Edward K. Nomoto, MD
Orthopedic Spine Surgeon located in Beverly Hills, Los Angeles, CA & Santa Monica, CA
A herniated disk can occur anywhere on your spine, and the pain and symptoms can range from mild to severe. Dr. Edward K. Nomoto knows that herniated disks can significantly impact your range of motion. He treats even the most severe cases, offering a myriad of treatment options including advanced safe minimally invasive surgery. Call or book your consultation online to visit one of his two Southern California offices: the Beverly Hills Spine Surgery and St. John’s Health Center in Santa Monica.
What’s a herniated disk?
The discs are pads that serve as "cushions" between the vertebral bodies, which minimize the impact of movement on the spinal column. Each disc is designed like a jelly donut with a central softer component (nucleus pulposus). An abnormal rupture of the central portion of the disc is referred to as a disc herniation.
The disks in your spine are jelly-like, doughnut-shaped rings that act as a cushion to prevent your vertebrae, the bones stacked together to make your spine, from rubbing together and causing damage.
When one of your disks degenerates as a result of aging or an injury, the central part can rupture into the outer ring, otherwise known as annulus fibrosis. When this abnormal rupture occurs, it’s called disk herniation or more informally, a slipped disk.
Herniated disks typically appear on the lower back between the fourth and fifth vertebrae on your lumbar spine. That could be because it’s consistently bearing the weight of your upper body and supporting your core.
You’re more likely to have a herniated disk if you have spine degeneration from an underlying medical condition or if you engage in persistent heavy lifting and bending your spine.
The pain from a herniated disk can range from mild to severe and depends on whether the nerves are being pinched or irritated.
What are the symptoms of a herniated disc?
The symptoms of a herniated disc depend on the exact level of the spine where the disc herniation occurs and whether or not nerve tissue is being irritated. A disc herniation may not cause any symptoms. However, disc herniation can cause local pain at the level of the spine affected.
If the disc herniation is large enough, the disc tissue can press on the adjacent spinal nerves that exit the spine at the level of the disc herniation. This can cause shooting pain in the distribution of that nerve and usually occurs on one side of the body and is referred to as sciatica. For example, a disc herniation at the level between the fourth and fifth lumbar vertebrae of the low back can cause a shooting pain down the buttock into the back of the thigh and down the leg. Sometimes this is associated with numbness, weakness, and tingling in the leg. The pain often is worsened upon standing and decreases with lying down. This is often referred to as a "pinched nerve."
What causes a herniated disk?
1. Wear and Tear on the Spine
Pain from a herniated disc is often the result of daily wear and tear on the spine. This is also called degeneration.
Our backs carry and help distribute our weight, and those intervertebral discs are made to absorb shock from movement (such as walking, twisting, and bending). Because our discs work so hard to help us move so well, they can become worn out over the course of time.
The annulus fibrous (the tough outer layer of the disc) can start to weaken, allowing the nucleus puplosus (the jelly-like inner layer) to push through, creating a bulging or herniated disc.
A herniated disc can also be caused by an injury. You can herniate a disc in a car accident, for example: the sudden, jerking movement can put too much pressure on the disc, causing it to herniate.
Or you can herniate a disc by lifting a heavy object incorrectly, or by twisting extremely.
3. A Combination of Degeneration and Injury
It may be that an intervertebral disc has been weakened by wear and tear (degeneration), making it more prone to herniation, should you experience a traumatic event or it could be that your disc has become so weakened that something that doesn't seem like a very traumatic event can cause a herniated disc.
A herniated disk can happen with age. Certain motions that force the disk out of place cause it, too. Additionally, improper posture and lifting heavy objects can strain your spine and result in a herniated disk.
If you’re overweight, you’re more at risk due to the additional strain from the weight on your disks, vertebrae, and spinal column. Weaker muscles and a sedentary lifestyle also increase the risk of a slipped disk occurring. Dr. Nomoto can diagnose a herniated disk with a physical exam and imaging tests, such as X-rays.
What are the treatments for a herniated disk?
Micro discectomy is the most common procedure performed in spine surgery. This is done when one has a herniated disc that is compressing the nerve and causing pain. A small incision is made in the back or neck and with the use of a microscope, the portion of the disc compressing the nerve is removed.
A combination of the following conservative treatment options can be used through at least the first six weeks of discomfort and pain:
•Physical therapy, exercise and gentle stretching to help relieve pressure on the nerve root
•Ice and heat therapy for pain relief
•Manipulation (such as chiropractic manipulation)
•Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen or COX-2 inhibitors for pain relief
•Narcotic pain medications for pain relief
•Oral steroids to decrease inflammation for pain relief
•Epidural injections to decrease inflammation for pain relief
Surgery Options for herniated disc
•Minimally Invasive Micro discectomy
•Minimally invasive Discectomy
•Medications to reduce inflammation and pain
•Physical therapy and rehabilitative exercise
Surgery is an option in more severe cases. A discectomy involves the surgical removal of part of or all of the herniated disk. A micro discectomy is the same process, but it consists of the use of a microscope to magnify the procedure.
If you have a herniated disk, Dr. Nomoto has plenty of experience in determining the appropriate treatment method for restoring your wellness. Call or book online to learn more about herniated disk treatments.