What is a Disc Herniation?

Disk herniation is a condition where the central nucleus pushes through the outer edge of the disc, causing a bulge that compresses the spinal nerves.

Disc Anatomy

Disc herniation is the most common cause of back pain. The intervertebral disks are flat and round, present between the vertebrae and act as shock absorbers when you walk or run. There is a soft, gelatinous material in the center (nucleus pulposus) that is encased in strong elastic tissue to form a ring around it called annulus fibrosus.

Symptoms of Disc Herniation

The symptoms of lumbar disc herniation include:

  • Mild to intense back pain, making it difficult to bend
  • Numbness and weakness in the leg or foot leading to the sensation of tingling (pins and needles)
  • Leg and/or feet pain making it difficult to walk or stand
  • In rare cases, loss of bowel and bladder function (cauda equine syndrome), requiring immediate medical attention

Diagnosis of Disc Herniation

The diagnosis of disc herniation includes a thorough review of your medical history and a physical and neurological examination. Neurological examination is performed to indicate any neurological injury and involves the evaluation of reflexes and muscle weakness by various tests. To confirm the diagnosis, your doctor may order an MRI to evaluate changes in the disk and spinal nerves.

Treatment of Disc Herniation

Non-surgical Treatment of Disc Herniation Non-surgical treatment is preferred over surgery and includes rest, activity modification, and pain medication, which include non-steroidal anti-inflammatory drugs, muscle relaxants, and epidural analgesic injections. Back braces are recommended for a few days to keep the lower back still and reduce mechanical pain due to movement. Physical therapy or acupuncture may be helpful in some cases. Surgery for Disc Herniation Surgery is considered in cases with significant leg pain, muscle weakness, and numbness that is unresolved after conservative treatment measures. Urgent surgery may be required if neurologic dysfunction or cauda equine syndrome occurs. Microdiskectomy is the most commonly used surgical procedure for lumbar disc herniation. It involves the removal of part of the herniated disk causing nerve compression. It is a comparatively safe procedure, but some of the risks include infection, nerve damage, dural leak, or hematoma. Most patients undergoing surgery find significant respite in pain after the surgery.

Treatment Options for Bicep Tendon Tears

Non-surgical Treatment Options for Bicep Tendon Tears

Conservative treatment for a proximal biceps tendon tear includes:

  • Ice application
  • Limiting activity
  • Non-steroidal anti-inflammatory medications to reduce the pain and swelling
  • Flexibility and strengthening exercises to restore the mobility and strength of the surrounding muscles

Surgery for Bicep Tendon Tears

Surgery to reattach the torn tendon back to the bone is rarely needed. However, it may be the best option for patients with partial tears who continue to experience symptoms after non-surgical treatments or who want all their arm strength back, such as athletes or manual laborers.

Your surgeon may opt for several surgical procedures for distal bicep tendon tear where the distal biceps tendon is reattached to the forearm bone. One or two incisions may be used. During the procedure, the tendon is attached with stitches through holes drilled inside the bone or small metal implants may be used to attach the tendon to the bone.