"As a neurosurgeon I frequently see patients with this question and understandably they are quite concerned" says Patrick J. Reid, MD, Neurosurgeon at St. Joseph Hospital.
"I want to allay some of the anxieties and concerns regarding herniated discs."

Symptoms of a herniated disc

• lower back pain which shoots down into the leg and may even go into the foot
• pain may be worsened by coughing or sneezing
• pain may be relieved upon flexing the knee and thigh
• numbness and weakness of the affected leg

Herniated discs are most frequently symptomatic in the lower back, where symptoms are caused when the disc herniation puts pressure on nerves in the spinal canal. 

• 89% occur in the lower back
• 10% occur in the neck
• 1% occurs in the mid-back

Will I need surgery?

Over 85% of patients with acute disc herniation will improve without surgical intervention in an average of 6 weeks.  These patients may be managed effectively with various treatments including:

• education and counseling
• analgesic medication and muscle relaxants
• physical therapy
• acupuncture
• injections

What are indications for surgery?

• uncontrolled pain
• progressive weakness
• unwillingness on the patient's behalf to wait for symptom resolution

The surgical procedure to treat a lower back disc herniation is called a lumbar discectomy.  It is one of the most frequently performed operations by a neurosurgeon. Patients are admitted on the day of surgery and may be discharged later that day, or the morning after.

In summary not all herniated discs cause symptoms and not all symptomatic herniated discs require surgery.  It is important to be assessed by a neurosurgeon who can determine what treatment if any is necessary.

Special thanks to Patrick J. Reid, MD, St. Joseph Hospital Neurosurgeon, for submitting this month's Health Tip!