When you come to the University of Michigan Health Comprehensive Spine Program for a herniated disc, you’ll be evaluated by our multidisciplinary team of specialists who will work with you to determine a personalized treatment plan. Our goal is to offer the most advanced and least invasive treatment to help improve your quality of life.
What is a Herniated Disc?
The bones that form the spine, or vertebrae, are cushioned by small, spongy discs. When these discs are healthy, they act as shock absorbers for the spine and enable the body to bend, twist and move freely.
When a disc is damaged it may bulge or break open, which is known as a herniated disc. This condition usually occurs in the lower back, but it can also be present in the neck and thoracic area (mid-back). The bulge can press on nearby nerve roots, causing pain, numbness and weakness in the area of the body where the nerve travels.
A herniated disc can be caused by a traumatic injury, improper lifting of a heavy object or, most often, age-related weakening of the spinal discs (called disc degeneration).
Symptoms
Symptoms of a herniated disc depend on the location of the disc and severity of the rupture. While some herniated discs cause no symptoms, many patients experience symptoms such as:
- Severe back, leg or arm pain, depending on whether the impacted nerve is in the lower back or neck.
- Numbness or tingling that radiates in the area of the body served by the affected nerve.
- Weakness in the area of the body served by the affected nerve.
- In severe cases, loss of bowel or bladder control.
Diagnosis
Our collaborative team begins by conducting a complete medical history and physical exam to identify the source of your back pain, followed by advanced testing that may include:
- Imaging tools such as X-ray, CT scan or MRI.
- Myelogram, a procedure in which dye is injected into the spinal fluid before X-rays are taken to show pressure on the spinal cord or nerves due to multiple herniated discs or other conditions.
- Nerve conduction study, which measures electrical nerve impulses and functioning in the muscles and nerves.
- Electromyography, a test to evaluate the electrical activity of the muscles while contracted and at rest.
After your diagnostic tests are completed, our specialists will talk with you about your treatment options.
Treatment
Non-surgical Treatment
- Conservative treatment for a herniated disc often starts with physical therapy. Our PT specialists help you identify positions that decrease your referred pain, and also help you develop a home program to prevent further damage or recurrence.
- Occupational therapy may be prescribed to provide instructions on how to keep your back straight and aligned, particularly when sitting for long periods.
- Pain management for a herniated disc depends on the location and severity of your condition. Our specialists may recommend techniques such as anti-inflammatory and pain medications, muscle relaxers and steroid injections.
- Traditional medicine combined with holistic therapies such as yoga, healing touch and acupuncture.
Surgical Treatment
When symptoms related to a herniated disc don't improve with conservative treatment or if symptoms worsen, surgery may be recommended. Our spine specialists are skilled in the use of minimally invasive techniques that incorporate advanced navigation and robotics procedures, leading to faster recovery, less discomfort and shorter hospitalizations.
Treatment options include:
- Laminectomy: Removal of fragments of bone and soft tissue, which are pushing on the nerves. Depending on certain factors, this may be performed as a minimally invasive procedure or an open procedure.
- Laminectomy and Spinal Fusion: For more severe cases, a laminectomy may be combined with a fusion, a procedure that reduces the movement in the damaged spine segment by permanently connecting two or more vertebrae using screws and rods to stabilize the spine. A bone graft is also typically performed using additional bone to fill in gaps between the vertebrae and stimulate the healing process.
- Discectomy: A minimally invasive procedure to remove the section of the disc that is irritating a nerve and causing pain. Depending on certain factors, this may be performed as a minimally invasive procedure or an open procedure.
Contact Us
You're about to make an important decision, and we want to help you make a good one. Our staff will be glad to talk with you about your options and how we can help. Please visit our Make an Appointment page for more information.