Sciatica and Herniated Disks: What You Need to Know Part 1
Sciatica and Herniated Disks: What You Need to Know
Part 1
I want to mention a couple of things before we jump into this somewhat complicated subject.
Firstly, this blog will have two parts because of the amount of information in it.
Secondly, I will be referring to some studies on the topics, and, instead of breaking up the text,
I am putting the names of all these articles at the very end.
Thirdly, sciatica is a symptom, not a cause.
Well, here we go.
Over the years, I have treated many patients with herniated disks and sciatica.
A herniated disk is a fairly common problem that can cause significant pain and discomfort, so I wanted to take a few moments to discuss what causes it and what you can do to avoid it.
First and foremost, let's define a herniated disk.
Your spine is made up of a series of bones called vertebrae, with a small, spongy disk between each vertebra that acts as a cushion.
These disks absorb shock and keep your spine flexible when you move.
However, these disks can become damaged and begin to bulge or even break open.
When this occurs, the soft material within the disk can push out and put pressure on nearby nerves.
This is what causes the pain and discomfort associated with a herniated disk.
So, what causes a disk to herniate in the first place?
There are a few things that can increase your risk:
1. Age: As we get older, our disks start to dry out and become less flexible. This makes them more prone to damage and herniation.
2. Poor posture: Sitting or standing with bad posture for long periods can put extra pressure on your spine and increase your risk of a herniated disk.
3. Overuse: Doing repetitive motions or lifting heavy objects can put a lot of strain on your back and increase your risk of disk damage.
4. Genetics: Some people are just more prone to herniated disks due to their genetics.
Numbers 2 and 3 above relate to the risks associated with some professions.
I will discuss this topic further in the article.
Now, just because you have a risk factor doesn't mean you're definitely going to get a herniated disk.
There are plenty of things you can do to reduce your risk.
Some commonsense things to do are:
1. Exercise regularly: Strengthening the muscles around your spine (the core!) can help support it and reduce your risk of injury.
2. Maintain good posture: Whether you're sitting at a desk or standing in line at the grocery store, make sure you're not putting unnecessary pressure on your spine.
3. Lift properly: If you have to lift something heavy, make sure you're using the proper form to avoid putting too much strain on your back.
4. Stay hydrated: Drinking plenty of water can help keep your disks hydrated and more flexible.
How many people suffer from a herniated disk?
(Here we have to enter the boring realm of dry statistical data, and I will list references to studies at the end of this post.
Please, bear with me through this part.
I do think that this information is important to get a fuller picture of this, somewhat difficult, topic).
It is difficult to give an exact number since the prevalence of herniated disks can vary depending on age, gender, and other factors.
However, studies suggest that herniated disks are a fairly common problem.
One study estimated that herniated disks affect about 1-3% of adults per year, with the highest incidence occurring in people aged 30-50 years old.
Another study found that up to 25% of adults may have a herniated disk, although many of these cases are asymptomatic (meaning the person has a herniated disk but doesn't experience any symptoms).
So, while the exact number of people who suffer from a herniated disk is difficult to determine, it's safe to say that it's a fairly common problem that many people will experience at some point in their lives.
What ages are most affected by a herniated disk?
Herniated disks can occur at any age, but they are more common in certain age groups.
The highest incidence of herniated disks occurs in people aged 30-50 years old, although people of any age can develop a herniated disk.
As we age, our disks lose water content and become less flexible, which can increase the risk of disk damage and herniation.
This is why herniated disks are more common in middle-aged and older adults.
However, younger people can also develop herniated disks, especially if they engage in activities that put a lot of strain on their backs, such as heavy lifting, repetitive motions, or contact sports.
What are the most common causes of a herniated disk in the lower back?
The most common cause of a herniated disk in the lower back is gradual wear and tear on the disks over time, which can lead to a condition called degenerative disc disease.
This occurs when the disks lose water content and become less flexible, making them more prone to damage and herniation.
However, other factors can contribute to the development of a herniated disk in the lower back, including:
1. Poor posture: Sitting or standing with bad posture for long periods can put extra pressure on your lower back and increase your risk of a herniated disk.
2. Improper lifting technique: Lifting heavy objects with improper form, especially when twisting, can put a lot of strain on your lower back and increase your risk of disk damage.
3. Trauma: A sudden injury or trauma, such as a fall or car accident, can cause a herniated disk in the lower back.
4. Obesity: Carrying excess weight can put extra strain on your lower back and increase your risk of disk damage and herniation.
5. Genetics: Some people are more prone to herniated disks due to their genetics.
What Occupations Are at Risk for Herniated Disk?
Several occupations are considered to be at risk for developing a herniated disc in the lower back due to the nature of their work.
Some of these occupations include:
1. Manual labor jobs: Jobs that involve heavy lifting, pushing, pulling, or bending are at an increased risk of developing herniated discs in the lower back.
Examples of these types of jobs include
Construction workers
Warehouse workers
Landscapers
2. Healthcare workers: Healthcare workers, including nurses and nursing aides, are at risk for developing herniated discs due to the physical demands of the job, which often involve lifting and moving patients.
3. Professional drivers: People who spend long hours sitting in a vehicle, such as truck drivers, delivery drivers, and taxi drivers, are at risk of developing a herniated disc due to the repetitive strain on the lower back from sitting for long periods.
4. Office workers: Although office work may not seem physically demanding, sitting for long periods and poor posture can increase the risk of developing a herniated disc in the lower back.
This includes people who work in front of a computer, such as accountants and programmers.
5. Athletes: Athletes who participate in sports that involve repetitive bending or twisting of the lower back, such as football, hockey, golf, or gymnastics, are at an increased risk of developing a herniated disc.
Important things to remember:
• MRI and x-ray testing do not evaluate the most important factors: the person’s function and spinal and pelvic movement
• Muscle relaxers are not the most ideal form of medication for pain. Spinal muscle spasms are a protective mechanism
• Bed rest and medication have been shown in studies to be detrimental to patients’ recovery
Yes, there is evidence to suggest that bed rest and medication may not be the most effective treatments for certain conditions, including back pain and sciatica.
A systematic review published in the European Spine Journal in 2016 found that bed rest is not effective for treating acute low back pain and may delay recovery and increase the risk of chronic pain.
In terms of medication, while certain medications like nonsteroidal anti-inflammatory drugs (NSAIDs) and muscle relaxers may help manage pain and inflammation, they are not always effective and can have side effects.
Additionally, a systematic review published in the Annals of Internal Medicine in 2015 found that opioid pain medications were not more effective than non-opioid medications for treating chronic back pain and had a higher risk of side effects.
The authors suggest that non-pharmacologic therapies, such as exercise, cognitive behavioral therapy, and spinal manipulation, may be more effective and safer for treating chronic back pain.
Instead of relying solely on bed rest and medication, experts recommend a combination of treatments, including physical therapy, exercise, and other non-pharmacological interventions.
These approaches can help patients manage their pain and improve their function and quality of life.
It's important to work with a healthcare provider to determine the most appropriate treatment plan for your individual needs.
Studies show that if not properly treated and rehabilitated,
patients with herniated disks and sciatica
are much more likely to re-injure and then more severely
According to the study in Spine Journal, patients with herniated discs who underwent surgery had a higher risk of reoperation compared to those who received non-surgical treatment.
The study found that the rate of lumbar disc surgery was lower after the implementation of multidisciplinary nonsurgical spine clinics, which emphasized conservative treatment and rehabilitation.
Another study found that patients with herniated discs who underwent interdisciplinary outpatient rehabilitation had better outcomes in terms of pain relief and function compared to those who received usual care.
The authors suggest that rehabilitation, which includes physical therapy, exercise, and education, is an important component of managing herniated discs and preventing re-injury.
Yet another systematic review found that patients with lumbar spinal stenosis (narrowing of the spinal canal – the space inside your vertebral column where the spinal cord is located) who underwent surgery had a higher risk of reoperation compared to those who received non-surgical treatment, which included physical therapy, exercise, and pain management.
The authors suggest that non-surgical treatments may be effective for managing lumbar spinal stenosis and reducing the risk of reoccurrence.
If you read up to this point, great job!
Understanding the risk factors, causes, and mechanics of herniated disks is super important for being able to fix your pain and prevent it from re-occurring.
In Part 2, you will find the answers to important questions, including:
· Are all sciatica cases caused by herniated disks?
· Who suffers most from Sciatica, women or men?
· What are the symptoms of Sciatica caused by a herniated disk?
· What are the symptoms of Sciatica NOT caused by a herniated disk?
· How to treat Sciatica at home?
I hope that the insights shared in this article will guide you toward a successful recovery from herniated disk symptoms.
If you found this article helpful, consider sharing it with others who might be on a similar journey.
Together, we can make the road to recovery a little less daunting.
Don't forget to sign up for my blog and receive our "Guide to Simple and Effective Stretching" absolutely FREE!
Below you'll find a list of related articles that can offer further insights.
I also encourage you to explore other articles on our website for relief solutions to lower back, knee, hip, shoulder, elbow, and foot/ankle injuries.
Remember, you're not alone in your journey.
I am here to provide the information and support you need.
Related Articles
Navigating Pain: A Practical Guide to Understanding and Managing Acute and Chronic Pain
Effective Low Back Treatment Solutions for Chronic Sufferers
Comprehensive Guide to Core Stabilization
Can You Successfully Treat Spinal Stenosis Without Surgery?
7 Dangerous Mistakes After Back Surgery
References:
Deyo, R. A., Mirza, S. K., & Martin, B. I. (2006). Back pain prevalence and visit rates: estimates from U.S. national surveys, 2002. Spine, 31(23), 2724-2727.
Brinjikji, W., Luetmer, P. H., Comstock, B., Bresnahan, B. W., Chen, L. E., Deyo, R. A., ... & Jarvik, J. G. (2015). Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. American Journal of Neuroradiology, 36(4), 811-816.
Stochkendahl, M. J., Kjaer, P., Hartvigsen, J., Kongsted, A., Aaboe, J., Andersen, M., ... & Bronfort, G. (2016). National Clinical Guidelines for non-surgical treatment of patients with recent onset low back pain or lumbar radiculopathy. European Spine Journal, 25(10), 282-289.
Chou, R., Deyo, R., Friedly, J., Skelly, A., Hashimoto, R., Weimer, M., ... & Brodt, E. D. (2015). Nonpharmacologic therapies for low back pain: a systematic review for an American College of Physicians clinical practice guideline. Annals of internal medicine, 163(2), 123-132.
Rasmussen, C., Nielsen, G. L., Hansen, V. B., & Jensen, O. K. (2008). Rates of lumbar disc surgery before and after implementation of multidisciplinary nonsurgical spine clinics. Spine, 33(24), 2679-2683.
Zaina, F., Tomkins-Lane, C., Carragee, E., Negrini, S., & Doria, C. (2016). Surgical versus non-surgical treatment for lumbar spinal stenosis. Cochrane Database of Systematic Reviews, (1).
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