Myths and Facts About Herniated Discs

May 9, 2016


Dr Berkowitz smallThere are twenty-three discs in the spine acting as shock absorbers between vertebrae. The discs have a tough outer portion surrounding a gel-like inner core or nucleus. There are some misconceptions about disc problems that stem in part from mid-20th-century treatments and prognosis.  

We talked with Dr. Robert Berkowitz to address these myths and get the facts about the diagnosis, prognosis and treatment of herniated discs:

Myth: Herniated Discs Always Cause Pain
Fact: They can, but do not always.

If fact, large numbers of people with disc abnormalities are asymptomatic. But that doesn’t mean those with pain have a lower pain tolerance or a more serious injury. The causes of pain during disc degeneration and herniation come from surrounding nerves in a patient’s spine, but the exact mechanism of pain generation is actually unknown.

Dr. Berkowitz explains some of the mystery surrounding this aspect of herniated discs. “It’s a bit of a mystery in that herniated discs, even those impinging greatly on some people’s nerves, don’t always cause pain. Which is why the medical community has multiple theories regarding the cause of pain in herniated disc patients. While it might seem obvious — that a bulging disc pressing upon a nerve would cause pain — the variation we see between patients has researchers considering other contributing factors. They’re looking into chemical components that might be involved and also considering if the location of the compression on the nerve determines pain levels. Regardless, everyone is different and so they feel differently and experience pain differently when it comes to herniated discs.”

Myth: Back Pain = a Herniated Disc
Fact: There are many causes of back pain.  And a herniated disc can be one of them, but often herniated discs cause pain and numbness in legs.

“Often times, I’ll see patients that think they have knee or hip problems and they actually have a herniated disc,” says Dr. Berkowitz.  

Sciatica, for example, can be caused by disc herniation in the lower part of the spine, but any nerves can be involved and cause symptoms such as pain, numbness, tingling and burning sensations in the back, legs or arms.

“People come to see us with a range of pains, and sometimes it is not what they think.  They might think it’s a herniated disc and it’s arthritis or a bone spur.  That’s why it’s so important not to just make assumptions or live with pain. Come in, get a physical exam, x-rays and, if needed, an MRI and then we can determine how best to help.”

Myth: Herniated Discs are Caused by Injury
Fact: Herniated discs can be a product of wear and tear or injury, but are often a combination of both.

According to Dr. Berkowitz, “Having a herniated disc is a genetic predisposition.  Some people get them and some don’t, but those that do usually have problems in their 30s, 40s and 50s.”

A weakened disc can mean that lifting or throwing something, as one had done many times before, can “suddenly” lead to injury. It’s a combination of a weakening outer disc layer and an activity that may compress a specific area and lead to a herniation.

“I tell patients that although they did something that seemed to ‘bring it on’, it’s likely it was eventually going to happen anyway,” says Berkowitz.  

Myth: Having a Herniated Disc is an Emergency
Fact: Rarely.

According to Dr. Berkowitz, a herniated disc is considered an emergency in only extremely rare circumstances. “Patients need to see us immediately if they experience progressive leg weakness within hours or days, a loss of bowel or bladder function or pain severe enough to keep them from walking. This would indicate the possibility of Cauda equina syndrome, a rare but serious condition, where extreme pressure and swelling of the nerves at the end of the spinal cord can lead to permanent neurological and physical problems.”

Myth: Herniated Disc Treatment Requires Risky Surgery
Fact: 90% of herniated discs get better with non surgical treatments. And if surgery is needed, it’s typically a minimally invasive, outpatient procedure.

Anti-inflammatories, cortisone injections, acupuncture and physical therapy, along with other non surgical techniques, often reduce or relieve pain as the disc heals naturally. Certain exercises and treatments can also aid in the healing process.

But if you need surgery, the methods Dr. Berkowitz use are minimally invasive, outpatient procedures. Traditional perceptions of back surgery (weeks of traction, inactivity, and dramatic risks) are simply no longer the case.

Dr. Berkowitz says, “We use the latest technology and most commonly do a procedure called MIS microdiscectomy.  MIS stands for minimally invasive surgery.  Essentially, we make an incision less than an inch long, remove the part of the disc impinging on the nerve, and then you go home the same day.  Most people have immediate relief of their pain and recover from surgery in a couple weeks.”

If you’re suffering from back pain radiating down one or both legs, neck pain and numbness radiating down one or both arms or progressive weakness in your arms or legs, call the Center for Orthopedics for a consultation today at 440.329.2800.



Entry Filed under: Back and Spine,Herniated Discs. Posted in  Back and Spine ,Herniated Discs .

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