90% of Americans will experience low back pain at some point. Dr. Jason Garrett discusses lumbar disc herniation (LDH), one of the most commonly diagnosed conditions. He discusses what a disc herniation is, why it’s misunderstood, as well as traditional treatment options for resolving this condition.
The spine is made up of a series of connected bones called “vertebrae.” The disc is a combination of strong connective tissues which hold one vertebra to the next and acts as a cushion between the vertebrae. The disc is made of a tough outer layer called the “annulus fibrosus” and a gel-like center called the “nucleus pulposus.” As you get older, the center of the disc may start to lose water content, making the disc less effective as a cushion. This may cause a displacement of the disc’s center (called a herniated or ruptured disc) through a crack in the outer layer. Most disc herniations occur in the bottom two discs of the lumbar spine, at and just below the waist.
One of the most commonly diagnosed, yet least understood, back conditions is lumbar disc herniation (LDH). A herniated lumbar disc can press on the nerves in the spine and may cause pain, numbness, tingling, or weakness of the leg called “sciatica.” Sciatica affects about 1-2% of all people, usually between the ages of 30 and 50. A herniated lumbar disc may also cause back pain, although back pain alone (without leg pain) can have many causes other than a herniated disc.
Recent studies indicate that often a herniated disc has no direct association with low back pain. In fact, according to the New England Journal of Medicine, 60% of people with a herniated disc have no presenting back pain. People often assume that everyone who has back pain has a ruptured disc. However, a true herniated nucleus pulposus (the official medical name for this problem) is not very common. Most problems that cause pain in the back are not due to a herniated disc. You can have a herniated disk without knowing it — herniated disks sometimes show up on spinal images of people who have no symptoms of a disk problem.
When a sprain or other injury triggers back pain, an MRI early in the diagnostic process may reveal a disc herniation. However, treating the herniation through traditional means (including pain management, injections, chiropractic manipulation, and surgery) is not likely to resolve the true source of the pain.
At Airrosti, we are experts at accurately diagnosing the true source of your back pain. In many cases, a herniated disc is not the actual cause of pain, and a proper diagnosis is critical to effectively treating the condition and permanently eliminating the pain. In most cases, your back pain can be resolved in as few as three visits based on patient-reported outcomes, with little to no down time. We also help many patients avoid unnecessary back surgeries.