How to treat a herniated disc?
A herniated disc is one of the most painful, debilitating lower back pain conditions. The pain caused by herniated disc is different for each person who experiences it and can even change as the condition progresses. Because this condition can be unpredictable, a herniated disc treatment that works can also vary from person to person. Here’s how to treat a herniated disc.
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The spine consists of 33 individual vertebrae, each stacked upon a fluid-filled sac that keeps the bones cushioned from rubbing against each other. This fluid-filled sac is called an intervertebral disc.
The spine consists of individual vertebrae with a spongy cushion separating each. The discs have a gel-like substance in them (like the gel in the insoles you put in your shoes or the gel in an eye mask) called nucleus pulposas. These oval discs help the spine be more flexible because each vertebra isn’t locked into another, and they also contribute to the spine’s flexibility.
When an intervertebral disc herniation occurs, the outer layer becomes weakened, allowing the nucleus pulposus to leak out. The cushion between the bones is gone, and the result can be very painful.
Over time and left untreated, disc herniation can cause permanent nerve damage.
A herniated disc can be caused by a number of different factors:
- Time: The continued action and pressure of gravity as people age can begin to wear down the annulus fibrosis
- Injury: If the spine is injured (i.e., as a result of a car accident or other trauma to the back), the intervertebral disc may be weakened and begin to leak
- Improper use: A sudden, awkward movement such as lifting a heavy object improperly can cause a herniated disc
There are also several risk factors that increase the likelihood that a person will experience a herniated disc. These include:
- Age: Because herniated discs can be caused by bone deterioration, older adults have a higher incidence.
- Genetics: There is a potential hereditary connection to disc herniation.
- Weight: Being overweight or underweight increases an individual’s risk for developing herniated disc.
- Lifestyle: Smoking contributes to bone density loss and can increase the spine’s vulnerability to fracture, either from injury or wear-and-tear. Excess consumption of alcohol and prolonged use of steroids can also contribute.
- Occupation: Occupations that feature repetitive motion and twisting or bending increase a person’s risk of a herniated disc.
Symptoms of a herniated disc are as varied as the condition itself, and vary from person to person. Herniated disc symptoms may include:
- Pain: Pain location varies depending on which disc is herniated. A herniated disc in the lower back can produce pain in the buttocks, thigh, and calf (and possibly the foot). If the disc is herniated in the neck, pain may be shooting in the arm and shoulder area.
- Tingling
- Numbness
- Weakness
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Herniated discs vs. Bulging discs
When your back is aching, especially along the spine, you may leap to the conclusion that you have a herniated or bulging disc. Many people use the words interchangeably, but there is a difference between the two conditions. How to treat a herniated disc may differ from how you treat a bulging one.
Bulging discs–sometimes also called slipped discs–are “contained.” This means that there are no tears in the disc itself, just that the disc is protruding out from between the vertebrae.
A herniated or ruptured disc has a tear or a rupture and is “uncontained.” The disc is not merely pushing out from between the vertebrae. It is torn, and some or all of the nucleus pulposas has leaked out. A herniated disc may be the second stage of a bulging disc. The vertebrae may have put so much pressure on the bulging disc that it ruptured.
Whichever condition you are suffering from, the result can be tingling, muscle weakness, pain that ranges from moderate to severe, and numbness. Always talk to your doctor to get an accurate diagnosis.
Poor posture, age, repetitive motion, injury due to strain, and normal wear and tear all contribute to herniated discs. Sometimes a herniated disc does not cause pain, but it can be addressed generally with a combination of pain treatments, either natural or prescribed.
What herniated disc treatment works varies widely depending on many different factors. These include:
- Location of the herniation
- Activity levels
- Other health conditions
- Severity of the herniation
For some patients, a course of over-the-counter non-steroidal anti-inflammatory drugs (nsaids) combined with targeted exercise and strengthening may be all that is necessary.
Any treatments are only started after your doctor has diagnosed the cause of your pain. Always work closely with them to explain all of your symptoms so they can make the most accurate diagnosis.
The Mayo Clinic has more information on the diagnostic tests for a herniated disc here.
Step 1: Anti-inflammatory medications
Whether over-the-counter or prescribed, a herniated disc treatment generally begins with a period of anti-inflammatory drugs used to control pain and inflammation. For some patients, this is enough to allow them to begin exercise or other activities to heal the herniated disc.
Epidural steroid injections or nerve blocks may be recommended for those patients who find no relief with nsaids. These injections target the affected nerves directly. Steroid injections are anti-inflammatory and offer pain relief but have only been proven effective for approximately 50% of patients. Nerve blocks numb the nerve so that other treatments can begin.
The following video shows you what you can expect during an epidural steroid injection procedure. Overall, this is a safe and effective option for many people, especially while also undergoing physical therapy or chiropractic care.
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Step 3: Physical therapy or chiropractic care
Because a herniated disc can be the result of decreased space between the vertebrae, doctors may recommend chiropractic care to help lengthen the spine and physical therapy to strengthen the supporting muscles.
Physical therapists may design an exercise plan, offer manual therapy, apply hot and cold treatments, or administer electrical stimulation. In combination with pain-relieving therapies, physical therapy can go a long way towards rebuilding the muscles around the spine.
Surgery is an option that you should exercise only after you’ve attempted other treatments. If pain and numbness persists, a pain management specialist may recommend a surgical procedure called a discectomy. This procedure removes the herniated material that is pressing on the nerve and causing pain.
For more serious and unresponsive pain due to a herniated disc, your doctor may recommend removing the entire disc. This is a rare procedure that includes inserting metal hardware to connect the remaining vertebrae for stability.
If a patient experiences sudden loss of bowel or bladder control, this is considered a medical emergency that is often addressed with surgery. This condition can become very serious very quickly, and patients should go to the emergency room if this arises.
How to prevent a herniated disc
As with many lower back pain conditions, the best way to treat a herniated disc is to take steps to prevent it from occurring in the first place. There are ways to keep your lower back safe and healthy. Here’s how.
Regular exercise that focuses on strengthening the abdomen and lower back is the best way to prevent a herniated disc.
Rather than spending hours doing crunches, exercises that focus on the whole body are just as valuable. Swimming, balancing poses in yoga (including planks), and targeted exercises for the back are excellent ways to help strengthen the muscles that support the spine.
A well-balanced diet that includes plenty of calcium and vitamin D-rich foods helps maintain strong muscles to support the spine. A healthy diet also helps maintain an appropriate weight for your frame.
Among other things, smoking contributes to a loss of bone density that can contribute to spinal fractures and herniated discs. Quitting smoking is one of the best things you can do for your health, with benefits that start just 20 minutes after your last cigarette. It may be difficult, but there are many resources out there to help.
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