Herniated Discs 101

What is a herniated disc?

A herniated disc is one of the most common reasons for long term disability in young people in North America. Basically, all of us have a jelly like substance in our vertebral joints. For some unknown reason (e.g. trauma, heavy lifting) this jelly-like substance leaks and impinges on the nerves which are leaving the spinal cord. When the nerves are pinched or compressed, the patient feels pain. When a herniated disc develops, it can limit how an individuals functions on a daily basis- the chief reason is because of continuous pain. The pain is a dull ache which often radiates to the back of the legs.

How is diagnosis of herniated disc made?

The diagnosis of a herniated disc can be made very easily with an MRI. However, even with a diagnosis, the treatment is somewhat difficult. There is no one type of treatment that works in everyone. Even the same treatment may not work in the future. For most patients with back pain, the treatment has to be individualized. Unfortunately, most health care professionals simply write a pain prescription, send you to a physical therapy exercise (owned by the physician), and then recommend surgery.

Who makes decision about treatment?

In general both the patient and physician should discuss the issue. However, since many patients do not know of all the options, they are at a major disadvantage. Physicians in general will recommend therapies which they know or therapies which are expensive

Can herniated discs occur in the neck?

Sure, herniated discs in the neck are common. But it is herniated discs in lower back that are frequently more disabling that those seen in the neck region.

Can the pain resolve on its own?

Definitely, if one is patient enough, pain from herniated discs will subside with time. In the majority of cases this may take anywhere from 4-6 weeks. Of course, you will need some pain medications for the first few weeks. Once the pain has diminished, one can start physical therapy.

Over time, the herniated disc will shrink and limit the compression on the nerves. Shrinkage of the herniated disc can take anywhere from 4-6 weeks. That is why it is extremely important not to undergo any surgery before this time.