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Levi Pearson, III, MD, MBA, DABA, DABPM
Insights and Advice On Herniated Discs
Metropolitan Pain and Spine
. https://www.metropolitanspine.com/

Insights and Advice On Herniated Discs

Pain and other symptoms generated from a cervical herniated disc or lumbar herniated disc can be misunderstood by medical and health professionals and patients alike. This confusion occurs partly because health professionals do not commonly agree on spinal disc pathology, and partly because disc problems such as a herniated disc are not always well explained to (or understood by) patients.

What’s a Herniated Disc,

Pinched Nerve, Bulging Disc?

Terminology about a herniated disc can be confusing. There are many different terms to describe a herniated disc, such as a pinched nerve, bulging disc, ruptured disc or slipped disc. These terms tend to be used somewhat differently among health professionals because there are no generally agreed upon definitions for many disc problems. Interchangeable terminology can be confusing and frustrating for patients who hear their condition referred to in different terms by different practitioners, causing the patients to remain unclear as to the real diagnosis.

The extent of disc problem or disc herniation does not necessarily correlate to the patient’s level of pain. Although it may seem contrary to common sense, the severity of pain from a herniated disc does not always correlate to the amount of physical damage to the disc. Additionally, less serious back problems may cause more pain than a herniated disc. For example, a large herniated disc can be completely painless, while a muscle spasm from a simple back strain may cause excruciating pain. This means that the severity of pain is not a determining factor for identifying a herniated disc.

Many herniated discs do not cause any pain. Radiographic findings of a disc herniation are common (such as from an MRI), but oftentimes the herniated disc is not associated with any pain or symptoms. While there may be an association between trauma to the disc and the onset of the patient’s symptoms, a herniated disc also may occur without a specific, recalled event.

It is difficult to distinguish a herniated disc from other spinal problems. The nerves and anatomical structures-such as discs, muscles and ligaments in the spine-have a great deal of overlap. This makes it difficult for the brain to distinguish between problems with one structure in the back versus problems with another.

Pain from a herniated disc is a complex personal experience. A herniated disc may not be painful at all times, or it may become more painful due to psychological factors in the patient’s life. Many studies have established a correlation between back pain and depression. While it is often not known which problem comes first-the pain or the depression-it is known that it’s important to treat both for the patient’s overall health. The pain may become more severe when compounded with other physical problems in the spine, or situational factors.

There is no single treatment that works best for all patients. Different treatment options are available for either a cervical or a lumbar herniated disc. Some patients may find that a combination of nonsurgical treatment options work best, while other patients may find that early surgical intervention is necessary to find adequate relief.

Working with a spine care professional, patients will need to develop an individualized treatment plan to relieve their pain and provide for long term rehabilitation.

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