Diagnosis and Treatment of Pain From Disc Herniations and Radiculopathy
Denver Back Pain Specialists’ physicians can perform a comprehensive evaluation of your discs and nerves through the use of history and physical examination, ordering and review of imaging such as MRIs, and the use of diagnostic spinal injections when needed. We work closely with physical therapists and other care providers to make sure that you receive a complete treatment and self care program. You can view additional information below and on the following pages of our website: Lumbar Radiculopathy video/brochure, Cervical Radiculopathy video/brochure, Disc pain, Epidural Steroid Injections for Radicular (Arm or Leg) Pain, Spine Specialized Physical Therapy, and other sections.
Physical Therapy Treatment for Disc Herniation
A Physical Therapist can evaluate you and design a treatment program based off of their findings and your individual goals that is far more specific. Your treatment would most likely involve not only exercises to help decrease your pain, increase your flexibility and increase your strength, but also manual therapy designed to decrease the stiffness in your joints, decrease muscle tension and decrease you pain.
As with any exercise program for the spine it is recommended that a medical professional, preferably a Doctor of Physical Therapy, evaluate you prior to beginning. None of these exercises should create any pain or reproduce any of your symptoms. They are meant to get you started in the right direction and help control your pain.
Call today to meet with one of our back pain specialists & find out how we can help. 303-327-5511
Disc Herniation and Anatomy of the disc
The disc is made up of the nucleus pulposus, annulus fibrosus and is closely associated the end plates of the vertebral bodies (bones). The nucleus pulposus (NP) makes up the center of the disc and is subject to high pressures. It is normally about 80% water and acts like a pivot point for the spine. The annulus fibrosus (AF) makes up the outer ring of the disc, is more fibrous, and consists of lamellae to help contain the nucleus.The AF is 65% water and absorbs stress. With aging the NP starts to resemble the AF as water binding decreases and degenerative changes occur.
As the disc continues to age its tolerance to compressive forces decreases and provides less shock absorption to the spine and less space for the nerve roots to exit.
The most common herniation of a disc is posterolateral but it can occur in any direction. With a posterolateral herniation the posterior longitudinal ligament is often affected which can cause low back pain related to disc pain. Injury to the disc commonly occurs with bending, lifting and twisting motions, especially in combination.
Disc Herniation Diagnosis
Disc herniation diagnosis will start with a physical exam and a review of your medical history. Depending on where you have symptoms and if you are experiencing disc related pain, your doctor will examine your neck, shoulder, arms, and hands, or your lower back, hips, legs, and feet. The doctor will be looking for numbness, muscle reflexes, strength and examining your posture. Other tests and exams doctors may use to diagnose are:
- Electromyogram (EMG) / Nerve Conduction Velocities (NCV) – measures the electrical activity of muscles and nerves
- Spine MRI or spine CT – shows if the herniated disk is pressing on the spinal canal
- Spine x-ray may be done to rule out other causes of back or neck pain
- Selective nerve root blocks (injections)
Treatment for Disc Herniation
Treatment for Disc Herniation can vary. Conservative treatment is the simplest and generally the most effective type of treatment. Conservative treatments involves avoiding painful positions and following a planned exercise and pain medication regimen. Other types of treatment involve therapy, medications, injections and surgery.
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