Our spine and its 24 vertebrae (not including the sacrum and coccyx) couldn’t do much without the cushioning provided by the spinal discs. These soft discs allow the vertebrae to move and the spine to bend without having bone grinding on bone.
But the spinal discs can also cause serious problems when they herniate and press on adjacent nerve roots as they exit the spinal canal. This causes pain in the area of the back with the nerve compression, and that pain also often radiates down into the area served by the nerve.
WHAT IS A HERNIATED DISC?
Our spine has 23 spinal discs, all with different jobs. They act as shock absorbers between each bony vertebra, hold individual vertebrae together, and are malleable enough to allow mobility in the spine. They are made up of two parts — a tough outer shell called the annulus fibrosis and a soft inner core called the nucleus pulposus. The discs are kind of like jelly donuts, metaphorically speaking. The outer shell is made of tough, durable, concentric sheets of collagen fibers.
The inner core is gel-like, made of a loose network of fibers suspended in a protein gel. The two sections fit together like two concentric cylinders. At birth and through our pre-adult years, our discs are very soft. At this point, they’re about 80 percent water. As we age, they begin the process of drying out, making them less and less gel-like as we get older.
“The car accident that I was in last year left me in nearly constant pain from bulging and herniated discs in my neck, after recovery from the surgery I was able to return to work and resume my regular schedule. I am very pleased with the results of your surgical procedure and I am now living a normal life without the kind of pain I was experiencing after the car accident. Thank you for using your GOD given talents to heal others.”
–S. Vaughan (Tampa, FL)
WHAT CAUSES A HERNIATED DISC?
There usually isn’t an exact cause when a disc herniates. The annulus becomes more and more brittle as we move into our 30s, making them more prone to herniating.
One good thing with the drying out of the discs is that after the age of 50 most people no longer have herniated discs. This is because the inner gel has become so solid that it can’t push out through the outer annulus.
These are typical reasons a disc herniates:
- Wear and tear — The cause of most herniations is simply gradual wear-and-tear that occurs with our discs, due to their continual use. This is called disc degeneration. As we age and our discs lose more and more of their water content, they become less flexible. This makes them more prone to tearing or rupturing, sometimes from the simplest twisting motion.
- Injury — It’s easy to assume a disc herniates due to trauma, such as a fall or blow to the back, but this is rare. Disc injury that leads to herniation is more likely to the most seemingly mundane movements. It can happen if a person lifts items using the back muscles rather than the legs. It can happen when combining lifting and twisting at the same time.
- Combination — The reality is that most herniated discs are a combination of discs becoming less flexible with age and a movement that stressed the disc making it push through the outer shell.
Certain factors can increase your chances of developing a herniated disc:
- Weight — Excess weight produces more stress on the discs in your lower back.
- Occupation — Jobs that involve a lot of lifting, pulling, pushing, and bending and twisting have increased chances of herniating discs.
- Genetics — Some people inherit a tendency for the discs to herniate.
WHAT ARE SYMPTOMS OF A HERNIATED DISC?
Discs typically herniate in the lumbar spine, the L1-L5 vertebrae. Less frequently, they herniate in the cervical spine, the neck. Common signs you have a herniated disc are:
- Arm or leg pain — If your herniated disc is in your lower back, the pain will radiate down into your buttocks, thigh, and calk on the side where the disc is pushing on the nerve root. If the disc has herniated in your neck, you’ll have the most pain in your shoulder and arm.
- Numbness or tingling — Another sign is if you feel numbness or tingling in the area served by the affected nerves. Cervical herniation, for instance, will often lead to tingling or numbness in the fingers.
- Weakness — As the herniated disc compresses the nerves, this will gradually weaken the muscles served by those nerves. This can impact balance, fine motor skills such as grasping items, and other functions.
HOW IS A HERNIATED DISC DIAGNOSED?
At Innovate Spine Care, Dr. Watson has various methods for diagnosing your herniated disc. He’ll first check your back for tenderness. He’ll have you lie flat and move your legs to determine which movements cause pain. He may also check your reflexes, muscle strength, walking ability, and sensory ability.
This is usually all that is necessary. However, if Dr. Watson wants to see which nerves are being impacted he may order imaging tests:
- X-rays — X-rays won’t show the disc herniation, but they will enable Dr. Watson to rule out other possibilities, such as a tumor or broken bone.
- CT scans — Computer tomography scans take a series of x-rays from many different directions and combine them into a cross-sectional image of your spinal column.
- MRIs — Magnetic resonance imaging uses radio waves and a magnetic field to create images of your body’s internal structures. For herniated discs, MRIs are effective for seeing the location and nerves impacted.
- Myelogram — A dye is injected into the spinal fluid and x-rays then track it. They will show pressure on the nerves.
WHAT ARE THE HERNIATED DISC SURGERY OPTIONS?
Once a disc herniates, it cannot be repaired or put back into its outer membrane. The area of the disc that is pressing on the nerve needs to be removed or otherwise addressed.
To relieve the nerve compression, Dr. Watson performs a discectomy and neural decompression. For these procedures, he uses a Thulium laser to treat the posterior annulus of each symptomatic herniated disc.
The use of laser energy delivers sufficient energy into the annulus of the disc to turn off the nociceptors (pain nerves), char the annulus, and sometimes shrink the area of herniation. This also seals the blood vessels extending into the annulus. These blood vessels bring compounds to the discs that can create further inflammation and pain in the area.
These discectomy and neural decompression procedures relieve low back pain and leg pain. They return nerve function by reducing compression, which relieves tingling, numbness, and muscle weakness.
HOW LONG DOES IT TAKE TO RECOVER FROM HERNIATED DISC SURGERY?
Recovery is much faster and easier than with traditional spinal surgery. Patients should anticipate at least one week of recovery where they have little physical activity. After that first week, patients usually begin walking. Increasing activity is up to the individual patient and his or her rate of healing. Dr. Watson will give you guidelines on what you can expect for your situation.
WHAT IS THE SUCCESS RATE OF HERNIATED DISC SURGERY?
There have not been enough of these procedures to generate an overall success rate. It’s best to instead look through our Innovative Spine Care testimonials. That will give you an idea of the success Dr. Watson has had in alleviating the chronic pain caused by herniated discs in our patients from Tampa and all across Florida.
IS HERNIATED DISC SURGERY PAINFUL?
Patients feel nothing during the procedure, as we administer intravenous sedation.
Compared with a microdiscectomy or other surgical procedures to address herniated discs, the recovery pain is far less. Because these procedures don’t have to move muscles or other structures out of the way, recovery is much easier and much faster. For the first week, there will be some pain. Dr. Watson prescribes prescription pain medication to mitigate this.
IS HERNIATED DISC SURGERY SAFE?
Again, compared with surgical discectomies, where incisions must be made on the back or side of the neck and paraspinal muscles must be retracted to gain access to the facet joint of the affected vertebra, laser-assisted treatment of herniated discs involves much less risk. Incisions are only a few millimeters, just large enough to accommodate laser-powered needles to pass to the affected disc.
There is a chance of injury to muscles, ligaments, and surrounding tissues, but this is small due to the lack of invasiveness involved. There is a chance that the treated disc with herniating again. This is more a factor of degradation of the disc and is also rare. There is a slight risk of infection from the needle, but this is quite low.
During your consultation, Dr. Watson will discuss any risks with you.
HOW MUCH DOES HERNIATED DISC SURGERY COST?
These procedures with Dr. Watson vary based on the patient’s unique situation. After Dr. Watson examines you during your consultation, he will have a better understanding of what your pain relief needs are. At that time, he can give you an estimate of the cost of your procedure.
IS HERNIATED DISC SURGERY COVERED BY INSURANCE?
Coverage can vary. In most cases, if Innovative Spine Care takes your insurance, we will work hard with the company to gain as much coverage as possible. These laser procedures are newer options for treating herniated discs without the invasiveness of open back surgery. Since these are newer methods, insurance can sometimes lag. Before Dr. Watson performs any procedure, he advises patients to fully understand what their insurance company is prepared to cover, what your deductible is, and other variables.
WHAT HAPPENS IF A HERNIATED DISC IS LEFT UNTREATED?
Just because a disc herniates doesn’t mean it absolutely needs treatment. Some people have a herniated disc and don’t have any symptoms. But it is more likely that when the inner portion of the disc pushes out through the exterior it will push on nearby nerves that are exiting the spinal column. This irritates the nerves causing pain, numbness, or weakness in an arm or leg (wherever the nerve is servicing).
If this is the case, leaving the disc untreated can lead to chronic pain. And if the nerve is being impinged enough, it can eventually lead to muscle weakness in the muscles served by the affected nerve. At Innovative Spine Care, Dr. Watson treats herniated discs and relieves the pain and corresponding problems associated with them.
“Dr. Michelli and his staff are so warm and welcoming. Each doctor and therapist care a great deal for their patients and make this place a great place to come to!”
“Dr. Waston is an amazing doctor at first I was nervous, but his level of confidence and prayer ensured me I will be fine. Highly recommended for a first time experience.”