There is often confusion when diagnosing back pain since many refer to their discomfort as being a pinched nerve or a herniated disc. The two conditions are the most common problem people experience, but they are both different issues that generally happen to occur at the same time.
Typically, a herniated disc occurs in the lumbar spine (back). Disc pain tends to most often take place in the lower back where most of the weight-bearing and movement in the spine movement occurs. A pinched nerve is caused by a herniated disc pressing against the nerve. In most cases, a herniated disc is not painful. The leaking of the gel substance, which it contains, can create pinches, inflames, and may irritate the nearby nerve.
A spine is made of twenty-four bones called vertebrae, but the lumbar (lower back) bears most of the weight of the body. In between each of the five lumbar vertebrae (bones) is a disc which acts like a shock-absorbing pad which prevents the vertebrae from rubbing together. A disc is filled with a gel-like center and if the disc ruptures or bulge called herniation, the gel substance escapes and causes irritation to the nerves resulting in inflammation, pressure, and pain. Some may also experience leg pain, numbness, and tingling.
A herniation may develop instantly or gradually over weeks or months. Many factors increase the risk such as lifestyle choices, aging, and poor posture. Obesity, inadequate nutrition and lack of regular exercise, as well as tobacco use, contribute to the condition. As the body ages, biochemical changes can cause the discs to dry out and be less capable to absorb shock through the spine. Also, body mechanics such as incorrect lifting and twisting, combined with daily wear and tear, stress the lumbar spine.
People should seek medical attention if there is numbness, weakness, tingling, extreme burning, and pain. An x-ray may be needed to determine other causes of back pain. Imaging tests such as a CT or MRI scan may be needed to verify the presence of a herniation.
The condition is most often treated with physical therapy, medication, and injection. Many find improvement in approximately 6 weeks and return to normal activity. However, those with continuing symptoms may be recommended to have surgery. Over time, the herniation may shrink, and the pain will subside and perhaps eventually disappear entirely.
Learn More About Ronnen Abramov, MS, DO Here
Ronnen Abramov, MS, DO is a Board Certified in Pain Management and Physical Medicine & Rehabilitation
Dr. Abramov received his medical degree from the Philadelphia College of Osteopathic Medicine. He completed his internship and Physical Medicine & Rehabilitation residency and his fellowship training in pain management at the Thomas Jefferson University Hospital
He is board certified in Physical Medicine & Rehabilitation and Pain Management. He specializes in intervention procedures, including epidural steroid injections, facet injections, sympathetic blocks.