How do I Know if I Have a Herniated Disc?
When most people hear the phrase “herniated disc”, they probably think of their uncle or dad lying on the ground in pain. You may have even been told that you have a herniated disc, and are thinking that you don’t want to end up like them and go down that road. The truth is that a lot of people are walking around with herniated discs and don’t even know it. Some have pain and some don’t. Some need surgery, but most won’t.
What is a herniated disc?
The discs in your back are like your back’s shock absorbers. Between each vertebrae in your spinal column there is a soft disc of jelly like material that can absorb some of the force as you bend and twist. Think of it like a jelly doughnut. Each disc has an inner core called the nucleus pulposus, which is like the jelly in the jelly doughnut. The outer layer is thicker and called the annulus fibrosus, which is like the doughnut part of the jelly doughnut. When a disc herniates, the nucleus pulposus comes out through the annulus fibrosus, or to continue the analogy, the jelly has come out of the doughnut. Now, sometimes when the jelly comes out, it can press on one of the nerves in your spine as it exits to travel down your leg or arm (or as it’s about to exit). Nerves don’t like being pressed, so they get irritated and can cause pain or numbness and tingling. This is what someone is feeling when they say that the pain is shooting down their leg or arm.
How do I know I have a herniated disc?
If you have a sudden onset of pain in your back that is worse when you lean forward, then you might have a herniated disc. And as I mentioned before, a herniated disc can also press on a nerve and cause pain to shoot down your leg if the disc is in your back, or shoot down your arm if the herniated disc is in your neck. Sometimes, people have all of these symptoms and don’t have a herniated disc, the symptoms are from something else. Actually, there are a lot of people who have herniated discs and have absolutely no pain. If you are between the ages of 40 and 59, and you have no back pain, you have a 22% chance of having a herniated disc somewhere in your lower back. If your aged 60-79, then you have a 36% chance of having a herniated disc, even if you don’t have any pain. Even more people are told that they have a “bulging disc”, which is where the jelly is about to come out of the doughnut, but it hasn’t quite yet.
What should I do about my herniated disc?
90% of the time, your body will resorb the herniated disc, and you will get better without any surgery at all! This may mean that you need to do physical therapy and might need to take medications to help with the pain such as an anti inflammatory, muscle relaxer, or in some cases a short dose of oral corticosteroids. And as I said before, a lot of people have bulging or herniated discs, and don’t even know it. However, if you find that the inside of your thighs is numb, and you are losing your bowels or bladder then you should seek immediate treatment as you might have something called cauda equina which needs urgent surgery. In the other case, if you have a big herniated disc in your neck that is causing you to lose hand dexterity or walk funny, then that is called myelopathy and will need surgery as well. Cauda equina is relatively rare, and while myelopathy is somewhat more common, it is not as common as having a slipped disc in your lower back. Chances are that you will get better with time.
I hope I was able to answer your questions about herniated discs. If there is something that you wanted me to talk about that I didn’t, or if you have any other questions, I encourage you to contact me.
-Written by Dr. Daniel Paull