Many people suffer from back and leg pain. For some, it may be intermittent, while others may experience pain on a daily basis. It can be easy to dismiss these types of pain as a simple part of growing older, but it is important to consult a physician or a physical therapist to discover the true source of the pain. Herniated Disc are one of the most common causes of neck, back, and leg pain. Although these occur most often in the lower part of the spine (lumbar), they can also occur in the neck (cervical).
What is Herniated Disc?
Discs are shock absorbing cushions positioned in the spine between two bones. The tear in the layers of the discs causes pain and nerves pinching. Reasons could be natural ageing process, any spinal trauma, repetitive stress, unhealthy body weight, poor nutrition, tobacco use or genetics.
The most common symptom of a herniated disc in the lower back is radiating pain through your buttocks, legs, and feet (sciatica). A herniated disc in the neck will cause neck pain that radiates into your shoulder, arm, hand, or fingers. Herniated discs in both areas can cause numbness and pain that intensifies with sudden movements (such as sneezing or coughing).
Treatment option for herniated disc.
There are various treatment options for herniated disc including surgery, invasive and conservative management. Unfortunately, some physicians are quick to suggest medications, injection or surgery as treatment options which have various side effects.
Firstly, a systematic review published in 2014 (1) concluded that spontaneous regression of herniated disc tissue can occur, and can completely resolve after conservative treatment. The rate of spontaneous regression was found to be 96% for disc sequestration, 70% for disc extrusion, 41% for disc protrusion and 13% for disc bulging.
Secondly, systematic review in 2010 (2) concluded that early surgery in patients with 6-12 weeks of radicular pain leads to faster pain relief when compared to conservative treatment like physiotherapy. BUT primary outcome measures are same after 1 and 2 years after the care. There is 100% recovery observed with conservative management too.
So now the questions are:
Why should you undergo a Surgery for pain due to disc herniation, if conservative treatment can be equally beneficial?
(1) The probability of spontaneous regression of lumbar herniated disc: a systematic review.
Chun-Chieh, et al; July 2014
(2) Surgery versus conservative management of sciatica due to a lumbar herniated disc: a systematic review
Wilco C. H. Jacobs, et al; October 2010
Dr. Mansi Parikh,
Co-Founder EndoRush App