A Blog by Dr. Nikhil Jain (Spine Surgeon)
Disc herniation can present as simple back pain, gluteal pain or pain in the legs associated with back pain. These patients most of the time give the history of “on and off” back pain which has now aggravated in intensity and is not responding to medications. An acute large disc herniation can also present as back pain associated with numbness in the legs and perineal area along with difficulty passing urine or constipation. Such cases are emergency and need to be evaluated urgently to prevent further damage. Below are the common causes of disc herniation.
- Men between 30-40 years of age
- Diabetes mellitus and hyperlipidemia
- Driving for long hours, physically demanding work, manual labor, and prolonged sitting
- Genetic predisposition
- Acute trauma
Depending on the patient presentation and location of disc herniation the disc prolapse can be managed
- Conservatively: without surgery
- SNRB: blocks for pain relief only
- Epidural blocks: pain relief only
Though many patients fear surgery, it is the most promising procedure when indicated. I have performed it in many patients and it has a > 95% success rate in patient relief.
Neurological deficits once if occurred cannot be reversed. The best we can do is prevention and timely intervention. Henceforth, it is important to consult a specialist whenever in doubt.