Disc Herniation

Disc Herniation

You may be like many other people and think that your sore and aching back is nothing to worry about or nothing that requires help. In most cases, that’s not the case. One of the instances in which you may need to turn to our NYC back doctor is when you have a disc herniation or a herniated disc. For some people, this condition leads to debilitating pain that does not allow them to move much or at all. For others, it creates a dull to sharp pain that comes and goes. If you believe you may have a herniated disc, not getting medical care for it could worsen the condition and lead to further limited movement or even more complex concerns later.

How Can Our Disc Herniation Doctor in New York help You?

The first step is to obtain guidance and understanding of what is occurring and why. This involves x-rays and an exam. During the process, our goal is to understand where the problem is and why it is occurring. It’s important to realize that, no matter how “okay” you feel today, this condition will not improve on its own and it may lead to limited mobility if not treated. With the help of our spinal column doctor, we can help you to find a way to reduce the pressure and pain you feel and improve the overall function of your vertebrae, the bones that help to protect your spinal column. By reducing the pain and pressure on these bones, it may be possible to increase your quality of life and restore some or all of your mobility. Don’t underestimate the importance of getting help for a herniated disc from our experienced New York City doctors. It could help to reduce your pain and help you to improve your future outlook.

What is a herniated disc?

In between each of your vertebral bones is an intervertebral disc.  The structure of a disc’s outer layer (annulus fibrosus) is made of strong fibrocartilage; it is constructed similar to a radial tire.   The annulus fibrosus encases a gel-like interior matter, the nucleus pulposus (Figure 1).  A disc herniates when the annulus fibrosus breaks open allowing some of the nucleus pulposus to leak out (Figure 2) into the spinal canal and/or onto spinal nerve roots.  Spinal canal and/or nerve compression (i.e., pinched nerve) causes pain and other symptoms.

 

Symptoms of a herniated disc

Where pain and symptoms develop depend on where a disc herniates.  Neck and low back disc herniation are similar but affect different body parts.

  • Pain: mild, moderate, severe, or varying
  • Pain that travels (radiates)
  • Movement aggravates pain.
  • Muscle spasms, cramping
  • Unusual sensations: tingling, numbness, pins and needles
  • Skin tenderness or sensations that follow the path of a nerve root.
  • Extremity weakness, sometimes functional loss

What can cause disc herniation?

Discs absorb and distribute external body forces during rest and activity.  The design and structure of ligaments, tendons and muscles help protect the spine by limiting excessive motion.  However, even the strongest ligaments and muscles can succumb to sudden and extreme force, such as might happen during a car accident.

Disc herniation usually happens gradually and involves a combination of factors.

  • Aging-related degenerative changes cause discs to be less hydrated, affecting shape and structure.
  • Smoking, leading a sedentary lifestyle, being overweight
  • Poor posture, incorrect body mechanics (i.e., ergonomics) and repetitive movements (i.e., lifting) create unnatural spinal stress.

Consider prompt medical attention if …

When pain develops suddenly for no apparent reason or after an accident, it is normal to be concerned.  It is your health, and that is important!  The list below can help you determine if your back or neck pain requires urgent care.

  • Pain after injury: a fall, car or industrial accident
  • Persistent pain that doesn’t stop or worsens.
  • Pain moves into another body part.
  • Extremity numbness, tingling sensations, weakness
  • Buttock and/or genital area numbness, tingling
  • Pain with a fever
  • Bowel or bladder dysfunction

Diagnostic examination

The purpose of a diagnostic examination is to learn about your general health, lifestyle, past medical history, and current back problem.  The information gathered by our staff during your exam is combined with imaging or other test results to confirm your diagnosis.

Questions our Doctors may ask include:

  • When did your pain start?
  • Did a particular event precede pain?
  • Has your pain improved or worsened?
  • Does neck or back pain radiate into another part of your body?
  • On a scale of zero (no pain) to 10 (agony), what is your current pain level?
  • Does pain affect your ability to work or perform ordinary activities of daily life?
  • Do pain and symptoms disrupt your sleep?
  • Other questions specifically related to you and your symptoms.

MRI is performed to evaluate your spine.  Sometimes a plain x-ray is ordered.  Depending on the results of your examination and MRI, we may conduct electrodiagnostic studies.

Interventional treatment for herniated discs

Seldom does disc herniation require spine surgery!  At Rehabilitation Medicine Center of New York, we may combine non-operative interventional treatments to help resolve pain and improve mobility.  Interventional means to ‘intervene’ to stop and manage pain while you heal.

Treatments are administered in a step-wise way.  We believe less can be more, and we apply that philosophy to our treatment approach.  For example, a non-steroidal anti-inflammatory drug and passive physical therapy may be as effective as a narcotic painkiller, but with fewer side effects.  However, no two patients are alike, and your herniated disc may require more aggressive care.

Spine pain treatments may include: