Between each of the vertebrae of the spine are soft disks filled with a gelatinous substance. These rubbery disks provide a cushion for the vertebrae and help hold them in place. As we age, our disks lose some of their flexibility and become flatter. They may be additionally weakened by stress caused by too much body weight, incorrect lifting, sudden pressure, vigorous repetitive movements and smoking.
When one of these disks moves out of place or ruptures, it is considered herniated. Sometimes the herniated disk may press on a nerve in the spinal canal, which results in back pain or sciatica.
When the herniated disk is in the lower portion of your spine, the symptoms may include back pain that extends into the buttocks and legs. When the herniated disk is in the upper portion of your spine, the resulting symptoms may include neck pain that extends into the shoulders and arms. You also might experience tingling, numbness, muscle spasms or weakness.
In order to make a correct diagnosis of your back pain, your doctor will require a complete medical history. A physical exam will most likely include a check for loss of sensation or numbness, how your reflexes respond, muscle strength and overall posture.
In many cases, your doctor will order X-rays to further examine the spine. Tests such as an MRI, CT scan, electromyography and myelogram can provide detailed information about the size and location of the disk herniation.
Treatments for herniated disks usually begin with bed rest, anti-inflammatories and pain medications as needed. Sometimes physical therapy can improve the symptoms. You may need epidural injections of a steroid to reduce the nerve irritation and facilitate healing.
When the condition is not responding to these measures, surgery is generally the next option considered. The type of procedure performed will depend upon where in the spine the herniated disk is located. If it is in the lower back, the surgeon may do a microdiscectomy or laminectomy based on the position and size of the disk. If it is in the neck region, the surgeon will most likely perform an anterior cervical discectomy. The disk is removed to relieve the pressure on the spinal cord and nerves.
Your surgeon at NYC Surgical will evaluate all your symptoms and imaging studies and discuss with you options to best meet your expectations with the appropriate procedure.