If you have back pain or sciatica, then you understand how the pain can limit your normal active lifestyle. The pain can prevent you from moving normally, and it may cause you to lose time at work or keep you from engaging in your normal recreational activity.
For many people, back pain seems to come on for no apparent reason. The symptoms may come out of nowhere and can range from mild to severe. Your pain may be present one day and then gone the next, only to return once again.
There are many different treatments for back pain including physical therapy, chiropractic care and injections. Some patients with severe symptoms benefit from spinal surgery to manage their pain.
Before initiating treatment, you should visit your doctor to get an accurate diagnosis of your condition. Your doctor can perform special tests to diagnose your condition and find the likely cause of your back pain or sciatica.
Causes of Back Pain
There are many different causes of back pain. Your pain may be the result of a combination of poor lifestyle habits including poor eating habits, deconditioning from a lack of appropriate exercise, and smoking. Sometimes frequent forward bending or heavy lifting may cause your pain, especially if your core is out of shape.
Some back pain, however, is caused by a structural problem in the spine that can be the result of a disease process that surgery can address.
Different anatomical structures in your back can cause your pain. These may include:
- Muscle and tendon strains
- Degenerative disc disease
- Facet joint arthritis
- Spinal stenosis
- Foraminal stenosis
- Vertebral compression fractures
- Spinal tumors (although rare)
- Bulging discs
- Herniated discs
When there is a problem with one or more of the structures in your spine, nerves can be pinched, causing pain in your back or symptoms in your leg or legs.
One of the most common causes of back pain is bulging discs or herniated discs. Intervertebral discs are small shock absorbers that are situated between spinal bones. There are two parts to each disc: the outer annulus fibrosis made up of cartilage, and the squishy inner nucleus pulposes.
A variety of things can cause the inner jelly material to press out of place. Usually this happens as a result of simple wear and tear. When this happens, pain can result in your back. If the disc is displaced far enough, it can irritate a spinal nerve and cause symptoms in your leg or legs.
Learning about symptoms that can occur with spinal disc problems can help you understand your own symptoms and the best way to treat your back condition.
Bulging Disc Symptoms
Bulging discs are extremely common and are often a “normal” part of the aging process. Bulging discs occur when the annulus, the outer band that contains the inner jelly-like nucleus purposes, weakness over time, becoming stretchy, allowing the jelly to protrude slightly into the spinal canal. Often this produces no symptoms.
Sometimes disc bulges are associated with back pain because they are a sign that the discs are degenerated and may not be performing their role as a shock absorber well. Sometimes they contribute to stenosis or a narrowing of the space around a nerve that produces symptoms of leg or arm pain.
A person with bulging discs may have the following symptoms.
- No symptoms
- Mild to moderate back or neck pain
- Rarely leg or arm pain
Symptoms of a Herniated Disc
Patients with a herniated disc typically experience more severe symptoms and may have neurological signs and symptoms like weakness or tingling in the leg or legs.
Herniated discs occur when a piece of jelly inner core actually squeezes out of the confines of the annulus. The jelly can then press against a spinal nerve, causing sciatica or severe symptoms in your back or leg.
Common symptoms of a herniated disc may include:
- Back pain on one side
- Pain in your buttocks, thigh, lower leg and foot
- Numbness or tingling in your thigh, leg or foot
- Weakness in the muscles of your thigh or lower leg
- Loss of control of your bowels or bladder (a severe and emergent condition known as cauda equine syndrome)
If you have any of these symptoms, you need to visit your doctor right away to figure out if your pain is from a bulging disc vs a herniated disc and to get started on the best treatment for you.
Remember, many people with bulging and herniated discs have no symptoms, and some people have severe symptoms with no evidence of a disc problem. You must consult with a trusted neurosurgeon who can help you decipher your symptoms and recommend the best treatment for you.
Treatment for Bulging Discs
Bulging discs typically cause mild symptoms and may be treated successfully with conservative measures. Many patients benefit from physical therapy to learn exercises and postural correction techniques to help keep their discs in the correct position. Chiropractic manipulations can help adjust the position of the discs to take pressure off of them.
Some patients with bulging discs benefit from spinal injections to help treat inflammation. Injections of a corticosteroid can help decrease your pain and improve your ability to move.
Although bulging discs can often be treated successfully with conservative measures, occasionally you may require a surgical intervention to regain full pain free motion in your spine.
Treatment for Herniated Discs
A disc herniation can be a serious problem, and it often requires surgery to regain full mobility. Most people with herniated discs get better without surgery, when they follow a conservative treatment plan that includes anti-inflammatories, physical therapy, and sometimes and steroid injection.
If your symptoms persist, you should see your neurosurgeon to discuss surgical options. The surgery most often performed for a herniated disc is a microdiscectomy. This a small surgery that involves taking the pressure off your nerve by removing the piece of the disc that is compressing it.
When considering surgery for a herniated disc, there are two different approaches that neurosurgeons use. Some traditional surgeons use a standard open approach to surgery. This requires a large incision and dissection of your back muscles off of your spinal bones.
A few innovative NJ neurosurgeons use a minimally invasive approach to herniated disc surgery. During this procedure, your doctor makes a small incision in your back and makes small holes in your back muscles, leaving them intact on your vertebra.
Specialized instruments are then introduced to your back that your neurosurgeon uses to see your discs and to cut away herniated material from your nerves.
Many patients with herniated discs choose minimally invasive spine surgery for the rapid return to function and decreased risk of blood loss and infection during the surgery.
If you have a bulging or herniated disc, you should take time to understand the different symptoms you may feel and the treatment options available to you. Working with a top-rated neurosurgeon can help you optimize your chances of making a full recovery from your back pain or sciatica.
