Herniated Disc? You Likely Won’t Need Surgery

You can get a herniated disc while playing sports or moving furniture around your house. You could be injured while picking up your grandchild. And it could even happen for reasons you will never know.

Herniated discs – also known as bulging, slipped or ruptured discs – can happen anywhere along your spinal column, which is comprised of 33 vertebrae, stacked one on top of the other. Positioned between each of those vertebrae are soft discs, which act as shock absorbers, stabilizers and cartilaginous joints that give your spine some mobility.

What Is a Herniation?

These discs have a tough outer shell but are also filled with a jelly-like substance. Herniations occur when that soft inner material breaks through the outer shell and protrudes into your spinal canal.

Herniations are more common in people who are overweight, smoke, live sedentary lifestyles and have jobs that require heavy lifting. Your risk for a herniation also increases as you get older.

If you have a herniated disc, you will most likely know something is wrong. They are one of the most common causes of pain in the arms, legs, back and neck. Symptoms include:

• Back pain
• Numbness or tingling in your legs or feet
• Pain radiating into your legs (Sciatica)
• Muscle weakness
• Neck pain
• Pain around your shoulder blades
• Numbness or tingling in your arms
• Pain that worsens when you turn your neck

Nonsurgical Treatment Options

Often, when someone learns they have a herniated disc, their first thoughts go to surgery. But the vast majority (80 percent to 90 percent) of disc herniations are treated without surgery. In most cases, before surgery is even considered, there are several strategies used. Those include:

Light activity: There was a time when extended bed rest would be recommended following a back injury. But light activity can reduce inflammation and help the healing process.

Medications: Various medications can boost your recovery. These include over-the-counter pain relievers, non-steroidal anti-inflammatory medications, muscle relaxers, oral steroids and sometimes more powerful opioids.

Physical therapy: A physical therapist will work with you on core stabilization and core strengthening exercises that can reduce stress on the disc and alleviate back pain.

Epidural steroid injection: Steroids are injected directly into the area around the spinal nerves. It can be an effective tool, though pain relief varies. For some people, it may last for a day or weeks, while others find permanent relief.

When Surgery Is Recommended

There are some instances in which surgery would be recommended right away. Cauda equina syndrome occurs when a herniated disc compresses a collection of nerve roots at the bottom of your spinal canal. It is a medical emergency that causes significant weakness in the lower extremities, along with urinary and fecal incontinence.

But with most disc injuries, your doctor will likely suggest waiting six to eight weeks to see if the more conservative options yield results. If your symptoms fail to improve, a microdiscectomy may be recommended.

During the procedure, your surgeon will make a small incision (about an inch or less long) to gain access to the damaged disc. By carefully working around muscle tissues and nerves in your spinal canal, your surgeon can remove the protruding disc material.

As with any surgery, there are some risks. Among the biggest with this procedure is a slight chance (about 10 percent) of another herniation.

Most people make a full recovery after the surgery. During the first two weeks, your activities will be restricted, with no repetitive twisting, bending or lifting anything heavier than 10 pounds. But after six weeks, most people can return to normal activities, with some limitations. A golfer, for example, might initially be limited to putting or chipping. Then, after about two to three months, you should be back to full activities, with no restrictions.