Mark W. McFarland, MD
This question came in over our web chat and it is a great one to answer. The human spine is made up of 26 vertebrae (bones) that go from your skull to your pelvis. In between these bones are discs that act as shock absorbers or cushions which help the bones of the spine move, rotate, bend and sit against each other.
These vertebral discs have a tougher exterior casing and inside a jelly-like composition of loose collagen fibers and water. When one of the discs becomes unhealthy, it can leak its contents, called the nucleus pulposis, into the epidural space, causing pressure on spinal nerves or the spinal cord.
A great way to envision this is to think of a jelly doughnut. If you squish the jelly doughnut too hard, the jelly will come out. That is kind of what happens to the vertebral disc when it herniates. Herniation is typically caused by an accident, injury, disease process or even simply aging, which we call degenerative disc disease.
So, how does a herniated disc feel?
You may think it would cause neck or back pain, but typically the pain will more often be felt in the areas that correspond to the nerve root being compressed. In the neck, this may mean the shoulder, upper arm, forearm or hand. In the lower back, it could mean the buttocks, thigh, calf, foot or toes. This pressure can cause pain, pressure, tingling, numbness, burning, loss of sensation and other issues, foot drop and even loss of bladder and bowel control in severe cases. Because a nerve is being compressed, the feelings/pain can vary from patient to patient.
How do you know you have one? As a fellowship-trained orthopaedic spine surgeon who has many years of clinical experience, I can examine you and from your symptomology surmise that you may have a herniated disc. The only way to know for sure is to order a diagnostic test called an MRI. The MR scan will produce 3-D images of your spine that will show the vertebral disc as well as the spinal cord and nerve roots, including the spine. An x-ray will only show me the vertebral bones. The MR scan will clearly show me if your disc is healthy, bulging or herniated and will help me determine what treatment plan would be best for you. For people who can’t have an MR scan, I will order a CT scan.
Do you Think you Have a Herniated Disc?
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