Disc Herniation

Most painful disorders of the spine stem from degeneration in the discs which are the soft part between the bones. The disc provides cushion and flexibility to the spine so like any soft part between two hard surfaces there are considerable stresses on the soft part and over time it can wear out. This is certainly true in machines and so without surprise it 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, then that pressure of 100 psi can cause failure. This results in one of the most common problems that we see, namely disc herniation.

The term “herniation” refers to something coming 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 rare exception Cauda Equina 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 and this can lead to sciatica which is defines as 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.

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