Why is a herniated disc so painful

By Adaku Nwachuku, DO. Lumbar Herniated Disc Video Save. Lumbar Disc Herniation. Curr Rev Musculoskelet Med. Kumar, M. Epidemiology, pathophysiology and symptomatic treatment of sciatica: A review. Gore S, Nadkarni S. Sciatica: detection and confirmation by new method. Int J Spine Surg. Published Dec 1.

Next a physical exam is performed to determine the source of the pain and test for any muscle weakness or numbness. Based on the results, you may be referred to a neurologist, orthopedist, or neurosurgeon for treatment. Magnetic Resonance Imaging MRI scan is a noninvasive test that uses a magnetic field and radiofrequency waves to give a detailed view of the soft tissues of your spine. Unlike an X-ray, nerves and discs are clearly visible Fig. It may or may not be performed with a dye contrast agent injected into your bloodstream.

An MRI can detect which disc is damaged and if there is any nerve compression. It can also detect bony overgrowth, spinal cord tumors, or abscesses. Myelogram is a specialized X-ray where dye is injected into the spinal canal through a spinal tap.

An X-ray fluoroscope then records the images formed by the dye. The dye used in a myelogram shows up white on the X-ray, allowing the doctor to view the spinal cord and canal in detail.

Myelograms can show a nerve being pinched by a herniated disc, bony overgrowth, spinal cord tumors, and abscesses. A CT scan may follow this test. Computed Tomography CT scan is a noninvasive test that uses an X-ray beam and a computer to make 2-dimensional images of your spine. This test is especially useful for confirming which disc is damaged.

EMG tests measure the electrical activity of your muscles. Small needles are placed in your muscles, and the results are recorded on a special machine. NCS is similar, but it measures how well your nerves pass an electrical signal from one end of the nerve to another. These tests can detect nerve damage and muscle weakness. X-rays view the bony vertebrae in your spine and can tell your doctor if any of them are too close together or whether you have arthritic changes, bone spurs, or fractures.

It's not possible to diagnose a herniated disc with this test alone. Conservative nonsurgical treatment is the first step to recovery and may include medication, rest, physical therapy, home exercises, hydrotherapy, epidural steroid injections ESI , chiropractic manipulation, and pain management. Self care : In most cases, the pain from a herniated disc will get better within a couple days and completely resolve in 4 to 6 weeks.

Medication : Your doctor may prescribe pain relievers, nonsteroidal anti-inflammatory medications NSAIDs , muscle relaxants, and steroids. Steroid injections : The procedure is performed under x-ray fluoroscopy and involves an injection of corticosteroids and a numbing agent into the epidural space of the spine.

The medicine is delivered next to the painful area to reduce the swelling and inflammation of the nerves Fig. Repeat injections may be given to achieve the full effect. Sign Up Now. Previous: Low Back Pain. May 15, Issue. Am Fam Physician. What is a herniated disc?

Picture 1. Why does a disc get herniated? Picture 2. What are the signs of a herniated disc? How does my doctor know I have a herniated disc? What can be done for the pain of a herniated disc? Sometimes stretching of the spine by your family doctor or a chiropractor can help the pain. Will exercises help the pain?

What about my posture? What are my chances of getting better? Picture 3. Read the full article. Get immediate access, anytime, anywhere.

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Typically, a herniated disc is preceded by an episode of low back pain or a long history of intermittent episodes of low back pain. Pressure on one or several nerves that contribute to the sciatic nerve can cause pain, burning, tingling and numbness that radiates from the buttock into the leg and sometimes into the foot. Usually, one side left or right is affected. This pain often is described as sharp and electric shock-like.

It may be more severe with standing, walking or sitting. Straightening the leg on the affected side can often make the pain worse. Along with leg pain, one may experience low back pain; however, for acute sciatica the pain in the leg is often worse than the pain in the low back.

Cervical spine neck : Cervical radiculopathy is the symptoms of nerve compression in the neck, which may include dull or sharp pain in the neck or between the shoulder blades, pain that radiates down the arm to the hand or fingers or numbness or tingling in the shoulder or arm. The pain may increase with certain positions or movements of the neck.

Fortunately, the majority of herniated discs do not require surgery. The time to improve varies, ranging from a few days to a few weeks. Testing modalities are listed below.

The most common imaging for this condition is MRI. Plain x-rays of the affected region are often added to complete the evaluation of the vertebra. Please note, a disc herniation cannot be seen on plain x-rays. CT scan and myelogram were more commonly used before MRI, but now are infrequently ordered as the initial diagnostic imaging, unless special circumstances exist that warrant their use. An electromyogram is infrequently used. The initial treatment for a herniated disc is usually conservative and nonsurgical.

A doctor may advise the patient to maintain a low, painless activity level for a few days to several weeks. This helps the spinal nerve inflammation to decrease.