Your Back Pain: Could It Be a Herniated Disc?

I'm not sure if it's a herniated disc?

Hello Doctor, I have been experiencing discomfort in my lower left back for over six months.
Initially, I thought it was just muscle fascia inflammation, but now I have a slight tingling sensation from my buttocks down to my calves, and I feel some pressure near the lumbar region of my spine when bending.
I have visited many hospitals, including both traditional Chinese and Western medicine facilities, and have undergone chest and abdominal X-rays.
The doctors have all concluded that there is no issue and just prescribed medication for me to take home, which hasn't led to significant improvement.
Recently, I went to an orthopedic specialist, who suggested that I might have a herniated disc.
The doctor mentioned that herniated discs cannot be detected through X-rays??? The doctor recommended that I could try an injection to see if it truly is a herniated disc symptom.
At that moment, I found the idea of an injection quite frightening, especially since the doctor seemed uncertain about my condition yet suggested the injection could confirm whether it is a herniated disc.
Could you please help me understand what my symptoms are? I have seen many doctors, and none have been able to clarify my situation.
I also asked the consulting physician about my symptoms, and she said they are mild to moderate.
Before this back pain, I worked as an office worker, and due to prolonged sitting, I am seeking your assistance.
Is there a chance that the injection could lead to a complete resolution of my condition?

Sunny, 20~29 year old female. Ask Date: 2017/02/14

Dr. Shi Guozheng reply Orthopedics

Herniated discs occur when the intervertebral disc protrudes and compresses nearby spinal nerves, leading to pain that typically radiates from the buttocks down to the thighs, calves, and feet.
Sometimes, there may also be symptoms of numbness.
This pain tends to worsen with increased abdominal pressure, such as when straining, using the restroom, or coughing.
In severe cases, it can lead to an inability to lift the foot or toes, and may even result in urinary or fecal incontinence.
After a medical examination, if necessary, imaging studies such as MRI or CT scans can be performed to confirm the diagnosis.
Injections may only provide temporary relief of symptoms; therefore, rehabilitation and medication are essential.
If symptoms persist, surgical intervention may be required.

Reply Date: 2017/02/14

More Info

Understanding your back pain, especially in the context of a potential herniated disc, can be quite complex. Based on your description, it seems that you have been experiencing discomfort in your lower back for over six months, which has now extended to your buttocks and calves, accompanied by a sensation of numbness. The pressure you feel near your spine when bending could indeed indicate an underlying issue, such as a herniated disc.

A herniated disc occurs when the soft inner gel of the disc bulges out through a tear in the tougher exterior. This can lead to compression of nearby nerves, resulting in pain, numbness, or weakness in the areas served by those nerves. In your case, the symptoms radiating from your lower back to your legs suggest that the affected disc may be pressing on the sciatic nerve or other nerves in the lumbar region.

You mentioned that you have undergone various imaging studies, including X-rays, which typically do not show soft tissue issues like herniated discs. Instead, Magnetic Resonance Imaging (MRI) is the preferred method for diagnosing disc herniation, as it provides detailed images of the soft tissues, including the discs and nerves. If you haven't had an MRI yet, it may be worthwhile to discuss this option with your healthcare provider.

Regarding the injection your doctor suggested, it is often used as both a diagnostic and therapeutic tool. Corticosteroid injections can help reduce inflammation and pain in the affected area, providing temporary relief. If the injection alleviates your symptoms significantly, it may indicate that a herniated disc or another nerve-related issue is indeed the source of your pain. However, it is essential to understand that while injections can provide relief, they are not a cure for the underlying problem. They can help manage symptoms, but they do not address the structural issues of the disc itself.

In terms of treatment options, if a herniated disc is confirmed, there are several approaches to consider. Conservative treatments typically include physical therapy, which focuses on strengthening the muscles around the spine, improving flexibility, and teaching proper body mechanics to prevent further injury. In some cases, medications such as non-steroidal anti-inflammatory drugs (NSAIDs) may be prescribed to manage pain and inflammation.

If conservative measures fail to provide relief, surgical options may be considered. Procedures such as discectomy (removal of the herniated portion of the disc) or spinal fusion may be recommended, depending on the severity of the herniation and the impact on your quality of life.

It's also important to address lifestyle factors that may contribute to your condition. As an office worker, prolonged sitting can exacerbate back pain. Implementing ergonomic adjustments to your workspace, taking regular breaks to stand and stretch, and incorporating exercises that strengthen your core and back muscles can be beneficial.

In summary, while your symptoms may suggest a herniated disc, a definitive diagnosis typically requires an MRI. The injection your doctor recommended can provide temporary relief and help confirm the diagnosis. If you continue to experience pain, it may be necessary to explore further imaging and treatment options. Always communicate openly with your healthcare provider about your concerns and the effectiveness of any treatments you undergo.

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