Most painful spinal disorders stem from degeneration in the soft part between the bones known as the disc. The disc provides cushioning and flexibility to the spine, so like any soft part between two hard surfaces there are considerable stresses on the soft tissue. Over time this can cause it to wear out. This is certainly true in machines and likewise happens in our bodies as well.
Fortunately, our discs can withstand a lot of pressure, as much as 100 pounds per square inch or psi. That’s a lot if you consider your car tires operate on about 30 psi. The problems start as we age and the discs go through their aging cycle just like the rest of our bodies. As the discs become more “incompetent” or degenerative, the pressure of 100 psi can cause failure. This results in one of the most common problems we see: disc herniation.
The term “herniation” refers to something protruding through something else. In the spine, the inner softest part of the disc (nucleus pulposus) comes through the outer tougher part of the disc (annulus fibrosus). This can result in back pain, leg pain or both. The treatment for this problem depends on which of these are your predominant symptoms.
Regardless of the predominant symptom, we would, (with the rare exception of Cauda Equine Syndrome), always recommend non-operative or conservative care to start.
Non-surgical treatment options
When the center of the disc comes out or herniates all the way through the outer part of the disc, it can put pressure on a nerve just behind the disc resulting in sciatica. This refers to leg pain, numbness, tingling, weakness or any combination of these symptoms. If the herniation is not complete and only goes through part of the outer layer, it can cause severe back pain but not the leg symptoms because there is no pressure on the nerve.