Seth Neubardt, M.D. & Jack Stern, M.D., Ph.D.

Wednesday, March 24, 2010

Remember—Most Herniated Discs Get Better!

It comes as a great surprise to many people to learn that 90% of all patients who have been diagnosed with a herniated disc get better on their own, without the need for surgery.

I always remind patients that the body wants to heal itself and is successful in doing so in the majority of cases. If you have symptoms for less than 4 weeks don’t give up on the hope that you will get better with time. In most cases, our bodies are able to do this without the need for an invasive procedure such as surgery.

How this actually happens is somewhat debatable, but most specialists in the field recognize that even a large herniated disc has the capacity to shrink in size and even resorb completely over a period of time. Along with the shrinking of the disc, the pain, numbness, tingling, or weakness may also resolve. For those patients lucky enough to have that occur, a surgery such as the anterior cervical discectomy and fusion will be out of the question. For the 10% or so of patients who do not get better over a period of time, surgery may be suggested.

Remember, the time period to get better is typically 6 weeks. 50% of patients are better within three weeks and 90% of patients are better by six weeks.

If your symptoms of pain related to a herniated disc in either the cervical spine or lumbar spine persist for more than six weeks, you may be a surgical candidate.

Friday, March 19, 2010

HERNIATED DISC, RUPTURED DISC, BULGING DISC, SLIPPED DISC OR EXTRUDED DISCS. What’s the difference?

HERNIATED DISC, RUPTURED DISC, BULGING DISC, SLIPPED DISC OR EXTRUDED DISCS. What’s the difference?

Many patients are confused about the difference between a herniated disc and a bulging disc and I want to take this time to clarify those terms. The least severe condition is the bulging disc and most doctors will consider a bulging disc to be a normal condition. Studies have shown that over 30% of MRIs on people who have no pain at all in the neck or back will have one or several bulging discs. From a surgeon’s standpoint, most often we view a bulging disc as a problem which is non-surgical and may or may not be even associated with pain in the neck or back. The condition that is more significant is that of the herniated disc. There are several terms that also describe the herniated discs and those include ruptured disc, extruded disc, and slipped disc. These all are pretty much the same thing. Frequently these terms are used to describe the extent of the herniation. Herniations can cause pain which radiates into the arm or leg. The cervical herniated disc will frequently give pain into the arm, but may also be associated with symptoms such as numbness, tingling, and weakness. A herniated disc in the neck which is large in size may also cause direct compression on the spinal cord and lead to symptoms of what we called myelopathy. Myelopathy is an abnormality which occurs when the spinal cord is compressed and this may lead to symptoms such as loss of bowel or bladder control, spasticity while walking, as well as weakness and other deficits of coordination. Herniated disc in the lumbar spine creates symptoms such as numbness, tingling, and weakness into one or both legs. In summary, if you have found out that you have a bulging disc on an MRI then most likely this is not a surgical problem and this may not even be related to the pain you are experiencing. If you have been diagnosed with a herniated disc on an MRI scan, then you may be a surgical candidate if you are experiencing symptoms of pain, numbness, tingling, and weakness into one or more extremities.

Monday, March 1, 2010

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