FAQs on Herniated Disc and Treatment Options in Nashville & Murfreesboro TN

A herniated disc is often referred to as a “slipped” or “ruptured” disc. Disc herniation can occur in the neck (cervical spine), mid-back (thoracic spine), or low back (lumbar spine). Discs are rubbery, soft pads found between the vertebrae that make up the spinal column. Discs function as cushions and shock absorbers, and they allow the back to bend, flex, and twist. Discs are composed of a thick, tough outer ring of cartilage, known as the annulus, as well as an inner jelly-like substance (the nucleus).

How common is herniated disc?

The prevalence of symptomatic disc herniation of the lumbar spine is around 2%, with the highest prevalence occurring in people ages 30 to 50 years. Herniated disc occurs twice as often in men than women, and around 95% of slipped discs occur in the lumbar spine region.

What causes a herniated disc?

A disc herniates when the center nucleus pushes through the outer cartilage and back toward the spinal canal. The pressure from the inner material presses on nerves, which are sensitive. This results in pain, weakness, tingling, and/or numbness in one or both legs.

What are the risk factors for herniated disc?

In younger people, the intervertebral discs have a high water content. However, as people age, the discs lose water, which decreases the flexibility of the cushion. As the discs shrink, the spaces between the bony vertebrae become narrow. Events and circumstances that can weaken the disc include:

  • Smoking
  • Improper lifting
  • Sudden pressure
  • Excessive strain
  • Repetitive strenuous activities

What are the symptoms of a herniated disc?

The lower back is most affected by a herniated disc. The most common symptom of a disc herniation is sciatica, which is a shooting, sharp pain that extends from the lower back into the buttocks and down the leg. This occurs when pressure is exerted onto the sciatic nerve. Other symptoms of a herniated disc include:

  • Tingling or numbness of the buttock or leg
  • Weakness in one leg
  • Loss of bladder or bowel control
  • A burning pain in the neck or back

How is a herniated disc treated?

Treatment of herniated disc depends on the severity of pain and the extent of nerve involvement. Treatment options include:

  • Medications – Depending on the severity of pain, the doctor can prescribe certain pain medications for a herniated disc. Options include nonsteroidal anti-inflammatory drugs (NSAIDs), Ultram, and opioids.
  • Physical therapy – To strengthen back muscles and improve flexibility, a physical therapist will work with the patient for several weeks. Treatment modalities include electrical stimulation, ultrasound therapy, and heat/cold treatments.
  • Epidural steroid injection (ESI) – With this procedure, a small needle is inserted through the soft tissues of the back, and then the needle is positioned into the epidural space. The doctor injects a long-acting corticosteroid near the spinal cord to relieve pain and decrease inflammation. Based on research studies, the ESI has an 80-90% effectiveness rate.
  • Radiofrequency treatment – This provides long-term pain relief for the neck, back, and legs. The doctor positions a tiny catheter near the spinal nerves, and uses radio waves to block pain signals in the nerve that cause discomfort. This procedure has a 75-80% success rate, according to recent clinical studies.
  • Neurostimulation – With this treatment, pain signals are blocked from traveling through the spinal cord to the brain. Devices used include transcutaneous electrical nerve stimulation (TENS) and spinal cord stimulation (SCS).

Resources

Bonaldi G, Baruzzi F, Facchinetti A, Fachinetti P, & Lunghi S (2006). Plasma radio-frequency-based diskectomy for treatment of cervical herniated nucleus pulposus: feasibility, safety, and preliminary clinical results. AJNR Am J Neuroradiol, 27:2104–2111.

Jordon J, Konstantinou K, & O’Dowd (2009). Herniated lumbar disc. Clinical Evidence (online), 1118.

McLain RF, Kapural L, & Mekhail NA (2005). Epidural steroid therapy for back and leg pain: mechanism of action and efficacy. Spine Journal, 5, 191-201.