Symptoms
Treatment of a herniated disc depends on a number of factors including: when the disc herniation occurred, symptoms experienced by the patient, the age of the patient, activity level, and the presence of worsening symptoms. Most often, treatments of a herniated disc begin conservatively and become more aggressive if the symptoms persist.
Causes
All physicians in our spine division are experienced in treating herniated discs, whether they result from an injury or gradual wear and tear. Our team has helped numerous patients relieve pain from disc herniation in the lower back (lumbar spine) and neck (cervical spine), as well as less common locations such as the midback (thoracic spine).
Prevention
A herniated disc is a painful condition that can also contribute to numbness or weakness. This condition can occur naturally over time due to degeneration or suddenly due to an injury. Some herniated discs heal naturally. It is important to be examined by a healthcare provider if your pain continues for more than a few days.
Complications
Injections. If rest, pain relievers, and physical therapy don't help with your pain, your doctor can inject a steroid medicine into the space around your spinal nerve. This is called an epidural injection. The steroid can help bring down the swelling, help you move more easily, and ease pain from a herniated disk.
What is the treatment for a herniated disc?
Why choose our herniated disc division?
Can a herniated disc heal itself?
Can an epidural steroid injection help with herniated discs?
How serious is a pars fracture?
In the typical bilateral pars fracture, healing without a brace and without reduced activity has a very poor repair rate. Even with the best healing fractures (unilateral and hypertrophic), healing with a brace and three to six months of reduced activity has a success rate hovering about 50%.
Do most pars fractures require surgery for treatment?
Most patients with pars defect do not require surgery and can experience relief with medications and rest. Anti-inflammatory medications and muscle relaxers are commonly used to treat pain. Often, a lumbar corset back brace is prescribed for the acute phase of the injury.
What happens if pars defect is left untreated?
If the fracture of the pars interarticularis is not treated, this fracture can worsen, eventually causing one of the vertebra to slide forward. This worsened condition is known as spondylolisthesis.
How do you treat a pars stress fracture?
Since a pars fracture is a break in the bone, only rest and time will promote healing. Most people with a pars defect do not require surgery with anti-inflammatory medications, Physiotherapy and recovery the recommended means of dealing with a pars stress fracture.
When is surgery needed for pars defect?
The pars repair procedure is a minimally invasive and is utilized when your child has persistent symptoms over 6 months despite strict activity modification as directed by a health care provider. This procedure has the advantage of motion preservation in the back when compared to a spine fusion.
What surgery is done for pars defect?
A laminectomy, a type of spinal decompression surgery in which the surgeon removes that portion of the vertebra that includes the pars interarticularis. This is used if there are nerve roots being affected that require decompression.
Can surgery fix pars defect?
Pars Repair In this procedure, a surgeon stabilizes the fractured portion of the vertebra. He or she uses a type of metallic fixation, such as a small wire, hook, screw, or rod, to join both sides of the fractured bone and secure the vertebra in place. This stabilizes the bone and allows it to heal.
Can a chiropractor help pars defect?
The treatment for pars defect or lumbar stress fracture involves four phases. Chiropractors adopt a conservative approach to treating lumbar stress fractures. Along with massage, heat or ice therapy, chiropractors use spinal stabilisation, spinal adjustments and suggest lifestyle changes for the treatment.
Is a pars fracture painful?
A pars defect or spondylolysis is a stress fracture of the bones of the lower spine. These fractures typically occur due to overuse. They can be on one or both sides of the vertebrae. It is a common cause of low back pain in children and adolescents.
How long does it take for a pars stress fracture to heal?
Restoration of normal function including return to sports Consequences of the Injury Just like any bone fracture, stress fractures in the low back need time to heal. This means resting from all sporting and impact activities until there is little, to no pain. This usually takes 4-8 weeks, but may take longer.
How do you sleep with a pars defect?
With this condition, it may be best to sleep on your sides with the knees curled up (in the fetal position). This helps relieve pressure on the nerve root. Another option is sleeping in a reclining chair or an adjustable bed. This allows the head and knees to remain elevated so it can relieve pressure on the nerve.
How serious is an L5 fracture?
L5 Vertebra Fracture Lawyers. A fracture of the fifth lumbar vertebrae is called an L5 fracture or L5 vertebra fracture. Any vertebrae fracture is a serious injury that necessitates immediate medical attention and evaluation.
How to treat a herniated disc?
Some exercises can help improve the symptoms of a herniated disc. A physical therapist can teach you which ones strengthen the muscles that support your back. Physical therapy programs also include: 1 Stretching exercises to keep your muscles flexible 2 Aerobic exercises -- such as walking or riding a stationary bicycle 3 Massage 4 Ice and heat 5 Ultrasound therapy 6 Electrical muscle stimulation
What is the bone that is removed from a herniated disc?
Sometimes your surgeon will also need to remove a small piece of bone called the lamina from the vertebra. The lamina forms a protective cover over your spinal cord. Removing part or all of it helps the surgeon access your herniated disk. It also can relieve pressure on your nerves and eliminate leg pain and sciatica.
How long does it take for a herniated disk to heal?
Most people with a herniated disk don't need surgery. Rest and other treatments should start to improve your symptoms within 4 to 6 weeks. But if your pain doesn’t improve, surgery might be an option. Talk to your doctor about surgery if: You’re not getting relief from pain relievers, injections, and physical therapy.
What is the procedure to remove a damaged disk?
Diskectomy. During this procedure, your surgeon removes your damaged disk to relieve pressure on your nerves. They can perform the surgery in a couple of ways:
What is the procedure called when you have two disks in your back?
This is called spinal fusion . Fusing the two disks will stop the bones from moving and prevent you from having any more pain. Artificial disk surgery. Only a few people are good candidates for artificial disk surgery because it only works on certain disks in your lower back.
How to stop back pain from a sprain?
You need to keep moving so your joints and muscles don't stiffen up. You can also use ice and heat to help relieve your pain. Just place an ice pack or warm wet towel on the area of your back that is sore. You can alternate hot and cold, or use whichever feels best.
How to help a back that hurts?
Rest can relieve swelling and give your back time to heal. While your back hurts, avoid exercise and other activities where you have to bend or lift.
What is the procedure to remove a herniated disk?
Diskectomy to remove your herniated disk. Laminectomy to remove part of the bone around a herniated disk and expand your spinal canal. Artificial disk surgery to replace a damaged herniated disk with an artificial one. Spinal fusion to directly join two or more vertebrae together to make your spine more stable.
What is a herniated disk?
A herniated disk is also known as a slipped disk or ruptured disk; it is one of the most common causes of back and leg pain. Herniated disks usually happen in the lower part of the spine.
How to tell if you have a herniated disk in your neck?
Symptoms of a herniated disk in your neck include: Pain near or between your shoulder blades. Pain that travels to your shoulder, arm and sometimes your hand and fingers. Neck pain, especially in the back and on the sides of your neck. Pain that increases when bending or turning your neck. Numbness or tingling in your arms.
How long does it take for a herniated disk to heal?
For up to 90% of people, herniated disk pain gets better on its own or with simple medical care. You’ll probably feel better within a month. If you don’t, you should see your healthcare provider. Some people need more aggressive medical measures, such as spinal injections or surgery.
What is it called when a vertebrae tear?
The disks act as buffers between your bones, allowing you to bend and move with ease. When one of these disks tears or leaks, it’s called a herniated disk .
What causes a herniated disk to rupture?
The leaked material may press on nearby spinal nerves. Several factors can contribute to a disk rupture, including: Aging. Excessive weight.
What is the best test for herniated disc?
Magnetic resonance imaging (MRI): The most common and accurate imaging test for a suspected herniated disk is an MRI. X-rays: Getting X-rays helps rule out other causes of back or neck pain. Computed tomography (CT): A CT scan show the bones of your spine.
How to treat a herniated disc?
Treatment for a herniated disc includes rest or limited activity for several days followed by gradual increase in activity over the next few weeks ice or cold packs used soon after an injury, heat packs used later, physical therapy, exercise (as advised by your doctor), massage, anti-inflammatory medications, muscle relaxers, steroids, and narcotic pain medications. If conservative treatments do not resolve the pain, then surgery may be indicated.
What are the symptoms of Compression Fracture vs. Herniated Disc?
Pain: It tends to be in the lower back but may occur in the middle or upper back or neck. Some people may also have hip, abdominal, or thigh pain.
What are the symptoms of a herniated disc?
Symptoms of a herniated disc ( slipped disc) include pain in the back or neck along with numbness or weakness in the corresponding organs, arms, or legs. Causes of vertebral compression fractures include osteoporosis, trauma, and diseases affecting bone (pathologic fracture). Risk factors for a herniated disc include degeneration from aging, ...
What is the difference between a compression fracture and a herniated disc?
A vertebral compression fracture occurs when the block-like part of an individual bone of the spine (vertebra) become compressed due to trauma. Discs are protective shock -absorbing pads between the bones of the spine (vertebrae). When a disc bulges, splits, or ruptures the ...
Why is surgery required for spinal fracture?
Surgery may be required to prevent the spine from pressing on the spinal cord or to stabilize the vertebra adjacent to the fracture site.
What is the condition where bone density is reduced?
Osteoporosis is a disease of bone in which bone density is reduced, which may increase the chance that a person could sustain a vertebral compression fracture with little or no trauma.
What is the compound used to treat osteoporotic fractures?
A cement or "biomaterial" compound is injected into the vertebra with the osteoporotic fracture. The material (usually methylmethacrylate) hardens, like cement, stabilizing the compressed vertebra. Studies using this technique have shown promise in relieving chronic pain associated with osteoporotic fractures.
Where is disc herniation pain?
Our team has helped numerous patients relieve pain from disc herniation in the lower back (lumbar spine) and neck (cervical spine), as well as less common locations such as the midback (thoracic spine).
Who is the spine surgeon at Johns Hopkins?
Johns Hopkins spine surgeon Amit Jain, M.D., explains what a herniated disc is, its associated symptoms and how it is diagnosed. He also covers treatment options and the prognosis for the condition.
Do herniated discs need surgery?
Most herniated discs don’t require surgery. They typically can be managed with a combination of the following treatments:
Can a herniated disc cause radiculopathy?
Herniated discs are very common and can be rather painful. They can lead to radiculopathy, myelopathy and similar conditions related to nerve compression. If a herniated disc is preventing you from doing the activities you enjoy, our spine specialists can help.
What is the best treatment for a herniated disc?
Nonsteroidal anti-inflammatory medications (NSAIDs) are commonly prescribed, and often help relieve the pain associated with a disc herniation. 3 By reducing inflammation, these medications can relieve some pressure on the compressed nerves. NSAIDs should be used under your doctor's supervision.
How to relieve a herniated disc?
Ice and heat application can be extremely helpful in relieving the painful symptoms of a disc herniation. 1 By helping to relax the muscles of the back, ice and heat applications can relieve muscle spasm and provide significant pain relief.
How soon after a herniated disc can you get surgery?
However, surgical treatment of a herniated disc may be recommended soon after the injury if several weeks of non-operative treatment doesn't provide adequate relief. It's important to realize that the size of the disc herniation and the amount of nerve compression doesn't dictate whether you will need surgery.
What is the purpose of a disc herniation injection?
Like oral anti-inflammatory medications, the goal is to relieve the irritation of the nerves. When the injection is used, the medication is delivered to the area of the disc herniation, rather than being taken orally and traveling throughout your body. 3 .
When will a herniated disc be treated?
on August 23, 2020. Treatment of a herniated disc depends on a number of factors including: when the disc herniation occurred, symptoms experienced by the patient, the age of the patient, activity level, and the presence of worsening symptoms. microgen / Getty Images.
Does lumbar stabilization help with herniated disc?
Physical therapy and lumbar stabilization exercises do not directly alter the herniated disc, but they can stabilize the lumbar spine muscles. This has an effect of decreasing the load experienced by the disc and vertebrae.
What is a herniated disc?
A herniated disc, also called a slipped or ruptured disc, is a common problem that can happen at any age, but becomes more common in middle age and beyond.
How long does it take for a herniated disc to go away?
The good news is that in most cases — 90% of the time — pain caused by a herniated disc will go away on its own within six months. Initially, your doctor will likely recommend that you take an over-the-counter pain reliever and limit activities that cause pain or discomfort.
Where in your body do you feel pain when you have a herniated disc?
For example, if the disc is in your neck, you may feel pain down your shoulder and into your arm.
Does Harvard Health Publishing have archived content?
As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.
Can you have surgery if your spinal cord is compressed?
Surgery is typically not recommended unless the problem does not respond to therapy, if you are having an increasingly hard time moving, or if your doctor believes the spinal cord is being compressed. To continue reading this article, you must log in.
What is the best treatment for a herniated disc?
For symptoms that are resistant to initial conservative treatments, continued conservative care or lumbar discectomy to remove the offending herniated disc material may be considered, and the question of which treatment is superior has sparked a major debate. In the last three decades, several RCTs and prospective cohort studies have shown that discectomy provides faster and/or greater pain relief, recovery from disability, and patient satisfaction compared to non-surgical care. Early evidence came from a large (507 patients), multi-centre prospective cohort study called the Maine Lumbar Spine Study (MLSS). At the one-year follow-up, patients treated with discectomy reported greater improvement in back and leg pain, functional status, and overall satisfaction, compared to non-surgical care.23Long-term follow-up analyses in the MLSS reported that these greater improvements among discectomy-treated patients persisted over five years for leg pain, back pain, function, and satisfaction,24and over 8 to 10 years for leg pain and function.25Another high-impact study is the Spine Patient Outcomes Research Trial (SPORT). It is a large, multi-centre RCT and an observational cohort study, comparing discectomy versus non-surgical care in patients with lumbar radiculopathy secondary to LDH. The RCT did not detect significant differences in pain, function, or disability between the treatment groups at the two-year follow-up.26However, this was later explained by a high crossover rate between the treatment groups in the RCT and the adjusted analysis showed in the discectomy group significantly better improvements in pain and function scores, sciatica scores, as well as higher patient satisfaction, compared to non-surgical care. The observational cohort showed that patients in the discectomy group had significantly greater improvements in primary outcomes (bodily pain, physical function) and secondary outcomes (bothersome sciatica, satisfaction, and self-rated improvement) over the two years of follow-up.27Longer term follow-up studies of the combined SPORT cohorts confirmed that the benefits of discectomy persisted for eight years.28A 2019 systematic review and meta-analysis examined 11 studies (3232 patients) comparing discectomy versus non-surgical care. Discectomy was found to be more effective than non-surgical care in significantly reducing leg pain, and back pain.29
What are the absolute surgical indications for disc herniations?
In all levels of disc herniations the absolute surgical indications include deteriorating neurological deficits with myelopathy or cauda equina syndrome. However, this review summarized the relative indications for surgery in each level.
How long does it take for lumbar disc herniation to improve?
In lumbar disc herniation (LDH), the indications for surgery include imaging confirmation of LDH, consistent with clinical findings, and failure to improve after six weeks of conservative care.
What is disc herniation?
Disc herniation is a localized displacement of disc material beyond the normal margins of the intervertebral disc space. The pain pathway originates in impingement of the nerve root by the herniated disc, which may in turn lead to nerve damage both by mechanical and chemical pathways. Mechanically, compression of the nerve likely leads to localized ischemia and nerve damage. Equally important, however, is the chemical cascade triggered by the nucleus pulposus on the nerve. A pro-inflammatory cascade mediated by tumour necrosis factor-alpha (TNF-α), interleukin factor-6 (IL-6), and matrix metalloproteinases (MMPs) leads to further sensitization and increased pain in the area.1,2
What is non surgical treatment for cervical radiculopathy?
Non-surgical treatment is the initial treatment of choice in most CDH patients with radiculopathy. It consists of a number of different modalities including immobilization, physical therapy, manipulation, traction, medication, and cervical steroid injection.5Good to excellent outcomes were reported in up to 90% of patients with non-operative management of cervical radiculopathy.9There are no clearly recognized indications for surgery in patients with CDH with radiculopathy.5Concerning signs or symptoms that might merit early surgical intervention include progressive neurologic deficits or signs of myelopathy (Fig. 1).10A trial of non-operative management is usually attempted in the absence of these signs. However, the length of non-operative management that has to be attempted is unclear. Wong et al noted in their systematic review that most patients experienced substantial improvement within 4–6 months.8A recent study by Burneikiene et al has shown that a longer duration of symptoms preoperatively corresponds to worse outcomes after surgery, with significantly better arm pain scores in patients who underwent decompression within six months of symptom onset, and the authors therefore recommended six months as the cut-off for non-operative management.11This finding has been supported by other authors.12A randomized controlled trial (RCT) is now underway to clarify indications for surgical treatment.13
Which spines have herniated discs?
In this lecture we will look at herniated discs in the cervical, thoracic and lumbar spine as each has varying thresholds for intervention.
Can a thoracic disc herniation be surgically treated?
Moreover, giant calcified thoracic disc herniations or myelopathy signs on magnetic resonance imaging, even in the absence of neurological symptoms, may benefit from surgical treatment as a preventive measure.
What is a herniated disc?
The discs can sometimes become compressed due to injury, or long term degeneration, which caused them to bulge and rupture. When a disc extends outwards and the inner nucleus breaks through the outer wall it becomes a herniated disc and can be very painful. They’re most common in the lower back and neck area of the spine, and happen frequently after sudden impacts like car accidents and sports injuries.
What happens if a herniated disc goes untreated?
A herniated disc can start out as just a mild pain and progressively grow into numbness and partial paralysis of the legs if a serious herniation goes untreated. Some patients won’t need treatment, but there’s no reason to risk the condition getting to that point.
Where do herniated discs occur?
The location of a herniated disc determines the surgical approach. Herniated discs most often happen in the lumbar spine, or the cervical spine. This is the lower back (lumbar) and neck (cervical), and it just so happens these are also the locations people experience pain the most frequently. Different procedures can be performed on these locations like the laminotomy. The laminotomy removes a portion of the lamina to make room for the herniated disc and thus the nerve will no longer be pinched. Many times a discectomy is also performed with a laminotomy, wherein a surgeon will also remove the portion of the herniated disc that is extending outwards. If the spine needs to be stabilizing a spinal fusion could also be performed, which involves fusing two vertebrae together with a bone graft and metal plates and screws to keep the fusing bones in place.
Can a herniated disc heal completely?
However, it may take up to 6 months for a herniated disc to heal with this approach. There’s also a chance it can get worse. Physical therapy might also help, and a steroid injection at the disc area will help reduce inflammation as well as control pain while the disc heals. The ways your body can resolve a herniated disc are by utilizing an immune response to reduce the herniated disc size and remove any inflammatory proteins, or the body absorbing water from the herniated disc which will cause it to shrink and no longer exhibit symptoms.
What causes a herniated disc?
A herniated disc occurs when a spinal disc protrudes through a casing in the spine. You fix a herniated disc with home care, alternative therapies, medications and surgery.
What is the best treatment for a swollen disc?
You may be prescribed a nonsteroidal anti-inflammatory drug ( NSAID) for mild to moderate pain. If the pain is more severe, your doctor might recommend an epidural steroid injection. This injection takes place with an X-ray guiding the needle into the affected disc.
What kind of scan is needed for a herniated disc?
If a herniated disc is suspected after performing basic tests, your doctor might order a magnetic resonance imaging ( MRI) scan. This will provide a clear image of your spine and confirm the diagnosis.
How do you know if you have a herniated disc?
If you have a herniated disc, you might experience symptoms such as: A persistent backache lasting more than a couple of days. Numbness, tingling, pain, or weakness that radiates down your buttocks and legs. A dull or sharp pain between the shoulder blades. Numbness, tingling, pain, or weakness that radiates down your arms and hands.
How much chance of repeat disc herniation?
Once a disc has herniated, you have a 5% to 10% chance of having a repeat disc herniation .
What is the test for sciatica?
If you are experiencing sciatica, your doctor might perform what is called the Straight Leg Test. They will ask you to lie on your back while they lift the leg that hurts. Where you experience pain during this test helps the doctor assess whether or not you have a herniated disc.
Can NSAIDs cause herniated discs?
NSAIDs and other medications may have different side effects. Consult your healthcare provider about possible complications of any medications you might take for your herniated disc. Possible surgical complications include infection, injury to nerves, dural tear, and the need for follow-up surgery.
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