help control the pain," Dr. Vega-Lelkes adds.

These injections, given in the doctor's office, reduce swelling around the disc to relieve symptoms. Your doctor may use X-ray or fluoroscopy to locate where the injection is needed.

When is surgery needed to fix a herniated disc?

"For patients whose symptoms do not subside with other treatments, surgery may be necessary," Dr. Vega-Lelkes says.

Your doctor may recommend surgery if:

  • Symptoms haven't improved after six weeks of nonsurgical treatment
  • A disc fragment lodges in your spinal canal and presses on a nerve, causing progressive weakness
  • You have difficulty performing basic activities, such as standing or walking

 

In most cases, the surgeon removes the protruding section of the disc. Rarely, the entire disc must be removed and the vertebrae fused with metal hardware to stabilize the spine. Your surgeon could also suggest implanting an artificial disc.

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