FAQs on Herniated Disc and Treatment Options
Sometimes called a ruptured disc, a herniated disc occurs most often in the lower back. Herniated disc is one of the most common cause of low back pain and sciatica, which is nerve-related leg pain.
Approximately 80-90% of people experience low back pain at some point during life. The prevalence of a herniated lumbar disc is around 2-3% in the U.S., with similar rates in other countries. This condition occurs more in people aged 30 to 50 years, with a male to female ratio of 2:1. The majority of herniated discs occur in the very low back region.
What is a herniated disc?
The disc like between your vertebrae (spine bones), and they act as shock absorbers when you bend, walk, or run. These discs are flat, round, and about a half inch thick. The outer layer is called the annulus fibrosus, whereas the inner soft, jelly-like center is called the nucleus pulposus. When the nucleus pushes against the outer annulus due to sudden injury or wear and tear, the pressure can cause low back pain. If the central material squeezes out, it can inflame the spinal nerves and produce sciatic nerve pain.
What are the risk factors for disc herniation?
Risk factors for a herniated disc include:
- Sporting events – Weight-bearing sports, such as hammer throw and weight lifting.
- Repetitive activities – These activities strain the spine, such as work-related bending, twisting, and lifting.
- Driving a motor vehicle – Driving for prolonged periods of time.
- Gender – Men between ages 30 to 50 years are more likely to experience disc herniation.
What causes a herniated disc?
As a person ages, the disc lose water content and weaken. This causes disc shrinkage, and the spaces between the vertebrae narrow. The normal aging process of the disc material is known as degenerative disc disease.
What are the symptoms of a herniated disc?
Low back pain is usually the first symptom of a herniated disc. The pain will last for several days, then gradually improve. Pain is often followed by leg pain, numbness, and weakness. The pain of a herniated disc often moves from the back down the buttock into the leg. For some patients, the pain radiates down into the foot.
How are herniated discs treated?
Depending on the associated symptoms and severity of the condition, there are several treatment options for a herniated disc. These include:
- Epidural steroid injection (ESI) – With this procedure, the doctor injects a long-acting steroid into the epidural space, which is between the epidural layer and the spinal cord. Done under x-ray guidance for correct needle placement, ESI is found to be effective 80-90% of the time.
- Selective nerve root block (SNRB) – For patients with sciatica, this block is useful for diagnosing the exact source of the nerve root pain. The doctor injects a numbing medication near the nerve root to numb the area and block pain signals. Nerve blocks have a 75-80% success rate, according to recent studies.
- Radiofrequency treatment – The doctor uses radio waves that produce heat to interrupt nerve signals that cause pain. This is often performed after a diagnostic nerve block. In a recent clinical study, all participants had some relief of pain after radiofrequency treatment, with the average duration of relief and success frequency remaining constant after each following treatment. The researchers concluded that repeated pulsed and continuous radiofrequency of the lumbar dorsal root nerve is a safe and effective long-term treatment for radicular pain.