Back pain is one of the most common medical complaints. Each year, up to half of all working Americans report experiencing back pain, according to research cited by the American Chiropractic Association, and up to 80 percent of people will suffer back pain at some point during their lifetime.
For many, conservative treatment such as rest and anti-inflammatory medication will be sufficient to provide pain relief. Often, the type of treatment necessary depends on the specific type of spinal injury. Among the most common sources of lower back pain or neck pain is a herniated disc.
What is a Herniated Disc
The human backbone, or spine, is comprised of bony vertebrae which run from the base of the skull to the tail bone. These vertebrae need cushioning between them to allow for flexibility and shock absorption of the spine. That cushioning comes in the form of discs between each vertebra.
The disc is comprised of two main parts: a tough but flexible outer layer (annulus fibrosis) and a jelly-like inner layer (nucleus pulposus).
A herniated disc occurs when the nucleus pulposus, the jelly-like center of the disc, pushes against and through the annulus fibrosis, or outer layer of the disc. While a herniated disc may be the result of a sudden injury, it is frequently caused by degenerative disease.
Often, the pressing of the inner layer against the outer layer causes pain in the area of the affected disc, typically the cervical spine (neck) or lumbar spine (lower back).
When the disc herniates, and the inner layer actually breaks through the outer layer, many people will find some relief from lower back pain, but will then face greater pain in related areas as the nucleus pulposus puts pressure on nerves. Symptoms of herniation may include sciatic leg pain or numbness or weakness of the legs.
When Do I Need to See a Doctor
If you are experiencing back or neck pain from an acute injury, or if your pain becomes chronic and doesn’t go away with rest and anti-inflammatory medications, it may be necessary to see a doctor about your pain.
According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, you should seek medical attention if you experience any of the following symptoms:
- Pain that occurs as the result of an injury
- Serious pain that is not relieved or improved by rest
- Pain in the back or neck that occurs as a result of an injury or fall
- Numbness or tingling of the arms, legs, back, or neck
- Pain that is accompanied by fever, weakness, numbness in the legs, unexplained weight loss, difficulty in urination
A doctor can evaluate the cause of the pain or weakness to determine an appropriate course of treatment.
What Are My Treatment Options
Your treatment options will depend upon a number of factors, but typically, doctors first recommend a nonsurgical approach including rest, anti-inflammatory medications, epidural steroid injections, and physical therapy.
However, some people do not experience significant pain relief after weeks or months of nonsurgical treatment. If a herniated disc is confirmed through diagnostic tests, such as MRI, a doctor may recommend spine surgery to repair the herniated disc.
Commonly, herniated disc surgery is performed as either microscopic (open) discectomy or endoscopic discectomy.
If surgery is recommended, your spine surgeon will determine the appropriate surgical procedure and discuss your treatment options with you.