Radiating pain, weakness, tingling. If these symptoms sound familiar, you may have a herniated disk —sometimes called a slipped or ruptured disk. While physical therapy and over-the-counter or prescription medications can help most people, your doctor may also recommend a special type of surgery called a discectomy to remove the herniated disk.So what does it mean to have a herniated disk? Simply put, it’s a bulge or tear of a disk in your spine. Your spine consists of 33 bones called vertebrae, and between these vertebrae are soft, rubbery cushions called disks that keep the spine flexible. A herniated disk occurs when the disk has either bulged out between the vertebrae or when a tear in the outer edge of the disk has allowed the soft, gel-like interior to push through, putting pressure on nerves in the spinal canal. About 1 to 2 percent of adults will experience a herniated disk, according to Wellington Hsu, MD, an associate professor in the orthopedic surgery department at Northwestern University's Feinberg School of Medicine in Chicago.
Herniated lumbar disk — a herniated disk in the lower part of the spine, which makes up the vast majority of herniated disk cases — typically occur between the ages of 30 and 50 and are twice as common in men than in women.Herniated lumbar disks can cause various symptoms, including:A slipped disk in the neck (herniated cervical disk) can cause pain and numbness in the upper body, including the neck, shoulder blade, upper arm, forearm, and elbows, and fingers.Herniated disk removal is a surgical option that can help relieve pain if nonsurgical options are not effective. Most people with herniated disks experience pain relief and improved movement after undergoing surgery.Is Herniated Disk Surgery Right for You? Before considering surgery, physicians typically start with conservative treatment options that include physical therapy, steroid injections into the spinal cord, pain medications, and rest, explains Jeffrey S. Fischgrund, MD, chairman of the Orthopaedic Department at William Beaumont Hospital in Royal Oak, Michigan.
That initial treatment will last about six weeks. More than 90 percent of people get better with nonsurgical treatments, according to the American Academy of Orthopaedic Surgery.However, if conservative treatment does not help, it may be time to consider surgery. Pain that's getting worse is a sign that your nonsurgical treatment options are not working. You might also experience numbness, weakness, and tingling in the buttocks and down one of your legs (sciatica).Dr. Fischgrund says he asks patients if the pain is affecting their quality of life and if no other treatment has helped. “If they answer yes, then surgery is a good option as it will get them predictably better, faster,” he explains. People experiencing leg weakness or bladder and bowel control problems caused by disk herniation usually need emergency surgery, he adds.The decision to have surgery isn’t always easy, but there is a huge benefit: 85 to 90 percent of patients will experience pain relief with surgery, says Fischgrund.The Basics of Herniated Disk Removal SurgeryIf you’re having herniated disk removal, your physician will first get a better look at your spine with different kinds of imaging techniques, such as magnetic resonance imaging
Before surgery, you’ll also need to have some routine tests, including blood work and an electrocardiogram. You’ll have to report to your physician what medications you’re taking, and you may have to stop taking certain medications, such as blood thinners and anti-inflammatory drugs, about a week before the procedure.Routine surgery for a herniated disk takes only about 45 minutes and is usually an outpatient procedure, says Hsu. The most common surgical approach is a discectomy or microdiscectomy, in which the surgeon makes a small incision in your back and removes the slipped disk. Another possible surgical procedure is a laminectomy or laminotomy, in which the surgeon removes the lamina — two small bones that make up the back portion of each vertebrae.The risks with herniated disk surgery are the same as for many other kinds of surgery, including bleeding, infection, or bowel and bladder problems, said Hsu. However, those risks are very rare.Although insurance normally covers the surgery, it could cost upwards of $50,000 if you have to cover the costs on your own.
Recovering From Herniated Disk RemovalAlthough immediate surgical recovery is 7 to 10 days, a full recovery takes two or three months. You’ll ease back into your regular routine and level of activity during this time.Many surgeons send their patients to physical therapy during recovery, especially if they had trouble walking before surgery. Physical therapy can help you regain your core strength through targeted exercises, according to Eric Robertson, PT, DPT, director of the Kaiser Permanente Northern California Graduate Physical Therapy Education, and clinical assistant professor at the University of Texas at El Paso.Most people are able to return to their normal level of activity after surgery. In fact, you may feel that you're able to move better because you're in less pain.For continued success after surgery, Fischgrund recommends that all patients maintain a healthy weight and perform core-strengthening exercises for long-term back health benefits.About 5 to 15 percent of patients experience recurrent disk herniation in the same area after they've had herniated disk removal.
If that should happen, your doctor would probably recommend a nonsurgical treatment plan first before considering another surgery. Having trouble logging in? Sign up for a free account Get unlimited access on Medscape. The spine, or backbone, is made up of a series of individual bones called vertebrae that are stacked to form the spinal column. Between the vertebrae are flat, round cushioning pads called intervertebral discs, which act as shock absorbers. Each disc has a soft, gel-like center — called the nucleus pulposus — surrounded by a tough, fibrous outer layer called the annulus. A herniated disc — also called a slipped disc or ruptured disc — occurs when pressure from the vertebrae above and below force some or all of the nucleus pulposus through a weakened or torn partThe herniated nucleus pulposus can press on the nerves near the disc, Herniated discs most frequently occur in the lower part of the spine; however they can also occur in the cervical and thoracic
A herniated disc is one of the most common causes of neck, back and/or leg pain (sciatica) and neckache. Herniated discs often produce no symptoms at all. Symptoms of a herniated disc in the low back include: Symptoms of a herniated disc in the neck include: Symptoms of a herniated disc in the mid-back tend toThere might be pain in the upper back, lower back, abdomen, or legs, as well as weakness or numbness in one or both legs. A herniation occurs when the outer part of the disc, the annulus, becomes weak and tears. Several factors can contribute to Herniated discs are very common. They occur more often in people aged 35 to 55 years. They are more common in men than in women. Your health care provider will begin an evaluation with a complete physical examination and medical history, including a review ofHe or she might perform a neurological exam to test your muscle reflexes, sensation, and muscle strength. The health care provider might use certain other
diagnostic tests to confirm the diagnosis and to better evaluate the site and extent of the herniation. These tests might include: Most herniated discs resolve on their own or with conservative treatment, which includes rest, anti-inflammatories, and physicalSome people find that ice packs or moist heat applied to the affected area provides some symptomatic relief of the pain and muscle spasms in the back. In cases that do not improve with conservative treatment, spinal injections or surgery might be needed. Common over-the-counter NSAIDs include aspirin, ibuprofen (Motrin®, Advil® and naproxen (Naprosyn®, Aleve®). You may take medicines with food to avoid stomach irritation. Muscle relaxants and various analgesics might be prescribed to relieve the discomfort associated with severe pain or muscle spasms in the initial treatment periods. The exercises prescribed by your physical therapist can also help relieve pressure on your nerves, reducing the symptoms of pain and