• Terminology about a herniated disc can be confusing. There are many different terms to describe a herniated disc, such as a pinched nervebulging disc, ruptured disc or slipped disc. These terms tend to be used somewhat differently among health professionals because there are no generally agreed upon definitions for many disc problems. Interchangeable terminology can be confusing and frustrating for patients who hear their condition referred to in different terms by different practitioners, causing the patients to remain unclear as to the real diagnosis.
 
  • The extent of disc problem or disc herniation does not necessarily correlate to the patient’s level of pain. Although it may seem contrary to common sense, the severity of pain from a herniated disc does not always correlate to the amount of physical damage to the disc. Additionally, less serious back problems may cause more pain than a herniated disc. For example, a large herniated disc can be completely painless, while a muscle spasm from a simple back strain may cause excruciating pain. This means that the severity of pain is not a determining factor for identifying a herniated disc.
 
  • Many herniated discs do not cause any pain. Imaging of a disc herniation are common (such as from an MRI or CT scan), but oftentimes the herniated disc is not associated with any pain or symptoms. While there may be an association between trauma to the disc and the onset of the patient’s symptoms, a herniated disc also may occur without a specific, recalled event.  I often tell patients that a plain xray does not show the disc or any other soft tissue.
 
  • It is difficult to distinguish a herniated disc from other spinal problems. The nerves and anatomical structures—such as discs, muscles and ligaments in the spine—have a great deal of overlap. This makes it difficult for the brain to distinguish between problems with one structure in the back versus problems with another. For example, a herniated disc can feel similar to a bruised muscle or ligament damage.
 
  • Pain from a herniated disc is a complex personal experience. Physical and psychological factors are constantly changing and can contribute to a patient’s experience of pain. A herniated disc may not be painful at all times, or it may become even more painful because of psychological and other factors in the patient’s life. For example, many studies have established a correlation between back pain and depression.  The pain from a disc herniation also may become more severe when compounded with other physical problems in the spine, or situational factors (such as poor posture, sitting for a long period, etc).
 
Because of the complexities of understanding pain from a herniated disc, patients should not attempt to make their own diagnosis. An inaccurate self-diagnosis may lead to further damage to spinal structures or to more severe episodes of back pain or leg pain if the condition is left untreated or treated incorrectly. Working with a spine specialist helps ensure that the correct location of a herniated disc, extent of the problem and source of pain are identified early on.  
If any of you have any questions on what the neck or back problem might be or looking for suggestions or care feel free to call me!  Or ask me at CF!! 
 
Dr. Meghan