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Herniated disc pain in your lower back can range from a mild ache to a shock-like pain that radiates into your leg. While most herniated discs gradually start to feel better within a few weeks, many common activities may inflame and worsen the pain. Here are a few activities to avoid. See Lumbar Herniated Disc: What You Should Know.
- “If you have a herniated disk, think about it as a jelly donut,” explains Dr. “The outside of the disk is like the dough of the donut and is called the annulus fibrosis.
- Herniated disc cases rely on experts who, in turn, rely on the best medical literature. Here are some of the key journal articles dealing with spinal disc herniations: 2020: Sloan, SR. Al: Combined nucleus pulposus augmentation and annulus fibrosus repair prevents acute intervertebral disc degeneration after discectomy.
- Managing your herniated disc. If you have a herniated disc, the key question is not whether it will technically heal. Rather, the most important question is how you should focus your treatment and rehabilitation to reduce your acute symptoms and prevent future problems. If you have recurrent symptoms from a herniated disc, there are known surgical options that have favorable results in.
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Overview
What is a herniated disk?
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 disks, which act as shock absorbers. Each disk has a soft, gel-like center — called the nucleus pulposus — surrounded by a tough, fibrous outer layer called the annulus.
A herniated disk — also called a slipped disk or ruptured disk — occurs when pressure from the vertebrae above and below force some or all of the nucleus pulposus through a weakened or torn part of the annulus. The herniated nucleus pulposus can press on the nerves near the disk, resulting in pain.
Herniated disks most frequently occur in the lower part of the spine; however they can also occur in the cervical and thoracic spine. A herniated disk is one of the most common causes of neck, back and/or leg pain (sciatica) and neckache
How common are herniated disks?
Herniated disks are very common. They occur more often in people aged 35 to 55 years. They are more common in men than in women.
Symptoms and Causes
What are the symptoms of a herniated disk?
Herniated disks often produce no symptoms at all. Symptoms of a herniated disk in the lower back include:
- Pain that radiates to the buttocks, legs and feet — called sciatica (Back pain might or might not be present, as well).
- Tingling or numbness in the legs or feet.
- Muscle weakness.
Symptoms of a herniated disk in the neck include:
- Pain near or over the shoulder blade.
- Pain that radiates to the shoulder, arm, and — sometimes — the hand and fingers.
- Neck pain, especially in the back and on the sides of the neck (The pain might increase when bending or turning the neck).
- Spasm of the neck muscles.
Symptoms of a herniated disk in the mid-back tend to be vague. There might bepain in the upper back, lower back, abdomen, or legs, as well as weakness or numbness in one or both legs.
What causes a herniated disk?
A herniation occurs when the outer part of the disk, the annulus, becomes weak and tears. Several factors can contribute to disk-weakening, including Va citrix workspace.
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- Aging and degeneration.
- Excessive weight.
- A sudden strain from improper lifting or from twisting violently.
What complications are associated with a herniated disk?
Chronic (ongoing) back or leg pain and loss of control or sensation in the legs or feet are some complications of an untreated disk herniation.
Diagnosis and Tests
How is a herniated disk diagnosed?
Your healthcare provider will begin an evaluation with a complete physical examination and medical history, including a review of your symptoms. He or she might perform a neurological exam to test your muscle reflexes, sensation, and muscle strength.
The healthcare 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:
- X-ray : X-rays use small doses of radiation to produce images of the body. An X-ray of the spine might be done to rule out other causes of the back or neck pain.
- MRI or CT scan:Magnetic resonance imaging (MRI) and computed tomography (CT) scans can show narrowing of the spinal canal caused by a herniation.
- Myelogram: This is an injection of dye into the spinal canal followed by a CT scan. A myelogram can help pinpoint the size and location of the herniation.
- EMG: An electromyelogram (EMG) involves placing small needles into various muscles and measuring electrical activity. The muscle's response, which indicates the degree of nerve activity, is measured. An EMG can help determine which nerve root or roots are being affected by the disk herniation.
Management and Treatment
How is a herniated disk treated?
Most herniated disks resolve on their own or with conservative treatment, which includes rest, anti-inflammatory medicine, and physical therapy. Some 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.
- Medicine:Nonsteroidal anti-inflammatory drugs (NSAIDs) help to relieve pain, inflammation, and stiffness, allowing for increased mobility and exercise.
Common over-the-counter NSAIDs include aspirin, ibuprofen (Motrin®, Advil®), and naproxen (Naprosyn®, Aleve®). You may take medicines with food to avoid stomach irritation.
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Muscle relaxants and various analgesics might be prescribed to relieve the discomfort associated with severe pain or muscle spasms in the initial treatment periods.
- Physical therapy: The goal of physical therapy is to improve core strength, flexibility and endurance to enable you to engage in your normal activities.
The exercises prescribed by your physical therapist can also help relieve pressure on your nerves, reducing the symptoms of pain and weakness. The exercise program often includes stretching exercises to improve flexibility of tight muscles and aerobic exercise — such as walking or using a stationary bike — to build endurance and improve circulation.
Other exercises might help to strengthen the muscles of your back, abdomen, and legs.
- Spinal injections — An injection of a cortisone-like medicine into the lower back might help reduce swelling and inflammation of the nerve roots, allowing for increased mobility. These injections are referred to as epidurals or nerve blocks.
- Surgery — Surgery might be needed for people who do not respond to conservative treatment, whose symptoms get progressively worse, or who experience progressive neurologic decline. Rarely, a large disk herniation might injure nerves to the bladder or bowel, which requires emergency surgery. The most common surgical options include microdiscectomy, laminectomy, or foraminotomy.
- Microdiscectomy — Microdiscectomy is a procedure used to remove fragments of a herniated disk, often using an operating microscope.
- Laminectomy — The part of the bone that curves around and covers the spinal cord (lamina) and the tissue that is causing pressure on the nerve or spinal cord are removed. This procedure is performed under general anesthesia. The hospital stay is one to two days. Complete recovery takes about six weeks.
Prevention
Can anything be done to prevent a herniated disk?
It is not always possible to prevent a herniated disk, but there are steps you can take to reduce your risk:
- Use proper lifting techniques. Do not bend at the waist. Bend your knees while keeping your back straight and use your strong leg muscles to help you support the load.
- Maintain a healthy weight. Excess weight puts pressure on the lower back.
- Practice good posture when walking, sitting, standing, and sleeping. For example, stand up straight with your shoulders back, abdomen in, and the small of your back flat. Sit with your feet flat on the floor or elevated. Sleep on a firm mattress, and sleep on your side, not your stomach.
- Stretch often when sitting for long periods of time.
- Do not wear high-heeled shoes.
- Exercise regularly to keep the muscles of your back, legs, and stomach strong. Engage in regular aerobic exercise. Try to balance flexibility with strengthening in a regular exercise program.
- Eat healthy, well-balanced meals.
Outlook / Prognosis
What is the outlook for people with herniated disks?
Most back and leg pain will get better gradually — usually within six weeks — by taking simple measures. In fact, most people with herniated disks respond to conservative treatment within six weeks and are able to return to their normal activities. Some will continue to have back pain even after treatment.
Herniated disc pain in your lower back can range from a mild ache to a shock-like pain that radiates into your leg. While most herniated discs gradually start to feel better within a few weeks, many common activities may inflame and worsen the pain. Here are a few activities to avoid.
See Lumbar Herniated Disc: What You Should Know
Sitting puts extra stress on your spinal disc and can exacerbate lumbar herniated disc symptoms.
ReadLumbar Herniated Disc Symptoms
Sitting too much
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Sitting puts more stress on your spinal discs, especially when slouching forward in a seat.1 To minimize pain from a herniated disc in the lumbar spine (lower back), try to stand up, move around, or lie down when possible.
Since sitting is often unavoidable, try these tips to reduce the load placed on your lumbar spine.
- Sit up straight with your shoulders rolled back towards the chair and shoulder blades down.
- Keep thighs about horizontal with the floor (hips should not be lower than your knees).
- Use a small pillow or rolled-up towel to support your lower back.
- Set a reminder on your phone to take breaks often and walk short distances.
If your job requires long hours at a desk or computer, consider using a sit-stand desk which allows you to stand intermittently throughout the day.
See Office Chair: How to Reduce Back Pain?
Doing laundry
Between bending down to pick up clothes, carrying a heavy basket, and reaching for various items, doing laundry puts a lot of pressure on your lower back. If possible, ask a friend or family member to help carry out this task until your back feels better. Many dry cleaners also offer a regular laundry service.
See Avoid Back Injury with the Right Lifting Techniques
Vacuuming
The repetitive forward-lunging motion typically used to vacuum the floor can irritate your herniated disc. Instead of extending your arm and bending your back, keep your back straight and walk the vacuum across the floor. Think of your legs doing the work instead of your arms. Another option would be to buy a robot vacuum cleaner to do the work for you. With this device, you can set it and forget it.
Feeding a pet
It may seem like a simple task, but bending down to fill your pet’s bowl with food and water is enough to cause a painful flare-up. If you’re unable to delegate this responsibility to someone else, purchase a specialty pet bowl equipped with an extended tube or built-in reaching aid. If you must lean over, keep one leg extended like a golfer would while picking up a golf ball—this takes stress off the lower back by keeping your alignment straight.
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Strenuous exercise
While exercise is still recommended, avoid high-impact activities or other movements that place too much stress on your spinal discs.
- Stay away from activities that cause repetitive loading on your lower back, such as running or jumping rope.
- Skip movements that involve significant axial loading on the lower back, such as squats and leg presses.
- Avoid toe-touches, sit-ups, and yoga poses that worsen the pain and lead to significant bending of the back.
See Exercise for Sciatica from a Herniated Disc
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Instead, try aerobic exercises, such as swimming and walking. Using a stationary bike can be an excellent source of exercise while recovering from a herniated disc. Hiking, especially up hills, can also be good. Aerobic exercise increases the flow of blood, nutrients, and oxygen to the soft tissue in the back, which can improve healing and reduce pain.2 You can also try strengthening exercises approved by your doctor or physical therapist.
Watch Video: 2 Walking Tips to Avoid Sciatica Pain Pc zip files for mac.
Low-impact exercises are generally easy and can be done on a regular basis. If these exercises are still uncomfortable, try aquatic therapy by simply walking in a pool. The buoyancy of water helps reduce pain during joint movements. Some evidence suggests that aquatic therapy may also help improve functioning in the lower back.3
See Water Therapy Exercise Program
Shoveling snow or gardening
Shoveling snow and gardening can worsen your disc pain, as it often involves heavy lifting, forward-bending, and twisting—motions that easily aggravate your discs. With snow, use a snowblower if you can, or get help from a neighbor. With gardening, try to avoid repetitive bending and stooping. Instead, stay in one position and vary your posture. If it is painful, the garden will have to wait another week. Giving yourself time to heal will allow you to be more independent in the long run.
See Snow Shoveling Techniques to Prevent Low Back Injuries
Commit to using good, supportive posture to help relieve pressure on your spinal discs and nerves. If your back pain does not resolve with these tips and techniques, call your doctor or health care provider.
Learn more:
References
- 1.Alamin TF, Agarwal V, Zagel A, Qeli A. The effect of standing vs. variants of the seated position on lumbar intersegmental angulation and spacing: a radiographic study of 20 asymptomatic subjects. J Spine Surg. 2018;4(3):509–515. doi:10.21037/jss.2018.08.03
- 2.Gordon R, Bloxham S. A Systematic Review of the Effects of Exercise and Physical Activity on Non-Specific Chronic Low Back Pain. Healthcare (Basel). 2016;4(2):22. Published 2016 Apr 25. doi:10.3390/healthcare4020022
- 3.Shi Z, Zhou H, Lu L, et al. Aquatic Exercises in the Treatment of Low Back Pain. American Journal of Physical Medicine & Rehabilitation. 2018;97(2):116-122. doi:10.1097/phm.0000000000000801