Herniated Disc in North Texas

A herniated disc is a condition that refers to a problem with one of the discs between the individual bones (known as the vertebrae) that stack up on top of each other to make your spine. Spongy discs called intervertebral discs are wedged in between the vertebrae that comprise the neck, thoracic region, and lower back. Most often, a herniated disc occurs when the gel-like substance in the middle of one of these spongy discs pushes through a tear in the tough exterior of the disc; this is called a herniated nucleus pulpous. This can cause patients a great deal of neck or back pain. Dr. Kendall Carll is a board-certified spine surgeon who has been practicing for more than 15 years in the Dallas, TX area. He diagnoses and treats herniated discs for patients of all lifestyles and offers both nonsurgical and surgical approaches for treatment.

Spinal discs play a crucial role in your spine’s ability to twist and flex forward and backward. They are engineered to endure tremendous amounts of stress. The discs have soft centers that are encased within tougher, banded exteriors. When the gel-like substance in the middle of the disc pushes through a tear, it can compress the spinal cord or the nerves that branch off either side of the spinal cord, creating an inflammatory reaction that can sometimes cause pain, numbness, or weakness in an arm or leg. Disc herniation is most often caused by the gradual, age-related wear and tear called disc degeneration. As you age, your spinal discs lose some of their water content. The dehydration makes them less flexible and more prone to tearing or rupturing in response to compression.

Reduce your risk for recurrent herniated discs by:

• Maintaining a healthy weight
• Using back braces when engaged in heavy physical activity
• Exercising to strengthen your back and core muscles
• Maintaining good posture

Most herniated discs occur in your lower back (lumbar spine), although they can also occur in your neck (cervical spine). The most common symptoms of a herniated disc are:

• Arm or leg pain
• Sharp, stabbing lower back pain or sharp, stabbing neck and shoulder pains
• Numbness, tingling or muscle weakness in your arms or legs
• Limited mobility
• A dull ache that can become progressively worse

Depending upon the location of the herniated disc, it may cause only intermittent pain, such as with sudden movement, or even a sneeze (if the disc is in your neck, for example).

In most cases, Dr. Carll will be able to determine if a herniated disc is the cause for your back pain simply through a physical exam. To confirm the diagnosis, he may also order x-rays, a CT scan, or an MRI. In rare cases, he might recommend a CT myelogram. For this procedure, the dye is injected into the spinal fluid, followed by a CT scan. This test can show pressure on your spinal cord or nerves due to multiple herniated discs or other conditions. To determine how significantly the herniated disc is impacting the local nerves, Dr. Carll may also order a series of nerve conduction studies (electromyograms), which measure how well electrical impulses are moving along nerve tissue. This can help pinpoint the location of the nerve damage.

Another way to diagnose a herniated disc is to perform a discogram. A discogram uses a special needle to inject dye the suspected area of injury. With a discogram, Dr. Carll can directly identify cracks in the disc in order to pinpoint the cause of the pain. He will then be able to create a customized treatment plan to correct the disc.

Any time you experience neck or back pain that travels down your arm or leg, or pain that is also accompanied by numbness, tingling or weakness, it’s time to see the doctor. The good news is that conservative treatments such as heat or ice therapy, bracing, and following a planned exercise and pain-medication regimen will generally relieve the pain from a herniated disc in a few days or weeks.

In some instances, muscle relaxers and epidural injections can be used to ease pain caused by localized muscle spasms and inflammation of the nerve branch. Physical therapy is often used to help patients understand how to adopt better body mechanics, which may help to limit further stress on the herniated disc. With these treatments, two to three days of rest is also recommended.

If the pain from the herniated disc persists unabated after a few weeks, surgery is perhaps necessary. The surgical options for herniated discs depend upon where the herniation is occurring. Dr. Carll can make small incisions in the neck for cervical herniations or in the back for lumbar herniations. In either case, the surgeon can remove the entire disc, or merely remove the herniated section. Dr. Carll could also remove a portion of the vertebra, typically the lamina, or the entire spinous process with the lamina. This procedure creates more room for the spinal cord and branching nerves, which may have been trapped or impinged previously by the herniated disc.

For all these surgical procedures, the physician will likely perform some type of spinal fusion to stabilize the spine, and prevent further vertebral movements that would generate pain.

Can a herniated disc heal on its own over time?
While some herniated discs may improve with time and conservative treatment, complete healing without intervention is not guaranteed. The body can sometimes reabsorb the herniated material, reducing symptoms, but this process can take several months. During this period, pain management, physical therapy, and lifestyle modifications are essential to prevent further aggravation. However, in cases where symptoms persist or worsen, medical intervention may be necessary.

Can a herniated disc lead to permanent nerve damage?
In some cases, if a herniated disc compresses a nerve for an extended period, it can lead to permanent nerve damage. This risk increases if the condition is left untreated or if conservative treatments fail to relieve pressure on the nerve. Symptoms of potential nerve damage include persistent numbness, weakness, or loss of bladder or bowel control. Immediate medical attention is crucial if these symptoms occur to prevent long-term complications.

How can ergonomic adjustments at work help with a herniated disc?
Making ergonomic adjustments at work can significantly reduce the strain on your spine and alleviate symptoms of a herniated disc. This includes using a chair with proper lumbar support, positioning your computer screen at eye level to avoid neck strain, and ensuring your feet are flat on the floor. Taking regular breaks to stand, stretch, and walk around can also prevent stiffness and reduce pressure on the affected disc. Implementing these changes can create a more comfortable and supportive work environment.

Dr. Carll treats numerous patients who suffer from herniated discs. If you are experiencing neck or back pain from a possible herniated disc, there’s no need to delay any longer. Dr. Carll can develop a direct plan of action that will address your disc pain. We invite you to call our office for more information.