I was told today that I have 3 herniated disks in my neck and I have to see a neurosurgeon, does this have to be surgery or is there any other way to treat them? While the spinal discs are designed to withstand significant amounts of force, injury and other problems with the disc can occur. When the disc ages or is injured, the outer portion of a disc may be torn and the disc鈥檚 inner material can herniate or extrude out of the disc. Each spinal disc is surrounded by highly sensitive nerves, and the inner portion of the disc that leaks out contains inflammatory proteins, so when this material comes in contact with a nerve it can cause pain that can travel down the length of the nerve. Even a small disc herniation that allows a small amount of the inner disc material to just touch the nerve can cause significant pain.
In general, patients usually are advised to start with a course of non-surgical treatments prior to considering spine surgery for a herniated disc.
But, there are a few relatively rare conditions that require immediate surgical intervention. Description
You've probably heard people say they have a "slipped" or "ruptured" disk in their neck or lower back. What they're actually describing is a herniated disk, a common source of neck, or lower back and arm or leg pain.
Disks are soft, rubbery pads found between the hard bones (vertebrae) that make up the spinal column. In the middle of the spinal column is the spinal canal-a hollow space that contains the spinal cord and other nerve roots. The disks between the vertebrae allow the back to flex or bend. Disks also act as shock absorbers.
Disks in the lumbar spine (low back) are composed of a thick outer ring of cartilage (annulus) and an inner gel-like substance (nucleus). In the cervical spine (neck), the disks are similar but smaller in size. A helpful comparison is a jelly donut: its thick outer portion represents the annulus, while the jelly is similar to the nucleus.
A disk herniates or ruptures when part of the center nucleus pushes through the outer edge of the disk. To continue with the donut analogy, the jelly pushes backwards toward the spinal canal. This puts pressure on the nerves. Spinal nerves are very sensitive to even slight amounts of pressure. Pain, numbness or weakness may occur in one or both legs.
Risk Factors/Prevention
In children and young adults, disks have high water content. As people age, the water content in the disks decreases. They become less flexible. The disks begin to shrink. The spaces between the vertebrae get narrower. The disk itself becomes less flexible. Conditions that can weaken the disk include:
Improper lifting
Smoking
Excessive body weight that places added stress on the disks (in the lower back)
Sudden pressure (which may be slight)
Repetitive strenuous activities
Symptoms
Lower Back: Low back pain affects four out of five people. Pain alone isn't enough to recognize a herniated disk. See your doctor if back pain results from a fall or a blow to your back. The most common symptom of a herniated disk is sciatica-a sharp, often shooting pain that extends from the buttocks down the back of one leg. It is caused by pressure on the spinal nerve. Other symptoms include:
Weakness in one leg
Tingling (a "pins-and-needles" sensation) or numbness in one leg or buttock
Loss of bladder or bowel control (If you also have significant weakness in both legs, you could have a serious problem. Seek immediate attention.)
A burning pain centered in the neck
Neck: Like pain in the lower back, neck pain is also common. When pressure is placed on a nerve in the neck, it causes pain in the muscles between your neck and shoulder (trapezial muscles). The pain may shoot down the arm. Sometimes the pain causes headaches in the back of the head. Other symptoms include:
Weakness in one arm
Tingling (a "pins-and-needles" sensation) or numbness in one arm
Loss of bladder or bowel control (If you also have significant weakness in both arms or legs, you could have a serious problem. Seek immediate attention.)
Burning pain in the shoulders, neck or arm
Diagnosis
To diagnose a herniated disk, give the doctor your complete medical history. Tell him or her if you have neck/back pain with gradually increasing arm/leg pain. Tell the doctor if you were injured. The doctor will physically examine you. This can determine which nerve roots are affected (and how seriously). A simple X-ray may show evidence of disk or degenerative spine changes.
MRI (magnetic resonance imaging) or CT (computed tomography) scans (imaging tests to confirm which disk is injured) or an EMG (a test that measures nerve impulses to the muscles) may be recommended if pain continues.
Treatment Options
Conservative treatment is effective in treating symptoms of herniated disks in more than 90 percent of patients. Most neck or back pain will resolve gradually with simple measures.
Bed rest and over-the-counter pain relievers may be all that's needed.
Muscle relaxers, analgesic and anti-inflammatory medications are also helpful.
You can also apply cold compresses or ice for no more than 20 minutes at a time, several times a day.
After any spasms settle, you can switch to gentle heat applications.
Any physical activity should be slow and controlled, especially bending forward and lifting. This can help ensure that symptoms do not return. Take short walks and avoid sitting for long periods. For the lower back, exercises may also be helpful in strengthening back and abdominal muscles. For the neck, exercises or traction may also be helpful. It's essential that you learn how to properly stand, sit and lift. This can help you avoid future episodes of pain.
Treatment Options: Surgical
If conservative treatment fails, epidural injections of a cortisone-like drug may lessen nerve irritation and allow better participation in physical therapy. These shots are given on an outpatient basis over a period of weeks.
Surgery may be required if a disk fragment lodges in the spinal canal and presses on a nerve, causing significant loss of function. Surgical options in the lower back include microdiskectomy or laminectomy depending on the size and position of the disk herniation. In the neck, an anterior cervical discectomy and fusion is usually recommended. This involves removing the entire disk to take the pressure off the spinal cord and nerve roots. Bone is placed in the disc space and a metal plate may be used to stabilize the spine. On occasion, a smaller surgery may be performed on the back of the neck that does not require fusing the bones together. Each of these surgeries is performed under general anesthesia. It may be performed as an outpatient or require an overnight hospital stay. You should be able to return to work in two to six weeks. i have a friend laying in a bed right now with a h. disk in her lower back and she has no insurance she is getting physical theropy, but they say it will take months before she will be better, if that doesn't work surgery is the next step, good luck There is a lot of information about them over at Wikipedia, I also recommend reading the external links, very informative, I learned something today. As far as the treatment goes, I would follow the advice of your doctor or see if you can get a second opinion but I think surgery is probably the only way to take care of it.
Good luck! I have one.
You have little cussions between your vertabrae. They are like sacs of jelly. The 3 sacs have broken and are oozing this jel. It is having the effect of reducing the cussioning of your spine.
I'd only let them do surgery if the pain made me suicidal. These operations can go very right or very wrong.
There is no way to totally fix it without surgery, but Chiropractic helped me a lot. Depending on the size of the herniated disc and the condition of the person, treatments of a herniated disc may be conservative or aggressive. The usual treatment for a herniated disc is to proceed conservatively. After diagnosing the problem, usually a period of rest is advised. It is important that rest take place initially, but that gradually you return to activities. Often a few days on relative inactivity will help tremendously. Initial treatments are aimed at minimizing inflammation around the nerve with anti-inflammatory medications and possibly an epidural steroid injection, and stabilizing the lumbar spine with physical therapy and strengthening exercises. Surgical treatment may be recommended soon after the injury if there is a significant neurologic component (i.e. weakness or numbness) to your problem. Most often surgery is recommended if more conservative measures do not relieve your symptoms. Surgery is performed to remove the herniated disc, and free up space around the compressed nerve. Depending on the size and location of the herniated disc, and associated problems (such as spinal stenosis, arthritis, etc.), the surgery can be done by several techniques. |
