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Herniated Disc Defined and Where to Seek Treatment in New Jersey

Smiling people in standing pose during outdoor yoga class The spinal column is made up of a series of bones called vertebrae that protect the spinal cord and support the back. Between each vertebra is a disc that cushions the spine and serves as a shock absorber. These intervertebral discs are made of a jelly-like substance called the nucleus pulposus that is surrounded by a ring of tissue, called the annulus, which holds the nucleus pulposus in place. A herniated disc occurs when a disc becomes misshapen, or torn, then portions of the disc extend out of alignment with the vertebral bones. Herniated discs can be caused by an injury or may simply develop from normal wear and tear on the spine as people age. At Centers for Neurosurgery, Spine & Orthopedics in northern New Jersey, patients can receive expert non-surgical and surgical treatment for herniated or ruptured discs.

What Causes Herniated Discs?

Often, herniated discs are just the result of the normal aging process. Like other joints, the discs can wear down over time. As a person ages, these discs lose elasticity, and the cartilage stiffens or tears. A tear in the annulus can cause some of the nucleus pulposus to protrude or push out. This is known as a herniated disc. Sometimes, a patient will herniate a disc if they lift a heavy object or injure their back or neck during a fall. Repetitive stress injuries or excessive weight also can lead to disc herniation or a disc tear. While the terms sometimes are used interchangeably, a bulging disc and a herniated disc are distinct. A herniated disc, also known as a slipped or ruptured disc, is caused by a crack or tear in the outer ring of the disc cartilage. A bulging disc, in contrast, remains intact but loses its original shape: it becomes compressed or flattens out. Bulging discs can be caused by poor posture or repetitive motions. Herniated discs usually are more painful than bulging discs, as they protrude farther and are more likely to irritate surrounding nerves. Over time, a bulging disc can progress into a herniated disc if there is additional cartilage damage.

How Common Are Herniated Discs?

About 5 to 20 adults in 1,000 will get a herniated disc each year. Fortunately, most patients do not require surgery: Cleveland Clinic reports that 90% of herniated disc cases resolve on their own or with conservative treatments.

Who Is at Risk for a Herniated Disc?

Certain factors may increase a patient’s risk of a herniated disc. These include:
  • Age:Herniated discs are most common among patients between the ages of 30 and 50.
  • Gender:Men are more likely to have a herniated disc than women.
  • Weight:Being overweight increases the risk of disc herniation.
  • Lifestyle or occupation:Patients with jobs that require sitting for long periods, lifting heavy objects, or performing repetitive twisting or bending motions have a higher risk.
  • Tobacco use:Smoking increases the risk of degenerative disc disease, including herniated discs.
Patients also may be genetically predisposed to disc problems.

What Are the Signs and Symptoms of a Herniated Disk?

Symptoms can vary based on the location of the affected disc. A herniated disc in the lower back (lumbar spine) may cause:

  • Sharp, radiating pain in the buttocks, leg, and foot
  • Back pain
  • Muscle weakness
  • Numbness or tingling in the leg or foot

A herniated disc in the neck (cervical spine) can result in:

  • Pain in the neck or shoulder blade
  • Radiating pain that affects the upper arm, forearm, and fingers
  • Numbness along the arm

Pain may increase when the patient bends or turns the neck. Some patients notice symptoms that are worse after standing or sitting for long periods, or when a sneeze, cough, or laugh causes a quick movement.

Resting and over-the-counter pain medications can help with herniated disc symptoms. However, if a patient suspects they have a herniated disc, they should see a doctor. A herniated disc may go away on its own in some cases, but it is important to get an accurate diagnosis and rule out other issues that could be causing muscle weakness or numbness. If left untreated, a herniated disc can cause nerve damage or other issues.

How Is a Herniated Disc Diagnosed?

If a patient is experiencing neck or back pain, their medical provider will conduct a physical examination, review the patient’s medical history, and ask about symptoms. The doctor will check the patient’s reflexes, posture, and muscle strength, and test for any numbness or loss of sensation in the limbs. The physician will ask when the back or neck pain first began and if any actions lessen the pain or make it worse.

To confirm a diagnosis of a herniated disc, a physician may order imaging tests including:

  • Magnetic resonance imaging (MRI) or computer tomography (CT) scan: These common imaging tests can show if a herniated disc is putting pressure on the patient’s spinal canal.
  • X-rays: A spine X-ray can help rule out other possible causes of neck or back pain.
  • Electromyogram (EMG):An EMG test can test nerve function and help determine which nerve a herniated disc is impinging.
  • Nerve conduction test: This diagnostic test measures how quickly an electrical impulse moves through a nerve and is used to identify nerve damage.

Can a Herniated Disc Be Treated Without Surgery?

Often, a herniated disc can be effectively treated without surgical intervention. Conservative treatment options include:

  • Rest:Periods of bed rest can help decrease pain.
  • Pain management:Epidural steroid injections or transforaminal injections of a small amount of localized steroids can drastically and potentially completely alleviate the symptoms.
  • Physical therapy guided by a doctor: Gentle back stretches and exercises can increase flexibility in the muscles around the disc, offering pain relief.

Will Medications Help a Herniated Disc?

Along with conservative pain management measures such as physical therapy and rest, certain over-the-counter and prescription medications can reduce pain and relax muscles. These medications might be recommended to a patient initially with symptoms of back pain, including a herniated disc:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs): These medications treat minor aches and pains by reducing inflammation.
  • Muscle relaxants: These medications relieve muscle spasms and pain caused by disc herniation.
  • Corticosteroids: This type of drug reduces the production of chemicals that cause an inflammatory response, so they can help relieve pressure around the disc.

What Minimally Invasive Treatments Might Be Considered?

If rest and other conservative care options are not sufficient, interventional injection treatments can provide relief from a herniated disk. These include:

Epidural Steroid Injections

This injection treatment delivers steroid medication around a pinched nerve in the epidural space between the patient’s vertebral canal and spinal cord. Epidural steroid injections can significantly reduce inflammation that is irritating surrounding nerves and causing pain or numbness.

Transforaminal Injections

A transforaminal injection is a quick procedure that uses fluoroscopic X-ray guidance to deliver anesthetic and anti-inflammatory medication into the foramen of the spine at the level where the disc is pinching the nerve root. Transforaminal injections can provide pain relief for up to several months.

Trigger Point Injections

Often muscles spasm secondary to nerve root impingement caused by a disc herniation. To relax the muscle spasm, a trigger point injection can be performed in the office. The pain management doctor will place local or use a dry needle technique to reverse and relax the muscle spasm.

What Surgical Treatments Are Used to Treat Herniated Discs?

CNSO takes a conservative approach to disc herniations and treatment, so surgery is recommended only if necessary. Surgical treatments for herniated discs include:

Discectomy

In this procedure, a neurosurgeon removes the damaged part of a herniated disc. A discectomy can be an effective treatment for radiating pain caused by a compressed nerve.

Cervical Disc Replacement

If the herniated disc is within the neck and is severe and/or accompanied by a rupture, the neurosurgeon may recommend a cervical disc replacement to preserve flexion, extension, and mobility of the neck. At CNSO, many patients have benefited and become pain-free with a cervical disc replacement (otherwise known as a cervical arthroplasty).

Laminectomy

This surgery removes the vertebral bone called the lamina. A laminectomy can relieve pressure on the spinal nerves or spinal cord itself caused by a herniated disc. It may be necessary to perform at the same time as a discectomy or only necessary as a decompression of neuronal tissue.

Fusion Surgery

Spinal fusion surgery may be recommended for patients with degenerative disc disease that is below the neck and too severe to only perform a partial discectomy. During this procedure, a spine surgeon connects two or more vertebrae to stabilize the spine. They use a bone graft and plates or screws to hold the spine in place.

CNSO neurosurgeons and orthopedic spine surgeons use the latest surgical advances and minimally invasive techniques to reduce the risk of post-surgical bleeding and infection. CNSO spine surgeons are also trained in the use of robotics for complex spine deformities.

Recovering From Herniated Disc Surgery

Most patients will need to take some time off from work to recover if only for a few days. Complete recovery time depends on the number of levels of the spine operated and whether a fusion was performed. A spine surgeon may recommend lifestyle changes to help prevent future disc problems, such as:

  • Quitting smoking
  • Limiting alcohol consumption
  • Maintaining a healthy weight
  • Practicing stress management techniques, such as yoga or meditation

Will Rehabilitation Involve Therapy?

Some patients will have a series of physical therapy appointments as part of their recovery after herniated disc surgery. Their physical therapy exercises may include:

  • Range of motion exercises to improve joint mobility and flexibility
  • Strengthening exercises to help the patient regain muscle strength after surgery
  • Pain management techniques such as stretches and movement-based therapies

What Kind of Follow-up Care Is Common After Herniated Disc Treatment?

In addition to physical therapy, patients can expect regular follow-up appointments after surgery to monitor improvement and healing, remove any stitches, and track the patient’s activity level. Check-ups after surgery may include X-rays or other testing. At CNSO, patients receive a personalized rehabilitation plan after surgery that will be modified as needed depending on the recovery timeline.

Why Choose CNSO for Herniated Disc Care?

The dedicated medical staff at CNSO takes a team approach to patient care, creating personalized treatment plans and working in coordination to ensure the best health outcomes. Patients at CNSO have access to an extensive onsite team of back and spine specialists, including:

  • Neurosurgeons and orthopedic spine surgeons
  • Physiatrists
  • Interventional pain management physicians
  • Certified physical therapists and rehabilitation specialists

CNSO supports patients throughout northern New Jersey, with convenient locations in Bergen, Passaic, Essex, Morris, and Hudson counties.

Find Comprehensive Herniated Disc Care at CNSO

A herniated disc can be a painful and disruptive issue that keeps patients from going to work or doing the things they enjoy. Fortunately, CNSO offers expert care for a wide range of spine issues, from slipped discs and sciatica to spinal stenosis and radiculopathy. Using the latest advancements in surgical and non-surgical care, each CNSO location in northern New Jersey provides comprehensive care. To learn more or schedule an appointment, contact CNSO today.

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In order to provide an accurate diagnosis with the most effective treatment option for “back problems” and brain tumors, CNSO is led by neurosurgeons and orthopedic spine surgeons. Under the care of our award-winning neurosurgeons and orthopedic spine surgeons, Northern NJ patients can have the confidence that their medical condition will be handled with consideration for their comfort and long-term well-being as well as technical excellence.

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