Herniated Disc Treatment in New Jersey
To understand what herniated discs in the spine are and how they are treated, it's helpful to know a little about the structure of the spine.
The spinal column, commonly known as the backbone, is composed of 24 individual bones known as vertebrae. The spinal column serves several important orthopedic functions. Vertebrae protect the spinal cord, and the spinal cord carries messages between your brain and the rest of your body. The spinal column also protects your surrounding organs and provides structure and support to the entire body.
In between each vertebra is a spongy disc that cushions and provides shock absorption and stability to the spine while helping facilitate bodily movement. Damaged discs can cause pressure on the spinal cord and are a common cause of back pain.
What Is a Herniated Disc?
A herniated disc is one of the most common disc injuries. It occurs when a disc sustains excessive irritation or pressure, causing the inner, gelatinous layer of the disc to break through the outer layer, into the spinal column. This bulge can press on nerves and cause pain, weakness and numbness.
Herniated discs can worsen over time. If you suspect you may have a herniated disc, don't wait — visit an orthopedist for an accurate diagnosis, and learn about herniated disc treatment options.
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What Are the Symptoms of a Herniated Disc?
A herniated disc can occur in either the cervical (neck), thoracic (mid-back) or lumbar (lower back) region. While some individuals with a herniated disc are asymptomatic, many others experience the following symptoms and require herniated disc treatment. Some of these symptoms include:
- Generalized back pain
- Back pain that increases from repetitive motion, such as bending or prolonged sitting
- Pain that increases from coughing, sneezing or straining
- Numbness or sensation of pins-and-needles that radiates into the extremities; a cervical herniated disc may result in neck or arm numbness, whereas a lumbar disc herniation may result in sciatica, a painful condition that irritates the nerve root that travels from the spine down to the leg.
In very rare cases, a herniated disc can lead to loss of bladder or bowel control. This usually occurs in conjunction with a more serious condition known as cauda equina syndrome which compresses the spinal nerve roots.
Risk Factors for a Herniated Disc
A disc herniation can develop as a result of a variety of lifestyle behaviors and genetic factors. They include:
- Lifting heavy loads. You can develop a herniated disc as a result of lifting an isolated heavy load, or by sustaining heavy loads on a regular basis.
- Obesity. Extra body weight contributes to the load burden on each disc, increasing your risk of injury.
- Poor physical fitness or sedentary lifestyle. Lack of musculature can put added pressure on your discs, increasing your chances of developing disc herniation.
- Poor posture. This can encourage unbalanced spinal alignment, which puts added pressure on your discs.
- Cigarette smoking. Smoking exposes your body to carbon monoxide, a harmful substance that diminishes your discs’ ability to absorb nutrients from your blood. This can cause your discs to dry out, compromising their ability to provide support.
- Age. As we age, our discs gradually lose fluid, increasing our chances of injury.
- Gender. Men between the ages of 20 and 50 are more likely to develop disc herniation than women, possibly due to lifestyle factors.
Diagnosing a Herniated Disc
If you are suffering from back pain, schedule an appointment with an orthopedist to obtain a proper diagnosis. They will ask about your symptoms, medical history and details surrounding injuries that may have caused the herniated disc. The orthopedist will perform a physical examination to look for signs of disc injury as well as to rule out other conditions such as a spinal cord tumor.
Physical Tests for Herniated Discs
Physical tests to screen for disc herniations may include:
- Range of motion tests. To look for signs of disc injury, your doctor may ask you to lean forward and backward as well as side to side.
- LaSegue test. This stretch test involves straightening out your leg and holding it at different angles to determine the location of the pain.
- Gait monitoring. This test determines whether you are having difficulty walking due to disc pain.
- Neurological tests. These tests check for muscle strength and loss of sensation, as well as reflex response.
If you exhibit pain, weakness or limited range of motion during your physical exam, your doctor may determine that you have a herniated disc.
Diagnostic Imaging Tests
Your orthopedic specialist may order imaging tests to confirm the herniated disc diagnosis and to rule out other conditions before proceeding with treatment. Imaging tests may include:
- X-ray imaging. Although an X-ray image cannot show soft tissue damage such as a herniated disc, it may help rule out other conditions that could be causing back pain.
- Ultrasound technology. This imaging technology provides more detailed images than those from an X-ray, yet not as detailed as those captured from an MRI. Using soundwaves to visualize internal structures, ultrasound is useful in identifying injuries to soft tissues, which can aid in the treatment for herniated disc.
- Magnetic resonance imaging (MRI). Magnetic wave technology can produce detailed images of soft tissue inflammations, swelling, herniated discs, degenerative disc disease and other orthopedic or neurological conditions.
- CT myelography. Using computed tomography, a contrast dye is injected into the fluid spaces to create images of the spine and show structures that may be putting pressure on the spinal cord, including herniated discs. By ruling out tumors or bone spurs caused by spinal stenosis, this test helps determine future herniated disc treatments or other recommended paths for treatments.
- Electromyography (EMG). By measuring electrical impulses, this imaging test can evaluate the overall condition of the spinal and peripheral nerves as well as isolate any signs of nerve damage, when necessary.
Herniated Disc Treatment
Herniated disc treatments are often conservative and involve rest and other noninvasive therapies. The type, location and severity of your herniated disc, combined with your age, health condition and lifestyle will help your doctor determine your path of herniated disc treatment.
Disc herniation treatment can include the following at-home and physician-assisted therapies.
- Rest. Take a break from exercise, weight-bearing, and strenuous activities. Many patients find that heating pads help reduce pain from a herniated disc.
- Anti-inflammatories. Mild to moderate pain may be treated with aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen, which may be helpful in reducing pain and swelling from your herniated disc.
- Neuropathic drugs. If you have severe pain, your herniated disc treatment may include medications to help decrease pain, which may include gabapentin, pregabalin or other medications.
- Steroid injections. For more severe cases, your doctor may inject an epidural steroid through X-ray guidance to help ease the pain.
- Physical therapy and rehabilitation. After an initial period of rest, stretching, light exercise or physical therapy can be helpful paths of treatment for a herniated disc, as building up musculature to help support your spinal column may alleviate pressure.
Herniated Disc Surgery
When you cannot achieve sufficient relief from pain, numbness or weakness with nonsurgical herniated disc treatments alone, or if you are encountering a loss of bladder or bowel control, surgery is sometimes necessary. Your doctor will take into account your age, overall health and other factors to determine whether surgery is a viable herniated disc treatment for you.
Discectomy or Microdiscectomy
The most common surgical treatment for a herniated disc, this procedure involves the removal of the portion of the disc that is protruding or putting pressure on the nerve root. Accessed through incisions in the back or neck, this procedure is performed under general anesthesia. Whenever possible, a microdiscectomy, which uses microscopic assistance, is performed; this is a newer and less-invasive procedure that involves smaller incisions. Depending on your health and lifestyle, you may be able to return to normal activities within 2 to 6 weeks, or longer if you have a job that requires heavy lifting.
Laminotomy or Laminectomy
This spine surgery is a herniated disc treatment option for those experiencing leg pain and sciatica. With the goal of enlarging the spinal canal to relieve pressure, it is performed under sedation. Your doctor makes an incision through the skin to remove the back of the vertebrae known as the lamina, to access the vertebrae and herniated disc. The damaged disc is then removed and sometimes the spine is stabilized through a separate procedure called spinal fusion. In most cases, you may return to normal activities within a few weeks, or longer if you have had a spinal fusion.
Artificial Disc Surgery
Performed under general anesthesia, artificial disc surgery is sometimes an option when a single disc in the lower back is damaged. It is not a good option for those who suffer from multiple disc damage or with arthritis or osteoporosis.
See how artificial disc surgery changed Dominic Pace's life.
Spinal Fusion
Spinal fusion is a procedure performed under anesthesia to improve your stability, correct a deformity or reduce back pain from a herniated disc. It connects two or more vertebrae by inserting a bonelike material in the space between them, anchored with metal plates, rods and screws. Spinal fusion often requires a hospital stay of a few days, and recovery will likely require a brace for support. Full healing and recovery may take several months to achieve.
There are benefits and risks involved in any herniated disc surgery. RWJBarnabas Health recommends addressing your questions and concerns with your doctor prior to scheduling any surgical herniated disc treatment.
The RWJBarnabas Health Difference
At RWJBarnabas Health, we aim to help our patients achieve a better quality of life by getting them back to everyday activities with ease. We are the largest health network in New Jersey. Our well-rounded orthopedic department is led by highly skilled medical professionals who will guide you through your herniated disc treatment with care and compassion.
Our team includes:
- Orthopedic surgeons
- Neurologists
- Neurosurgeons
- Pain management specialists
- Physician assistants
- Registered nurses
- Physical therapists
With access to the latest technologies to diagnose a wide array of orthopedic conditions, we can administer therapies and treatments for herniated discs that promote enhanced healing, aid in pain management and encourage better patient outcomes for you and your family.
Do you suffer from symptoms of a herniated disc? RWJBarnabas Health can help.
