Disc Herniation

Injury to the discs of the lumbar spine (low back) is a very common condition occurring in 5-20/1000 individuals every year. It is often precipitated by lifting in a forward bent position, conditions that place a load on the lumbar discs.

Pain from disc herniation or injury is severe and frequently disabling. It is often accompanied by protective muscle spasm. This may lead to an erroneous assumption that the injury is muscular. Stretching only aggravates the situation.

The most comfortable position in this setting is lying down, often with the legs elevated and supported on a chair or couch. This position decreases pressure in the disc and opens the spinal canal. Ice may decrease muscle spasm and provide temporary relief.

The good news is that 93% of patients with acute disc herniation, including those with sciatica, get better with a comprehensive conservative (nonsurgical) treatment program (Saal et al, Spine: July 1990). Only a very small minority require surgery for resolution of symptoms.

Disc Herniation Expert

A disc herniation expert is a medical professional who specializes in diagnosing and treating disc herniations. Disc herniations, also known as herniated or ruptured discs, are a medical condition that affects the spine and can cause pain, numbness, and potentially other neurological symptoms.

The human spine is made up of a series of interconnected bones, called vertebrae, which are separated by discs. The disc has a tough, outer layer, the annulus fibrosus, that surrounds a soft, gel-like center. When the outer layer tears, the soft center can push out through the tear. This is what is known as a disc herniation. This protrusion can then impinge on nearby nerves, leading to pain, numbness, and weakness in the neck, back, arms, or legs.

Prior to a disc herniating, there are often a series of repeated stresses to the disc that render it susceptible to injury. In the neck, looking down either at a computer screen or cell phone places a load on the cervical discs. In the low back, prolonged sitting or forward bending and lifting load the discs of the lumbar spine. The final event that creates symptoms is often trivial; bending forward to pick up a toothbrush or putting on or tying a shoe. It is the previous conditions of stress on the spine that are important in the development of a disc herniation.

Disc herniations usually heal on their own slowly over weeks to several months. The most important part of treatment is to avoid factors that may impede this natural healing; prolonged sitting, repetitive lifting, looking down etc. The use of anti-inflammatory medication, including NSAIDS or corticosteroids (prednisone), decreases swelling and pressure on neurologic structures. Strengthening of transversus abdominis, an important “core” muscle, helps with both healing and avoiding aggravation of symptoms or recurrence.

The natural impulse of the patient is often to seek initial care from an orthopedist or a spine surgeon. As it is infrequent that individuals require surgery for a disc herniation, it is advisable to seek care first from doctors trained in the conservative management of these medical problems, limiting the surgical approach only to individuals who fail an optimal treatment program. Overall, 93% of individuals with a disc herniation recover with a comprehensive rehabilitation program.

At the Physicians’ Back Institute, Drs. Irène and Robert Minkowsky have successfully been treating patients with acute disc herniations for over 35 years. They have a well-developed treatment protocol that includes all aspects of an optimal conservative treatment program. They are experts in identifying the occasional individual who will fail conservative treatment and require surgery; in these instances, they facilitate the transfer of care to the spine surgeon. As a result of their comprehensive approach, their program is usually successful in alleviating pain and restoring patients back to their full active life.

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Don’t let chronic pain and musculoskeletal injuries affect your quality of life. Drs. Irène and Robert Minkowsky have helped thousands of patients. Let the doctors at the Physicians’ Back Institute treat you so you can enjoy an active lifestyle. They are proud to serve the San Francisco Bay Area.

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