of the back. These soft tissues support the back and help hold it together.
The discs that sit between the vertebrae have a tough outer shell and jelly-like center. The outer shell of the discs can sometimes break open, spilling the jelly material inside. This is what doctors call a herniated disc. � �
Herniated discs can cause symptoms, because the jelly material that spills out of them can irritate nearby nerves. Plus, the disc itself can bulge and press on nerves. � �
This article will discuss herniated discs only in the lower back. Other parts of the back can have herniated discs, but that is less common. � �
What are the symptoms of a herniated disc in the lower back? " � Herniated discs do not always cause symptoms. When they do, the most common symptom is tingling, pain, or numbness that spreads down one leg. These symptoms affect different parts of the leg, depending on which disc in the lower back is herniated. � �
Will I need tests? " � Probably not. There are tests that can check for a herniated disc, but most people do not need them. That's because many people who have symptoms of a herniated disc get better on their own, regardless of what that test shows. � �
Imaging tests, such as an MRI or a CT scan, can show what the tissues inside the back look like. These tests can find a herniated disc if one is there. But doctors do not usually offer this test until a person has had symptoms for at least 4 to 6 weeks. In most cases, it does not make sense to order the test sooner, because the treatment for herniated disc during those first few weeks is the same no matter what an imaging test might show. � �
Should I see a doctor or nurse? " � See your doctor or nurse right away if you have: � �
- New back pain that goes down into the groin or leg
- Back or leg pain along with leg weakness or problems controlling your bowels or bladder
- A problem called "foot drop, " � which is when you cannot seem to hold your foot up, for example, while walking
- Back or leg pain along with a fever or other symptoms that worry you
How is herniated disc treated? " � A small number of people end up needing surgery to treat a herniated disc. But most people do well with simpler treatments, such as: � �
- Pain medicines that you can get without a prescription (If these do not work, doctors and nurses can prescribe stronger pain medicines.)
- Medicines to relax the muscles (called muscle relaxants)
- Injections of medicines that numb the back or reduce swelling
- Physical therapy to teach you special exercises and stretches
- Spinal manipulation, which is when someone like a physical therapist or a chiropractor moves or "adjusts the joints of your back
- Acupuncture, which is when someone who knows traditional Chinese medicine inserts tiny needles into your body to block pain signals
- Massage
How do I know if surgery is right for me? " � Your doctor will tell you if surgery could help you. Then the two of you can decide together if surgery is right for you. � �
Surgery to treat a herniated disc involves exposing the spine and removing the disc that is damaged. It could help you feel better faster than you would without surgery. But, like any surgery, it also comes with risks. � �
Although surgery can speed up recovery, it is not usually necessary for a herniated disc. That's because over time the body absorbs the jelly from a damaged disc and heals in its own. But this can take months. � �
People who have a lot of discomfort or who want to get better fast, sometimes choose surgery. People who are afraid of surgery or who feel like they can cope with their symptoms sometimes decide against surgery. � �
If your doctor suggests surgery to treat a herniated disc, ask: � �
- How likely is it that surgery will help my symptoms?
- How quickly will I recover from surgery?
- What are the risks of surgery?
- What happens if I do not have surgery?
Is there anything I can do on my own to feel better? " � Yes. One of the most important things you can do to feel better is to stay as active as possible. Even if you have some pain or discomfort, you should not stay in bed or rest too long. � �
People used to think that bedrest was the best thing for an injured back. The truth is, bedrest can actually make back problems worse. That's because the back can get weak and stiff with too much rest. � �
Do not worry that you will do yourself harm by being active. It might hurt a bit more when you move around, but activity will do you good. � �
Can herniated discs be prevented? " � Probably not. People sometimes think that they got a herniated disc, because they lifted something the wrong way or strained their back somehow. The truth is, there is not much proof that moving or lifting the wrong way can cause a herniated disc. � �
All topics are updated as new evidence becomes available and our peer review process is complete. � �
This topic retrieved from UpToDate on: Nov 04, 2014. � �
Topic 83078 Version 4.0 � �
Release: 22.8 - C22.208 � �
� � 2014 UpToDate, Inc. All rights reserved. � �
figure 1
Anatomy of the back
Low back pain can be caused by problems with the muscles, ligaments, discs, bones (vertebrae), or nerves. Often back pain is caused by strains or sprains involving the muscles or ligaments. These problems cannot always be seen on imaging tests, such as MRIs or CAT scans.
Graphic 56246 Version 3.0
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Anatomy of the back
Low back pain can be caused by problems with the muscles, ligaments, discs, bones (vertebrae), or nerves. Often back pain is caused by strains or sprains involving the muscles or ligaments. These problems cannot always be seen on imaging tests, such as MRIs or CAT scans.
Graphic 56246 Version 3.0
View Original
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