Long Answer: discs act as cushions between the vertebrae in your spine. They’re composed of a tough outer layer of cartilage that surrounds a softer material in the center. It may help to think of them as miniature jelly doughnuts, exactly the right size to fit between your vertebrae.

A bulging disc simply extends outside the space it should normally occupy. The bulge typically affects a large portion of the disc, so it may look a little like a hamburger that’s too big for its bun. Usually bulging is considered part of the normal aging process of the disc and is therefore common to see on MRIs.

A herniated disc, on the other hand, results when a crack in the tough outer layer of cartilage allows some of the softer material inside to protrude out of the disc. Herniated discs are also called ruptured discs or slipped discs.

Bulging discs are more common, while herniated discs are more likely to cause pain. But many people have bulging discs or herniated discs that cause no pain whatsoever.

If you have any questions leave us a comment or contact us at zerospinepain.com

Image and article from mayoclinic.com

What causes sciatica?
The most common cause of sciatica is a bulging or ruptured disc (herniated disc) in the spine pressing against the nerve roots that lead to the sciatic nerve. But sciatica also can be a symptom of other conditions that affect the spine, such as narrowing of the spinal canal (spinal stenosis), bone spurs (small, bony growths that form along joints) caused by arthritis, or nerve root compression (pinched nerve) caused by injury.

What are the symptoms?
Symptoms of sciatica include pain that begins in your back or buttocks and moves down your leg and may move into your foot. Weakness, tingling, or numbness in the leg may also occur.

• Sitting, standing for a long time, and movements that cause the spine to flex (such as knee-to-chest exercises) may make symptoms worse.
• Walking, lying down, and movements that extend the spine (such as shoulder lifts) may relieve symptoms.

How is sciatica diagnosed?
Sciatica is diagnosed with a medical history and physical exam. Our specialists at The Minimally Invasive Spine Institute will ask you questions about your symptoms. In some cases just asking you these questions is enough to diagnose that you have sciatica, but X-rays and tests such as magnetic resonance imaging (MRI) & Pain Mapping are done to help find the exact cause of the sciatica.

How is it treated?
In some cases, sciatica will improve and go away with time. Initial treatment can focus on medicines and exercises to relieve pain. You can help relieve pain by:

• Avoiding sitting (unless it is more comfortable than standing).
• Alternating lying down with short walks. Increase your walking distance as you are able to without pain.
• Taking acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil) or naproxen (Aleve).
• Using a heating pad on a low or medium setting, or a warm shower, for 15 to 20 minutes every 2 to 3 hours. You can also try an ice pack for 10 to 15 minutes every 2 to 3 hours. There is not strong evidence that either heat or ice will help, but you can try them to see if they help you.

Additional treatment for sciatica depends on what is causing the nerve irritation. If your symptoms do not improve, we may suggest physical therapy, injections, or even surgery. Learn more about our minimally invasive procedures at zerospinepain.com.

A pinched nerve can occur anywhere in your body. For example, a herniated disc in your spine (neck, thoracic or lumbar) may put pressure on a nerve root, causing pain that radiates down the back of your leg (sciatica), or down your arms or hands. Another common type of pinched nerve is the median nerve in the carpal tunnel in your wrist; compression of that nerve can lead to pain and numbness in your hand and fingers (carpal tunnel syndrome). These are just two common examples of pinched nerves; many other nerves can be pinched including those in your neck, shoulder, elbow and other areas.

With rest and other conservative treatments, most people recover from a pinched nerve within a few days or weeks. In some cases, however, surgery is necessary.

Symptoms:

• Numbness or decreased sensation in the area supplied by the nerve.
• Sharp or burning pain, which may radiate outward. When the pinched nerve comes from the spinal cord, coughing or sneezing may aggravate the pain.
• Tingling, “pins and needles” sensations (paresthesia).
• Muscle weakness or twitching in the affected area.
• Frequent feeling that a foot or hand has “fallen asleep.”

Our Approach to Pinched Nerve Repair:
Many things can cause a pinched nerve. Whether it’s facet disease and bone spurs, disc bulges or herniations, or thickened ligaments due to arthritis, the Minimally Invasive Spine Institute can treat the source minimally invasively with a tiny laser through a 7 or 15 mm incision to free the nerve and rid you of your pain. And because we do not use expandable retractors, like many others who claim to do minimally invasive surgery, we avoid cutting muscle altogether, so you can get back to life as quickly as possible.

If you have a question about our approach to repairing pinched nerves leave us a comment below, read more on our website, or contact us.

What is a bone spur?

A bone spur (also referred to as an osteophyte) is a bony growth formed on normal bone. Most people think of something sharp when they think of a “spur,” but a bone spur is just extra bone. It’s usually smooth, but it can cause wear and tear or pain if it presses or rubs on other bones or soft tissues such as ligaments, tendons, or nerves in the body. Common places for bone spurs include the spine, shoulders, hands, hips, knees, and feet.

Click here to see an example of a bone spur

In the picture linked above is an example of three small bone spurs on a pig specimen. Picture credit to Wikipedia.

A bone spur forms as the body tries to repair itself by building extra bone. It generally forms in response to pressure, rubbing, or stress that continues over a long period of time.

Some bone spurs form as part of the aging process. As we age, the slippery tissue called cartilage that covers the ends of the bones within joints breaks down and eventually wears away. In addition, the discs that provide cushioning between the bones of the spine may break down with age. Over time, this leads to pain and swelling and, in some cases, bone spurs forming along the edges of the joint. Bone spurs due to aging are especially common in the joints of the spine and feet.

Can you remove my bone spur?

Using the most minimally invasive techniques available, we can enter through a tiny 7 or 15 mm incision to shave the bone spurs off and free the nerve and rid you of your pain without causing any trauma to your body.

Common symptoms include:

• Back pain that comes and goes
• Spinal stiffness in the morning, such as after getting out of bed or after activity
• Pain, tenderness or numbness in the neck
• Lower back pain that runs down into the buttocks, thighs, or pelvic area
• Pain or tenderness in the shoulders, hips, knees or heels
• A crunching feeling or sound of bone rubbing on bone
• Weakness or numbness in legs or arms
• Limited range of motion, difficulty bending or walking
• Spinal deformity

Read our blog post Minimally Invasive Arthritis and Bone Spur Repair

ZeroSpinePain.com or @ZeroSpinePain
Bone spur facts are from WedMD (link)

Definition:
Arthritis can affect any part of the body, even the spine. It occurs when the cartilage in the joints are worn down as a result of wear and tear, aging, injury or misuse. Osteoarthritis, the most common form of arthritis, also includes loss of cartilage, overgrowth of bone and the formation of bone spurs. This causes the bones under the cartilage to rub together, causing pain, swelling and loss of motion of the joint. Osteoarthritis can occur in any joint but most often occurs in the hips, knees, hands or spine.

In the spine, osteoarthritis can cause stiffness and pain in the neck or in the lower back. Cervical arthritis (also called cervical spondylosis) affects the upper spine and neck. Lumbar or lumbosacral arthritis affects the lower back and pelvic area. Ankylosing spondylitis is another type of spinal arthritis.

Symptoms:

• Back pain that comes and goes
• Spinal stiffness in the morning, such as after getting out of bed or after activity
• Pain, tenderness or numbness in the neck
• Lower back pain that runs down into the buttocks, thighs, or pelvic area
• Pain or tenderness in the shoulders, hips, knees or heels
• A crunching feeling or sound of bone rubbing on bone
• Weakness or numbness in legs or arms
• Limited range of motion, difficulty bending or walking
• Spinal deformity

Learn how we can help your with our 5 step program.

As more and more healthcare facilities use the phrase “minimally invasive,” a few surgery centers have started to push the phrase “laser spine surgery” and it has caused some confusion on the difference between minimally invasive spine surgery and laser spine surgery.

The truth is, these key marketing phrases like laser spine surgery do not mean that they are providing a more advanced minimally invasive service. The laser is simply used to perform the cutting of the spinal components, for example the herniated disc.

“You don’t necessarily need a laser to perform these procedures,” says Doctor Won, “because a coagulating device, which is a lot cheaper, can achieve about the same amount of work.”

Dr. Won goes on to say that “sometimes the laser does make the procedure easier, but people love the word laser.” The phrase ‘laser spine surgery’ is “mainly for marketing.”

Whether the surgeons use a laser or a coagulating device, those tools are not the differentiating factor that makes this procedure innovative. The key to minimally invasive spine surgery is that the incision is only 3mm which leads to less anesthesia, less recovery time, less trauma, less blood loss, and less scarring.

So the point is, laser spine surgery is not any different from minimally invasive spine surgery. Laser spine surgery is a method of minimally invasive spine surgery. It is merely a part of the process, not a new technique.

In fact, what these doctors are doing is a minimally invasive procedure. Below is a screenshot of the procedure that they aired yesterday morning. It’s obvious that the patient is in no pain. In fact he’s sitting right there in the studio in a suit and tie!

Below is a shot of the endoscope that the doctors are using to perform the procedure. It’s likely that this endoscope is not exactly the same model that we use at The Minimally Invasive Spine Institute, but the point is that minimally invasive procedures are just as Diane described it in the video, “painless” and the recovery is so quick that you can quickly return to work.

You can watch the procedure on the ABC news website.

Scoliosis – It is not a disease, it’s a descriptive term used to describe the way in which a person’s spine is curved from side to side, shaped like an “S”. All spines have curves. We need these spinal curves to help the upper body maintain proper balance and alignment over the pelvis. However, when there are abnormal side-to-side curves in the spinal column, it is refered to as scoliosis.

Endoscopy The use of an instrument called an endoscope to look inside the body. It is a minimally invasive diagnostic medical procedure that is used to assess the interior surfaces of an organ by inserting a tube into the body.

As shown in the picture on the right, a endoscope is consists of
- a rigid or flexible tube
- a light delivery system to illuminate the organ or object under inspection
- a lens system transmitting the image to the viewer from the fiberscope
- an additional channel to allow entry of medical instruments or manipulators

Minimally Invasive Procedure – It refers to a less invasive procedure than traditional open surgery. A minimally invasive procedure involves the use of laparoscopic devices and remote-control manipulation of instruments with indirect observation of the surgical field through an endoscope or similar device. The procedure is carried out through the skin, a body cavity, or an anatomical opening.

Read part one here.

Degenerative Disc Disease

The term “degenerative”, which means deterioration over time, implies that the symptoms will get worse with age. While it is true that the disc degeneration is likely to progress over time, the low back pain from degenerative disc disease usually does not get worse and in fact usually gets better over time. It is often that case that these symptoms can be treated without surgery! Less than 10% of patients need intervention or treatment beyond rest, over the counter medications, or physical therapy.

And finally the term “disease” is cause for much confusion. Degenerative disc disease is not really a disease at all, but rather it is referring to the more general meaning of disease, a condition that causes pain, dysfunction, or distress to the afflicted.

Herniated Disc – A herniated disk is sometimes referred to as a slipped disk or a ruptured disk. It is often the result of an injury or trauma to the spine.

Your spinal column is made up of bones (vertebrae) that are cushioned by small disks consisting of a tough outer layer (annulus) and a soft, jelly-like inner layer (nucleus). These disks act as shock absorbers, protecting the spine and nerves from the stress of everyday tasks – as well as strenuous work such as heavy lifting.

When a disk “herniates,” a tear or weakness in the annulus allows the jelly-like nucleus to push out into the spinal canal. If it puts pressure on a spinal nerve, the herniated disk can cause pain, numbness or weakness in the back, legs or arms – depending on where the disk is located. Herniated disks are most common in the lower spine, but about 10% occur in the neck.

We’ll define and explain more words concerning back pain in the next post. Subscribe to our RSS feed so you don’t miss it! Subscribe using RSS or receive an email each time we publish a new post.