Herniated Disc Injuries
A herniated disc often results from trauma suffered
in motor vehicle accidents and from work related injuries.
The consequences of suffering from a herniated disc can
result in loss of time from work, the need for medical
treatment (possibly even including surgery), and the
loss of enjoyment of one’s quality of life.
What is a Herniated Disc?
The spine runs from the back of the neck down to
the lower back. It is composed of a series of
connected bones called vertebrae that surround the
spinal cord and protect it from damage. Nerves
branch off the spinal cord and travel to the rest
of the body, allowing for communication between
the brain and the body. By sending a message down
the spinal cord and out through the nerves the
brain can make muscles move. The nerves also send
monitoring information such as pain and temperature
from the body back to the brain.
The vertebrae are connected by a disc and two small
joints called "facet" joints. Each disc consists
of strong connective tissues which hold one vertebra
to the next. The disc is made of a tough outer layer
called the "annulus fibrosus" and a gel-like center
called the "nucleus pulposus. The center of the disc
also contains water, helping the disc act as a cushion
act as a cushion or shock absorber between the vertebrae.
The disc and facet joints allow for movements of the
vertebrae and therefore let you bend and rotate your
neck and back. When a disc deteriorates or suffers
trauma, the outer layer can tear, allowing displacement
of the disc's center (called a herniated or ruptured
disc) through a crack in the outer layer (the annulus),
into the spinal canal (the space occupied by the nerves
and spinal cord). The herniated disc can then press on
the spinal nerves, often also resulting in inflammation.
Depending on the location of the disc that is ruptured,
this can cause pain, numbness, tingling or weakness in
the neck, shoulders, arms, back, legs or feet.
Common Symptoms of a Herniated Disc
Common symptoms resulting from a herniated disc include:
- Prior to complete disc rupture with herniation,
it is common to experience bouts of neck, shoulder,
back, or leg pain. This pain comes from an injury
to nerves. Damage to the sciatic nerve leading from
the lower back down the leg is called sciatica.
- Once the disc ruptures, there can be an onset of
sudden, severe, pain.
For example, if the herniation involves
the bottom two discs in the spinal column, the
pain usually begins in the lower back. The
bulging disc in this location exerts pressure
on the sciatic nerve, and sharp pain may follow
that nerve all the way down the leg and into
the foot. Pressure on this nerve may also eventually
cause numbness or a "pins and needles" sensation.
Over time, the surrounding muscles can weaken and
shrink in size.
- One may also experience numbness
or weakness with a herniated disc.
Again as an example, if the herniation is in the
lower spinal cord, the numbness is most frequently
reported to be in the calf, the sole of the foot
or the big toe, and the weakness is often
experienced as an inability to walk up the stairs
normally, an inability to walk on the toes, an
inability to lift the foot while walking (a
"foot-drop"), or a weakness in flexing or extending
the knee, foot, or leg.
- In certain circumstances, there may also be the onset
of difficulty controlling urine (bladder incontinence),
difficulty controlling bowel movements (bowel
incontinence), or numbness in the perineal region
(saddle region), usually noticed after wiping in the
bathroom. These symptoms may indicate the presence of
cauda equina syndrome, which can require immediate
Diagnosis of a Herniated Disc
X-rays of the low back area are obtained to search
for unusual causes of pain, including tumors,
infections, fractures, etc. CAT Scans and MRIs of
the spinal cord area are used to identify the disc
herniation and determine the degree of the
degeneration. Your doctor may test for changes in
the reflexes, sensation and strength caused by the
herniated disc. A nerve test may also be ordered to
determine whether there is ongoing nerve damage,
whether the nerves are in a state of healing a past
trauma, or whether there is another site of nerve
Treatments for Disc Herniations
The initial treatment for a herniated disc is usually
conservative, nonoperative treatment. One usually
begins with resting the low back area, maintaining
a comfortable posture and painless activity level
for a few days to several weeks, to allow the spinal
nerve inflammation to resolve. In addition,
non-steroidal anti-inflammatory medication such as
Motrin, Voltaren, Naprosyn, Lodine, Feldene, Clinoril,
Tolectin, Dolobid, Advil or Nuprin may also be used.
Other medication alternatives can include an epidural
steroid injection utilizing a spinal needle with the
guidance of x-rays to direct the medication to the
exact level of the disc herniation.
Physical therapy may also be beneficial. The therapist
can perform an in-depth evaluation, and use the
information obtained from the evaluation, combined with
a physician's diagnosis, to create an individualized
treatment plan. The treatment plan may include the use
of such modalities as traction, ultrasound, and electrical
muscle stimulation, to relax the muscles which are in
spasm and secondarily inflamed from the compressed spinal
nerve. Pain medication and muscle relaxing medications may
in combination with the physical therapy or other
conservative, non-operative treatment to relieve pain
while the spinal nerve root inflammation resolves and the
body heals itself. The majority of disc herniations
(approximately 90%) respond well to conservative treatment.
In those cases in which conservative treatments are not
successful and the pain is still severe or muscle weakness
is increasing, surgery may be the next option.
Surgery may be in the form of a percutaneous discectomy
if the disc herniation is small and not a completely
extruded disc fragment. If the herniation is large,
or is a free fragment, a microlaminotomy with disc
excision may be necessary. A microlaminotomy requires one
to two days of hospitalization after the surgery for the
wound to heal and postoperative physical therapy to begin.
If you or someone you love have suffered a herniated disc
in an accident due to someone else’s negligence or
intentional acts, you
should immediately contact a competent attorney. The
attorney will work with the injured person to determine
the legal options that may be available. These options
can include workers’ compensation and the possibility of
recovering directly from the person or persons responsible
for the injury. Given that the cost in medical expenses
and loss of income resulting from a herniated disc injury
can rise into the hundreds of thousands and even millions
of dollars, exploring legal remedies may make a substantial
Our law firm, together with the network of other
law firms that we work with, helps victims of
personal injury nationally.
Law Office of Joseph A. Hernandez
675 VFW Parkway #312
Chestnut Hill, MA 02467
Phone: (781) 461-9400
Toll Free: (866) 461-9400
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