Article featured on NY Orthopedics
Back pain is one of the most common types of pain you are likely to encounter, whether that’s due to pushing yourself too hard on the field or just a result of aging. A herniated disc is one common cause of back pain that can bring people a bit of anxiety when diagnosed. The most common question people have is whether they will need surgery to relieve their pain.
To answer these questions, let’s go over what a herniated disc is and what causes it. We’ll also look at some common ways doctors treat a herniated disc and when surgery is the right decision.
What is a Herniated Disc?
Your spinal column is made up of multiple vertebrae stacked upon one another. Between each vertebra is a thin disc composed of a soft nucleus surrounded by a thick layer of tissue called the annulus. These discs act as a shock absorber that provides support to the spine every time you move.
A herniated disc occurs when the disc’s nucleus starts protruding outside the annulus and into the spinal canal. As time goes on, the disc starts putting more pressure on spinal nerves within your spinal column, causing a range of symptoms that include:
- Numbness and tingling in other body parts
- Weakness in the legs or hands that make daily activities a chore
- Pain you may feel in the lower back and other parts, like arms, legs, feet, and buttocks.
What Causes a Herniated Disc?
While injuries or sprains can certainly cause a herniated disc, it’s more commonly the cause of natural wear and tear as we age. As we get older, the annulus becomes more prone to tears, increasing the chances that a disc might slip during activity. There are also a few risk factors that can increase your chances of getting a herniated disc:
- Weight. The more weight placed on the vertebrae, the greater the chance a disc might slip.
- Sedentary lifestyles. Staying active and increasing physical strength helps to support the back and put less stress on the spinal column.
- Rigorous jobs. If your occupation requires a lot of heavy lifting, it may increase your chances of a herniated disc.
- Smoking. Studies show that tobacco can decrease oxygen to the spinal column, increasing the chances that disc tissue will break down.
- Genetics. People with family histories of herniated discs are more at risk.
What Are Some Common Herniated Disc Treatments
If you’re diagnosed with a herniated disc, that does not mean you require surgery. Depending on the severity of your herniated disc, you may only require conservative, non-surgical treatments to eliminate any pain you may feel. Some common, non-surgical treatments include:
- Light activity to reduce inflammation
- NSAIDs to help relieve mild pain. In some cases, a doctor may opt for a spinal injection to better target the area of the herniated disc.
- Routine physical therapy to strengthen the muscles and put less stress on the discs.
In more severe cases, surgery may be required to correct a herniated disc if more conservative treatments are ineffective. The most common surgical procedure is a discectomy, where a doctor will remove the damaged portion of a disc. This type of surgery is performed more often with herniated discs that cause arm and leg pain. If possible, a surgeon will opt for a microdiscectomy which is less invasive than traditional discectomies, where a large incision is made to remove the entire affected disc.
What Should I Expect During a Herniated Disc Surgery?
During a microdiscectomy, a surgeon will place you under general anesthesia. From there, a surgeon may choose one of several approaches to reach the affected disc:
- Midline Microdiscectomy. Here the surgeon will make a small incision in the back and lift the nearby muscles away from the vertebrae. They will then hold the layers of muscle back as they remove portions of the damaged disc.
- Tubular Microdiscectomy. During this procedure, a surgeon will make a tiny incision and insert small tubes through the muscle to give them access to the damaged disc.
- Endoscopic Microdiscectomy. A surgeon makes a microincision in the back and inserts a small camera and instruments to remove the damaged tissue. This helps provide the least amount of trauma to the surrounding muscles and tissue.
What Does Recovery Look Like for a Herniated Disc?
Recovery times from a discectomy can vary depending on the type of procedure performed. However, a doctor will generally suggest around two to three weeks of rest to allow the tissue to heal. Typically, it will take around six weeks before most patients will be cleared to return to work.
A doctor will likely suggest routine physical therapy around three weeks in to help strengthen the muscles and speed recovery. People who work in sedentary jobs that require a lot of sitting should be conscious of their posture and try not to place any additional stress on their back as it heals.
