A herniated disc is one of the most common causes of neck, back, and leg pain. This bulged, slipped, or ruptured disc presses on the spinal nerve often producing severe pain. Most of the time, a herniated disc heals on its own with some medication and physical therapies but in some cases, surgery is the only option left. In this article, we will discuss the diagnosis and treatment of displaced discs.

Diagnosis

Your doctor will perform a physical examination after discussing your symptoms and medical history. This may include the following tests:

• • Straight leg raise (SLR) test: This test predicts if a disc herniation is present in young adults. You lie on your back and your doctor lifts the affected leg keeping your knee straight. If you feel pain down the leg, it indicates that you have a herniated disc.
  • Neurological examination: This will help your doctor determine if you have any loss of sensation or muscle weakness. The doctor will check your muscle strength by making you walk on heels and toes. Loss of sensation is detected by checking whether you can feel a light touch on your leg and foot. Lastly, your doctor will also check reflexes at the knee and ankle.

• Image testing: If your doctor suspects another condition, he/she may order the following tests:

• X-rays: Simple X-rays do not detect herniated discs but they rule out other causes of back pain such as tumors, a broken bone, or an infection.

• MRI: Radio waves are used to create images of the body’s internal structures. This test confirms the location of the herniated disc and also shows which nerves are affected.

• CT scan: Series of X-rays are taken from different directions and later combined to create cross-sectional images of the spine.

• Myelogram: This test is done by injecting dye into the spinal fluid before a CT scan is taken. It shows the pressure on the spinal cord or nerves due to herniated discs.

Treatment

Initial treatment for a herniated disc is usually non-surgical. The majority of the patients recover in a couple of weeks and are free of any symptoms by 3 to 4 months.

• Non-surgical treatment:

• Rest: A couple of days of bed rest will usually help relieve back and leg pain. Take breaks throughout the day and make your physical activity slow. Avoid movements that can cause further pain.

• Nonsteroidal anti-inflammatory drugs (NSAIDs): Drugs such as naproxen or ibuprofen can help relieve pain.

• Epidural steroid Injection: Injections like cortisone are injected into the space around the nerve. It provides short-term pain relief by reducing inflammation. 

• Physical therapy: Some relevant exercises will help strengthen your lower back muscles.

Nonsurgical treatments do not heal the disc but rather they help relieve the pain while your body works to heal the disc.

• Surgical treatment: 

When non-surgical treatments no longer work, surgery is the only option left. Your doctor will suggest surgery if you continue to have numbness or weakness in the leg and/or foot, difficulty standing or walking, or loss of bladder or bowel control even after at least 6 weeks of non-surgical treatments.

There is up to a 20-25% chance that the disc will herniate again in your life even after surgical and non-surgical treatment. Recently there has been ample research on the treatment of disc herniation. If you are someone looking for an experienced neurosurgeon with years of relative experience, visit Dr. Moksha Ranasinghe at Southern California Brain & Spine Surgery in Los Angeles. Call (213) 369-4583 to schedule an appointment.