Herniated Discs

Herniated Discs

Herniated discs are very common and can be present without any symptoms. One study in 2017 examined 100 adults who had no back pain at all. Yet, more than 50, examined with magnetic resonance imaging (MRI), were found to have “bulging” vertebral discs.

Herniated discs can also cause chronic pain and discomfort, which sometimes includes weakness and numbness or tingling in the back and legs. However, there are many treatment options that can help ease or eliminate the pain. Needless to say, a full examination and proper diagnosis is the first step when you suspect you have a slipped disc.

A very small percentage of people with herniated discs resort to surgery

What is a vertebral disc?

The spinal cord is made up of interlocking vertebrae that are stacked up one on top of the other with the largest at the small of your back and the smallest in your neck. In between each of these vertebrae is a rubbery cushion that supports the next vertebrae, but allows it to move smoothly.

The disc that acts like a cushion is often described as similar to a jelly donut because it is soft in the interior and tougher, more fibrous, around the outside — almost like a belted car tire. The fibrous outer section helps the disc maintain its shape and its soft interior.

What can go wrong?

Unfortunately, time and Mother Nature is working against us when it comes to our vertebral discs. As we age, the discs become “more fibrotic” and less flexible. Injuries and strains begin to take a toll on our discs, too. A herniated disc is one that has become torn, ruptured or displaced.

What can we do about it?

There are many treatment options for slipped discs. These include:

Medications

Over-the-counter pain relievers are often effective, including aspirin and ibuprofen.

Prescription strength medication is also used to reduce pain. Anti-inflammatory medication is often prescribed for patients with slipped discs.

Anticonvulsants and muscle relaxers are also effective in many cases.

Neuromodulation

This relatively new approach involves implanting electrodes near your spinal cord or near the area of pain. The electrodes send high frequency (10 kHz) pulses to the area by way of a pulse generator and a handheld device. A recent Boston PainCare study found 71.4 percent of patients reduced their dependence on pain medications using high-frequency spinal cord stimulation.

Cortisone injections

Corticosteroids are effective as an inflammation-suppressing treatment. Doctors use spinal imaging to direct the injection so that it goes exactly where it is needed. (Steroids taken orally are also used to reduce inflammation.)

Surgery

A very small percentage of people with herniated discs resort to surgery. A lumbar laminotomy is one option. This involves removing the afflicted disc. After the discectomy, a spacer is placed between the two neighboring vertebrae. The spacer can be metal, plastic or bone and it often includes bone graft material. This allows the two vertebrae to “fuse together.” Sometimes metal rods or screws are also used. This is all done to stabilize the spinal cord.

Other options

A variety of alternative options are considered for lower back pain, including stress reduction, losing weight, yoga, acupuncture, heat, chiropractic intervention and physical therapy.

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