What Are The Symptoms
Symptoms of a herniated disc vary greatly depending on the location of the herniation and your own response to pain. If you have a herniated lumbar disc, you may feel pain that radiates from your low back area, down one or both legs, and sometimes into your feet . You may feel a pain like an electric shock that is severe whether you stand, walk, or sit. Activity such as bending, lifting, twisting, and sitting may increase the pain. Lying flat on your back with knees bent may be the most comfortable because it relieves the downward pressure on the disc.
Sometimes the pain is accompanied by numbness and tingling in your leg or foot. You may experience cramping or muscle spasms in your back or leg.
In addition to pain, you may have leg muscle weakness, or knee or ankle reflex loss. In severe cases, you may experience foot drop or loss of bowel or bladder control. If you experience extreme leg weakness or difficulty controlling bladder or bowel function, you should seek medical help immediately.
What Causes Slipped Discs
A slipped disc occurs when the outer ring becomes weak or torn and allows the inner portion to slip out. This can happen with age. Certain motions may also cause a slipped disc. A disc can slip out of place while you are twisting or turning to lift an object. Lifting a very large, heavy object can place great strain on the lower back, resulting in a slipped disc. If you have a very physically demanding job that requires a lot of lifting, you may be at increased risk for slipped discs.
Overweight individuals are also at increased risk for a slipped disc because their discs must support the additional weight. Weak muscles and a sedentary lifestyle may also contribute to the development of a slipped disc.
As you get older, you are more likely to experience a slipped disc. This is because your discs begin to lose some of their protective water content as you age. As a result, they can slip more easily out of place. They are more common in men than women.
What Is A Herniated Disk
A herniated disk is an injury of the spine . You have a series of bones in your spine, stretching from the base of your skull to your tailbone. Between your vertebrae are round cushions called disks. The disks act as buffers between your bones, allowing you to bend and move with ease. When one of these disks tears or leaks, its called a herniated disk.
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Herniated Disc Surgery: What To Expect
Causes, effects, and when surgery is right
Between each of the bones in your spine is a disc. These discs act as shock absorbers and help cushion your bones. A herniated disc is one that extends beyond the capsule containing it and pushes into the spinal canal. You can have a herniated disc anywhere along your spine, even in your neck, but its most likely to occur in the lower back .
You might develop a herniated disc from lifting something the wrong way or from suddenly twisting your spine. Other causes include being overweight and experiencing degeneration due to disease or aging.
A herniated disc doesnt always cause pain or discomfort, but if it pushes against a nerve in your lower back, you may have pain in the back or legs . If a herniated disc occurs in your neck, you may have pain in your neck, shoulders, and arms. Besides pain, a herniated disc can lead to numbness, tingling, and weakness.
Surgery involving the spine is typically not recommended until youve tried all other options. These may include:
- nonsteroidal anti-inflammatories
- steroid injections
If these are ineffective and you have persistent pain that is interfering with your quality of life, there are several surgical options.
When considering surgery, make sure you see a qualified spine surgeon, and get a second opinion. Before recommending one surgical procedure over another, your surgeon will likely order imaging tests, which may include:
Tips For Relieving Pain From Herniated Discs
Do you experience achy or sharp radiating pain to your shoulder, arm, buttock or leg? This may be an indicator of a bulging or herniated disc in the neck or back. Between each of the vertebrae that make up your spine are small cushions called discs.
Herniated discs are more common in the 30-50 age bracket. A herniated disc is when the material inside the disc pushes outwards, irritating the nerve exiting at that level. This can be on either side of the spine and depending on the nerve affected in the neck or back, can cause radiating pain, numbness and loss of sensation.
Most people are able to relieve their pain from a herniated disc using medications and physical therapy, with improvements seen in about four to six weeks. However, in cases where the pain is very severe, surgery may be used as a last resort treatment.
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How Serious Is A Bulging Disc
Unlike a herniated disc, where the inner nucleus actually pushes through a tear in the outer annulus, a bulging disc happens when the entire disc changes shape and protrudes outward, into the spinal canal, but the annulus is still intact, and the nucleus remains inside the annulus.
As the disc is invading the space within the spinal canal, it can compress a nerve and cause a variety of issues felt throughout the body.
How serious a bulging disc is will depend on the degree of nerve involvement, location and severity of the bulging disc, not to mention other important variables such as patient age and overall health.
Common causes of a bulging disc are degenerative disc disease, poor lifestyle habits such as repeatedly lifting heavy objects with the back muscles, rather than the leg muscles, chronic poor posture, and carrying excess weight.
If a bulging disc is left untreated and worsens, it can easily become a herniated disc, so part of the focus of treatment for a bulging disc is to prevent it from becoming herniated.
So once a person is diagnosed with a bulging disc, what bulging disc treatment options are there?
How Do Doctors Diagnose A Slipped Disc
If you have neck or back pain that doesn’t get better with home treatment, your doctor may order tests to find the cause of your pain.
- Magnetic resonance imaging : This device creates detailed images of a targeted area of your body. Doctors can use it to look at your spine and find any abnormalities.
- X-rays: Sometimes, asymptomatic herniated discs are discovered when you have an x-ray of your abdomen or back for a different reason.
- Computed tomography : This type of scan looks at the bones of your spine to find any issues.
- Myelogram: This test uses contrast dye to identify any narrowing of the spinal canal to find a herniated disc.
- Electromyogram: This test can help doctors pinpoint which nerves are affected by a herniated disc.
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Herniated Disc Exercise : Reduce The Radiating Leg Pain
The first thing you have to do is to try to reduce the radiating pain. You can do this by stretching your back backward as far as possible. It is called extending your back.
You can do this in two ways: While standing or while lying in a prone position. Ill discuss the one in when you stand because thats the easiest one for most people.
It will instantly relieve your leg pain.
Perform the exercise like this:
- Place your index fingers on the painful spot in your back
- Apply pressure in a forward direction
- Now bend all the way backward
- Make sure also to extend your neck for maximum result
- Hold this position for 3 seconds
- Repeat this ten times
You can also see how to perform the exercise in the video.
Make sure that you perform this exercise several times a day. Its especially important to complete the activity every time youve to bend forward or lifted something.
When youve performed the exercise, you will notice that the radiation in your leg reduces and sometimes even totally disappears.
It is what you want to achieve.
When you feel the radiation coming back into your leg, its time to do the exercise again. You want to keep the radiation away so that the intervertebral disc has time to recover.
You can also use this back stretcher to reduce the pressure on your nerves. It does the same as the exercise but it easier to do for some people.
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Physical Therapy Guide To Herniated Disk
A herniated disk occurs when the cushion-like cartilage between the bones of the spine is torn, and the gelatin-like core of the disk leaks. Often mistakenly called a slipped disk, a herniated disk can be caused by sudden trauma or by long-term pressure on the spine. This condition most often affects people aged 30 to 50 years men are twice as likely to be diagnosed as women. Repeated lifting, participating in weight-bearing sports, obesity, smoking, and poor posture are all risk factors for a herniated disk. The majority of herniated disks do not require surgery, and respond best to physical therapy. Physical therapists design personalized treatment programs to help people with herniated disks regain normal movement, reduce pain, and get back to their regular activities.
Physical therapists are movement experts. They improve quality of life through hands-on care, patient education, and prescribed movement. You can contact a physical therapist directly for an evaluation. To find a physical therapist in your area, visit Find a PT.
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Certain Sleep Positions Help Relieve Herniated Disc Pain
Pain from a lumbar herniated disc can worsen during the night. You may find comfort sleeping in a position that relieves pressure from the spine. A couple good options include:
Your preferred sleeping position and pillow placements will likely be determined by the location of your herniated disc. Try a few different pillow and positions to see what works best for you.
See Best Pillows for Different Sleeping Positions
Get An Mri Before Considering Surgery
MRIs are necessary before considering having ones vertebral discs operated on due to their costly nature and risk involved with such procedures. If you get one, your doctor will be able to see the extent of your herniated disc and better advise you on the steps to take going forward.
If youve tried these options but still arent pain-free, ask your doctor about what you can do next. If your herniated disc is too large, surgery may be necessary to relieve pain and other symptoms. Surgery might be something to consider!
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When & How To Seek Medical Care
Fortunately, the majority of herniated discs do not require surgery. With time, the symptoms of sciatica/radiculopathy improve in approximately 9 out of 10 people. The time to improve varies, ranging from a few days to a few weeks.
- Limit activities for 2 to 3 days. Walking as tolerated is encouraged, along with an anti-inflammatory, such as ibuprofen, if not contraindicated for the patient. Bedrest is not recommended.
- Primary care evaluation during this time may lead to considering other non-surgical treatments noted below, such as physical therapy.
- Radiographic imaging, such as an MRI, is not recommended by the American College of Radiology, unless symptoms have been present for six weeks.
- Referral to a spine specialist, such as a neurosurgeon, is also recommended if symptoms persist for greater than four weeks. A specialist will often want advanced imaging, such as the MRI, completed prior to the appointment.
- Urgent evaluation and imaging is recommended if there are symptoms of significant leg/arm weakness, loss of feeling in the genital/rectal region, no control of urine or stool, a history of metastatic cancer, significant recent infection or fever AND radiculopathy or a fall/injury that caused the pain. Imaging should also be considered earlier for findings of progressive neurologic deficit on exam.
What Is A Slipped Disc
When you have a âslippedâ disc, a disc does not actually slip. What happens is that part of the inner softer part of the disc bulges out through a weakness in the outer part of the disc. A prolapsed disc is sometimes called a herniated disc. The bulging disc may press on nearby structures such as a nerve coming from the spinal cord. Some inflammation also develops around the prolapsed part of the disc. Inflammation may irritate a nerve and also causes swelling, which may put pressure on a nerve.
Any disc in the spine can prolapse. However, most prolapsed discs occur in the lower back . The size of the prolapse can vary. As a rule, the larger the prolapse, the more severe the symptoms are likely to be.
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What Is The Treatment For A Herniated Disc
conservativesurgeryphysical therapy including exercise
Spinal injections are also a non-surgical option. They may be recommended for short-term pain relief. Most people have relief from pain and other symptoms with conservative treatment.
Surgery is recommended for only a small number of people with herniated disc disease. It may be appropriate when a person continues to have severe or worsening pain or neurologic symptoms. There are both minimally-invasive and open surgery techniques.
As mentioned, exercise is a part of treatment for a herniated disc. The type and method of the exercise is important in order to support recovery and to avoid further injury.
There are many different exercises to help with back pain due to a herniated disc. We provide 5 effective ones. Also, you may know of other ways to perform these exercises. We provide one method for each.
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Medical History And Physical Examination
After discussing your symptoms and medical history, your doctor will perform a physical examination. The exam may include the following tests:
- Neurological examination. A neurological examination will help your doctor determine if you have any muscle weakness or loss of sensation. During the exam, the doctor will:
- Check muscle strength in your lower leg by assessing how you walk on both your heels and toes. Muscle strength in other parts of your body may also be tested.
- Detect loss of sensation by checking whether you can feel a light touch on your leg and foot.
- Test your reflexes at the knee and ankle. These may sometimes be absent if there is a compressed nerve root in your spine.
Clinical photo of a doctor performing the straight leg raise test.
Reproduced from JF Sarwak, ed: Essentials of Musculoskeletal Care, ed. 4. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2010.
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Symptoms Of Herniated Lumbar Disc:
Lower back pain Leg pain Leg numbness or tingling Pain is worse from sitting Restricted trunk flexionSciatica pain
Please note, a herniated disc DOESNT always cause pain, so you must get a proper diagnosis.
What does a herniated disc feel like?
Lower back pain is typically the first symptom of a lumbar disc herniation. Often this pain will last for a few days and then subside, but leg pain, numbness or tingling, and/or weakness of the lower extremity often follows.
Typically the leg pain eventually travels below the knee and can even affect the ankle and foot.
How long does the pain last?
Most patients with a lumbar disc herniation will improve gradually over a period of days to weeks, with most patients being symptom free within 3 to 4 months.
Patients that actively participate in an exercise program often report a significant reduction of pain and improved ability to perform their activities of daily living.
How To Diagnose A Herniated Disc
Your doctor or chiropractor will need to do a physical exam, followed by some questions about where and when the pain started.
Imaging tests will need to be taken to confirm if you have a bulging disc or a herniated disc. Common imaging could include an MRI, X-rays, or CT scans.
This combination of information will allow your chiropractor or doctor to make a diagnosis about the root cause of your low back pain.
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Secret #: Get Acupuncture Or Epidurals
Almost no one likes the thought of needles, but for those with chronic health problems that lead to bulging or herniated discs, such as spinal stenosis or degenerative disc disease, epidurals and acupuncture can be another means of controlling pain.
The majority of people can heal naturally with non-invasive treatments from their chiropractor, but when healing isnt possible, other methods might need to be employed.
Epidural steroid injections to areas where herniated discs are causing intense pain can not only provide long-lasting pain relief, but they can also prevent or delay the need for surgery.
Acupuncture uses extremely thin needles to stimulate the bodys own painkillers, as well as promote healing and a sense of well-being.
Speak with your chiropractor about whether either of these options might work for you.