A spinal disc (also known as an inter-vertebral disc) is a cushion-like plate in between individual spinal vertebrae. It consists of a jelly-like softer center called Nucleus pulposus encased within a tougher and fibrous exterior called anulus fibrosus. A herniated disc ( also referred to as ruptured or slipped disc) occurs when a crack in the fibrous outer portion of the disc allows the nucleus pulposus (softer jelly) to push out or leak through it. The leaking jelly-like nucleus pulposus may cause irritation or pinching on adjacent nerves resulting to symptoms such as pain and weakness in the arm or legs. Most patients experience asymptomatic types of disc herniation and hence they do not require herniated disc surgery. Symptomatic herniated may be characterized by radicular pain. That is, the disc itself is not painful but the leaked jelly exerting pressure on a nerve is what causes the irritation and pain. If this is the case, seek out cervical herniated disc surgery in Jacksonville. This type of pain may radiate either from the neck down an arm or from the lower back down to a leg depending on the location of the affected inter-vertebral disc . The pain is in most cases accompanied by weakness on the affected arm or leg. Leg pain caused by a pinched/ irritated nerve is called sciatica. Another type of pain, slightly similar to this is the axial pain caused by a disc degenerative disease. Axial pain should be ruled out before the initiation of herniated disc management.
The management/care of a herniated disc should be individualized because correction of the pain varies depending on its source, severity and other specific symptoms that the patient may present with. It is therefore important to know that the management of a herniated disc in the cervical region may be different from that of a herniated disc in the lumbar region. Spine specialists (http://drmichaellordmd.com/spine/) will be able to answer this for you. Normally, patients are started on conservative (non-surgical) management for about four to six weeks before spinal surgery is considered. Nonetheless, this isn’t always the case and it shouldn’t limit the doctor particularly when immediate herniated disc surgery will be beneficial to the patient. An example of such a case is when the pain progressively becomes severe and/or with progressive leg or arm weakness.
Management of Lumbar Disc Herniation
The conservative management includes the prescription of NSAIDs and narcotic analgesics, application of ice & heat therapy to relieve pain, physical therapy to alleviate the pressure on the nerve and oral steroids & epidural injections to decrease inflammation.
If the pain is not controlled after the six weeks of conservative management then surgical intervention is indicated. Lumber decompression surgery and mostly microdisectomy (microdecompression)-a type of lumber decompression surgery- is done. In this procedure, the herniated part/nucleus pulposus is not removed under the nerve root, instead, pressure on the nerve is relieved by giving more space and hence healing begins. The pain is relieved after the surgery but complete healing may take a month or more.
Management of Cervical Herniated Disc
The initial conservative management includes rest and use of NSAIDs to alleviate pain. If the pain persists, then other drugs like oral steroids are prescribed to decrease the inflammation. If the pain still progresses then herniated disc surgery (Anterior cervical disectomy and fusion ) is done. In this type of herniated disc surgery, the disc material is removed through the the front of the neck and then the disc space fused.
Herniated disc surgeries from doctors with great track records such as Dr. Michael Lord, M.D., are very successful when done the correct way.