If you have lower back pain, you are not alone. Back pain is the second most common neurological ailment in the world — only headache is more common. Fortunately, most occurrences of low back pain go away within a few days. Others take much longer to resolve or lead to more serious conditions. Nearly everyone at some point has back pain that interferes with work, routine daily activities, or recreation. One of the most common causes of acute back pain is herniated disk or a problem with one of the rubbery cushions (disks) between the individual bones (vertebrae) that form our spine. A spinal disk basically has a softer centre encased within a tougher exterior. A herniated disk occurs when some of the softer centre pushes out through a crack in the tougher exterior. This irritates nearby nerves and results in excruciating pain, numbness or weakness in the arm or leg. Interestingly, there are many people who experience no symptoms or discomfort from a herniated disk. Herniated disks are most common in middle age, especially between 35 and 45, due to aging-related degeneration of the disks.Excess body weight causes extra stress on the disks in your lower back. People with physically demanding jobs have a greater risk of back problems. Repetitive lifting, pulling, pushing, bending sideways and twisting also may increase your risk of a herniated disk. Disk herniation is most often the result of a gradual, ageing-related wear and tear called disk degeneration. As you age, your spinal disks lose some of their water content. That makes them less flexible and more prone to tearing or rupturing with even a minor strain or twist. It is possible that one can have a herniated disk without knowing it; they sometimes show up on spinal images of people who have no symptoms of a disk problem. The location of the symptoms varies and depends on where the herniated disk is located along the spine.
Typically a herniated disk is easily diagnosed after a simple physical exam and assessment of one’s medical history. To rule out other conditions and to check which nerves are being affected, a number of imaging and nerve tests might be prescribed.
Generally, treatment will depend on the following broad conditions such as age, overall health, and medical history, extent of the condition, tolerance for specific medications, procedures or therapies and expectations for the course of the condition.
Conservative treatment (that is centered around avoiding painful positions and following a planned exercise and pain-medication regimen) is known to effectively relieve symptoms in most people with a herniated disk.
The treatment may also have one or more of the following components:
For mild to moderate pain over-the-counter pain medication, such as ibuprofen (Advil, Motrin, others), acetaminophen (Tylenol, others) or naproxen (Aleve, others) might be prescribed. For stronger pain, a range of stronger prescription drugs may be preferred—these may include medicines that help relieve nerve-damage pain and muscle relaxants. Inflammation-suppressing drugs may sometimes be injected directly into the area around the spinal nerves, using spinal imaging to more safely guide the needle. Alongside, your doctor at BRAINS may prescribe physiotherapy, which help minimize the pain of a herniated disk.
A very small number of people with herniated disks eventually need surgery. It is recommended in the following cases:
- Conservative treatment fails to improve your symptoms after six weeks
- A disk fragment lodges in your spinal canal, pressing on a nerve resulting in progressive weakness
- You’re having significant trouble performing basic activities such as standing or walking In many cases, surgeons can remove just the protruding portion of the disk. Rarely, however, the entire disk must be removed. In these cases, the vertebrae may need to be fused together with metal hardware to provide spinal stability.
For the diagnosis and management of this degenerative disease, doctors at BRAINS use the most advanced technologies and procedures currently available to diagnose the condition and manage and mitigate its symptoms:
- X-ray: Which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.
- Magnetic resonance imaging (MRI): Uses a combination of large magnets, radio frequencies, and a computer to produce detailed images of organs and structures within the body.
- Myelogram: Uses dye injected into the spinal canal to make the structure clearly visible on X-rays.
- Computed tomography scan (also called a CT or CAT scan): Uses a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body.
- Electromyography (EMG): A diagnostic test that measures muscle response or electrical activity in response to a nerve’s stimulation of the muscle.