HEALTH & WELLNESS
Lumbar disc herniation or a pinched nerve?
Many refer to their discomfort as being a pinched
nerve or a herniated disc. The two conditions are the
most common source of the pain, but they are both
different issues that happen to occur at the same
time.
Typically, a herniated disc occurs in the cervical
spine (neck) and the lumbar spine (back). Disc pain
tends to most often take place in the lower back,
where most weight-bearing and movement in the
DR. CHU-
spine occurs. A pinched nerve is caused by a herni-
KUANG
ated disc pressing against the nerve. In most cases,
CHEN
a herniated disc itself is not painful, but the leaking
gel substance that it contains pinches, inflames and
irritates the nearby nerve.
The spine is made of 24 bones called vertebrae, but the lumbar
(lower back) bears most of the weight of the body. In between each
of the five lumbar vertebrae is a disc which acts like a tough fibrous
shock-absorbing pad, preventing the vertebrae from rubbing to-
gether. A disc is filled with a gel-like center. If the disc ruptures or
bulges, this gel escapes and causes irritation to the spinal nerves
resulting in inflammation, pressure and pain. Some may also expe-
rience leg pain, numbness and tingling.
The spine contains many nerves that branch out and travel to
various parts of the body. If a disc herniates, it usually presses on
the spinal cord or spinal nerves, which pass through small areas
between the vertebrae and discs. If a herniated disc presses into
the area, it can compress (“pinch”) the nerve, which causes pain.
A herniation may develop instantly or gradually over weeks or
months. Factors that increase the risk include lifestyle choices, ag-
ing, poor posture, obesity, inadequate nutrition and lack of regu-
lar exercise as well as tobacco use. As the body ages, biochemical
changes can cause the discs to dry out and be less capable to ab-
sorb shock from movement. Additionally, body mechanics such as
incorrect lifting and twisting combined with daily wear and tear
put stress on the lumbar spine. Rheumatoid arthritis and genetics
may also contribute.
It’s important to seek medical attention for numbness, weak-
ness, tingling and extreme burning or pain. An X-ray may be need-
ed to rule out any other causes of back pain. Imaging tests such as a
CT or MRI scan can verify the extent and location of any damage to
the soft tissues. Sometimes a myelogram (injection of dye) is need-
ed so the physician can view the problem area more easily.
The condition is most often treated with rest, pain medication,
spinal injections and physical therapy. Many find improvement in
approximately six weeks and return to normal activity. However,
those with continuing symptoms may be recommended for sur-
gery. Over time, the herniation may shrink and the pain will sub-
side, perhaps eventually disappearing entirely.
Chu-Kuang Chen, M.D., Ph.D., is the medical director at Princeton
Pain Management. He is board-certified in anesthesiology and pain
medicine. Dr. Chen has special expertise in neck pain, back pain,
fibromyalgia, primary headache disorders, sciatica, sports injuries,
vertebroplasty (kyphoplasty) and cancer-related pain. He has re-
ceived the Patients’ Choice Award and Compassionate Doctor Recog-
nition Awards from Princeton Pain Management, has an outstand-
ing patient satisfaction reputation and is located in the Medical Arts
Pavilion, 5 Plainsboro Road, Plainsboro, NJ 08536. To schedule an
appointment, please call 609-497-4371 or visit www.princetonpain-
management.com.
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■ JANUARY 2019 73