Disc Herniation: Causes, Symptoms, and Treatment Options

Q: Disc Herniation: Causes, Symptoms, and Treatment Options

Hello： According to what you mentioned, <...after being referred and researching, you can undergo minimally invasive lumbar disc surgery, which is scheduled for June 3...> Since you have already consulted with other physicians for surgery, you should first ask the original surgeo

Herniated disc

In 2014, I experienced pain in my lower back, buttocks, and the outer side of my thighs.
An MRI revealed degeneration of the intervertebral discs at the L3-L4 levels, which was likely the cause.
The doctor recommended physical therapy, but in January 2016, my symptoms worsened, with pain and numbness in my knees and tightness in the inner thighs.
Additionally, I experienced pain on the outer side of my knees after prolonged walking.
After multiple visits to the hospital, I underwent another MRI, which showed that the previously degenerated discs had severely herniated.
The doctor suggested performing a nerve block procedure to treat and diagnose any issues at the L3-L4 levels.
During the procedure, I experienced unbearable pain in my lower back and knees, but there was slight improvement a week later.
However, I continued to experience soreness and pain, requiring medication and physical therapy for about four months.
After researching and receiving recommendations, I opted for minimally invasive lumbar disc surgery, which took place on June 3.
Upon waking up, I noticed tightness on the outer side of my right knee.
After returning to my hospital room, I experienced unbearable pain on the outer, front, and inner sides of my right knee, which felt worse than before.
Now, nine days have passed, and my symptoms have not improved.
Could you please explain what might be causing this? Thank you.

jjp, 40~49 year old female. Ask Date: 2016/06/12

Dr. Lai Zhaokang reply Neurosurgery

Hello: According to what you mentioned, <...after being referred and researching, you can undergo minimally invasive lumbar disc surgery, which is scheduled for June 3...> Since you have already consulted with other physicians for surgery, you should first ask the original surgeon, as they are more familiar with your condition.
// However, if you are dissatisfied with the results of the surgery at the external hospital and wish to consult other physicians, please bring a copy of your pre-operative MRI and X-rays, etc., for further evaluation.
// If it is convenient for you to come to our Changhua Hospital, please visit my clinic for an assessment.
Wishing you all the best.
// Dr.
Lai Chao-Kang, Chief of Spine and Neurosurgery at Changhua Hospital.

Reply Date: 2016/06/12

More Info

Disc herniation, also known as a herniated disc, occurs when the soft inner gel of a spinal disc protrudes through a tear in the tougher exterior. This condition can lead to various symptoms, including pain, numbness, and weakness in the affected areas. Understanding the causes, symptoms, and treatment options for disc herniation is crucial for effective management and recovery.

Causes of Disc Herniation
The primary causes of disc herniation include:
1. Degenerative Disc Disease: As we age, the discs in our spine lose hydration and elasticity, making them more susceptible to herniation. This is often seen in individuals over 30 years old.

2. Injury or Trauma: Sudden injuries, such as those from falls or accidents, can cause a disc to herniate. Lifting heavy objects improperly can also lead to disc problems.

3. Genetics: A family history of disc problems can increase the likelihood of developing a herniated disc.

4. Lifestyle Factors: Obesity, sedentary lifestyle, and smoking can contribute to disc degeneration and increase the risk of herniation.

Symptoms of Disc Herniation
Symptoms can vary depending on the location of the herniated disc and whether it compresses nearby nerves. Common symptoms include:
- Localized Pain: Pain in the lower back or neck, depending on the location of the herniation.

- Radiating Pain: Pain that travels down the leg (sciatica) or arm, often described as sharp or burning.

- Numbness or Tingling: Affected areas may experience numbness or tingling sensations.

- Weakness: Muscle weakness in the legs or arms can occur if nerve roots are compressed.

Treatment Options
Treatment for disc herniation typically begins conservatively and may include:
1. Physical Therapy: A structured rehabilitation program can help strengthen the muscles supporting the spine, improve flexibility, and reduce pain.

2. Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) can help alleviate pain and inflammation. In some cases, corticosteroid injections may be recommended to reduce swelling around the affected nerves.

3. Activity Modification: Avoiding activities that exacerbate symptoms is crucial. Gradually returning to normal activities is essential as symptoms improve.

4. Surgery: If conservative treatments fail to provide relief after several months, surgical options may be considered. Procedures such as microdiscectomy or laminectomy can relieve pressure on the affected nerves.

Post-Surgical Considerations
In your case, it appears you underwent a minimally invasive surgery for your herniated disc. Post-surgical pain, especially if it is more severe than pre-surgical pain, can be concerning. Several factors may contribute to this:
- Postoperative Inflammation: Surgery can lead to inflammation in the surrounding tissues, which may cause increased pain initially.

- Nerve Irritation: If the nerve was compressed for an extended period before surgery, it may take time to heal, leading to ongoing symptoms.

- Scar Tissue Formation: Sometimes, scar tissue can develop around the surgical site, potentially causing pain or discomfort.

Recommendations
1. Follow-Up Care: It is essential to maintain regular follow-up appointments with your healthcare provider to monitor your recovery. They may recommend imaging studies to assess the surgical site.

2. Pain Management: Discuss your pain levels with your doctor. They may adjust your pain management plan, including medications or physical therapy.

3. Physical Therapy: Continuing physical therapy post-surgery can help improve mobility and strengthen the muscles around your spine, which may alleviate pain.

4. Patience and Recovery: Recovery from disc surgery can take time. It is crucial to be patient and allow your body to heal properly.

In conclusion, understanding the complexities of disc herniation, including its causes, symptoms, and treatment options, is vital for effective management. If your symptoms persist or worsen, do not hesitate to reach out to your healthcare provider for further evaluation and guidance.

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