Doctors will often interchangeably use the terms herniated disc, slipped disc, pinched nerve, and bulging disc. Though this affliction has several different terms, either the slipping or degeneration of a spinal disc causes all of these issues. The type of pain associated with a herniated disc will be determined by its cause. It can easily be diagnosed, and then treated with either nonsurgical or surgical procedures depending on the severity of the condition.
Symptoms of a Herniated Disc
The symptoms associated with a herniated disc vary depending on the patient’s specific problem. There are two types of pain that can be caused by a herniated disc, axial pain and radicular pain. When a disc has degenerated, a patient will often experience axial pain, which is pain felt in the disc space itself. Axial pain can also extend down into the lower back or the legs.
When a disc has slipped or dislocated itself in some way, radicular pain is often experienced. A herniated disc pinching a nerve in the back causes radicular pain. This leads to radiating pain that can be felt in several areas of the body, depending on the problematic disc’s location. Radicular pain can either shoot from the neck down, in the neck, or through the legs. When radicular pain shoots through the legs, it is often referred to as sciatica.
Doctors can often reach a determination on the likely cause of back pain by conducting a physical examination and reviewing the patient’s symptoms and medical history. Once a doctor has reached a diagnosis, further testing is done for confirmation. Some tests that may be used are a CT scan, an MRI scan, and a discogram. A computerized tomography (CT) scan works like an x-ray, but the image is reformatted to show cross sections of the spine. A magnetic resonance imaging (MRI) scan can be used to assess the spinal nerves, disc alignment, height, hydration, and configuration of the spine. A discogram is often used if surgery is being considered. In this test, a dye is injected into the disc to recreate normal pain. This is used to determine which disc is causing the problem.
After diagnosis, the patient’s primary care physician will often refer them to a spine specialist, such as Dr. Solomon Kamson of the Spine Institute Northwest. Additional testing may be performed to determine if the correct diagnosis has been made. Some nonsurgical options for treating a herniated disc include rest, pain management, and physical therapy. However, in severe cases or when more conservative treatment options have not been enough to alleviate pain, surgery may be performed to remove the offending disc.
One common surgery for a herniated disc is a minimally invasive procedure known as a lumbar discectomy. A lumbar discectomy requires only a small incision, often less than one inch. This incision is made over the herniated disc. Then, the surgeon inserts a retractor, to remove a small amount of the lamina bone and allow the surgeon a view of the spinal nerve and disc. Next, the surgeon retracts the nerve and removes the damaged disc. Finally, bone graft material is used to replace what was removed and the incision is closed up. The Spine Institute Northwest specializes in minimally invasive spine surgery procedures like the discectomy.