Do all Disk herniations Cause Pain?

Do all Disk herniations Cause Pain?

Do all Disk herniations Cause Pain?

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Surprisingly,  many disk herniations are not associated with pain.  The classic 1990 paper written by Boden et al demonstrated the prevalence of significant lumbar MRI findings in asymptomatic individuals.

As a Doctor,  and Spine Specialist,  I know this to be true.  I see it almost on a daily basis in my office.  There is too common a scenario where a patient with back pain will insist on an MRI study of the back.  By the time the MRI is authorized,  and obtained,  the patient is pain free.   Still,  most will undergo the MRI,  and the images will show a disk herniation.    At that point,  there are often multiple factors that will lead both the Patient and the Doctor to conclude the MRI finding must have been the cause of the pain.  In reality,  there is no solid proof that the findings on the MRI was the cause of the transient back pain.

As a non physician,  most have also heard  “My Doc says I have a few bulging disks in my back” from friends,  family and co-workers.   Yet,  strangely,  the one declaring the bulging disks seem to be doing all sorts of activities that should be avoided because of the “bulged disk”.   If you think about it,  the “bulged or slipped disk” identified on the study probably was not causing pain,  as that person is not limited in any activities.

The reality is we do not completely understand why some people with large disk herniations are completely symptom free,  while others have tremendous impairment.

What we Spine Surgeons do know,  is that unless the findings on the MRI correspond with a specific pattern of complaints and physical examination findings,  the disk herniation may not be the source of the pain.  In that scenario,  any surgery to remove a disk herniation may not relieve the pain.  As surgeons develop more experience,  they recognize the nuances of the patterns,  and are better deciding  WHEN to do the surgery,  not just HOW to do the surgery.

Citations

  • Abdul Jalil MF, Lam MF, Wang YY. Is that lumbar disc symptomatic? Herniated lumbar disc associated with contralateral radiculopathy. BMJ Case Rep. 2014 May 7;2014 PubMed PMID: 24811105

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Author and Contributor to www.Spine-Health.com – July, 2015

www.Spine-Health.com/author/john-h-shim-md-facs

Chief of Surgery, Mease Countryside and Mease Dunedin Hospitals, Safety Harbor and Dunedin, Florida. 2014-2016.

Orthopaedic Section Chief Mease Countryside Hospital; Safety Harbor, Florida Mease Dunedin Hospital; Dunedin, Florida.2008-2013

Board Member Morton Plant Mease Research Council

Co-Director of Mease Neuro-Ortho Spine Center Mease Dunedin Hospital; Dunedin, Florida.

One of “6 Spine Physicians Ranked #1 on Google” – December 2016

Top Ten Most Liked Spine Surgeons on the Internet – July 2016

2016 Spine Surgeons to Know list – January 2016

2014 Spine Specialists to know list – September 2014

One of Ten Leaders of Certified Spine Programs – December 2011

 

The Best Orthopedics in Tampa

The information provided on this website does not provide or should be considered medical advice. It is not a substitute for diagnosis or treatment of any condition. The information provided is for informational purposes only. You should not rely solely on the information provided on this website in making a decision to pursue a specific treatment or advice. You should consult directly with a professional healthcare provider.

As a condition of using the information on this website, ShimSpine and its physicians are not responsible for any advice, diagnosis, treatment or outcome you may obtain.

ShimSpine.com is completely self-funded. No outside funds are accepted or used. This website does not utilize paid advertising as a source of revenue.
Outpatient Spine Surgery Considerations. www.Spine-Health.com. January 2016.

What is Spinal Stenosis? www.Spine-Health.com. October 2015.

Surgeon insights on the Changing Landscape of Orthopedic Care. OrthopedicToday. June 2014

Chapter 33: Interspinous Spacers. Shim JH, Mazza JS, Kim DH Published in Minimally Invasive Percutaneous Spinal Techniques. Elsevier Health Sciences, Philadelphia, Pennsylvania. (Published 2011)

Chapter 35: Minimally Invasive Percutaneous Lumbar Fusion Technique.Shim JH, Mazza JS, Kim DH Published in Minimally Invasive Percutaneous Spinal Techniques. Elsevier Health Sciences, Philadelphia, Pennsylvania. (Published 2011)

March 2010 Minimally Invasive Transforaminal Lumbar Interbody Fusion American Academy of Orthopaedic Surgeons Annual Meeting New Orleans, Louisiana February 2010

February 2010 A Review of Dynamic Stabilization in the Lumbar Spine Selby Spine Symposium; Park City, Utah

November 2009 Lumbar Spinal Stenosis Community Based Lecture; Tampa, Florida

September 2009 Instructor/Proctor Minimally Invasive Lumbar Cadaver Lab; Tampa, Florida

February 2009 New Spinal Technology: Cervical Disc Replacement and Interspinous Spacers. Selby Spine Symposium; Park City, Utah

February 2008 The Degenerative Spine: The Role of Dynamic Lumbar Stablization and Interspinous Spacers Selby Spine Symposium; Park City, Utah

October 2008 Emerging Technology and Techniques in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

September 2007 Emerging Technology in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

October 2006 Emerging Technology and Techniques in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

May 2005 The Role of Kyphoplasty in the Treatment of Vertebral Compression Fractures Mease Neurosciences Symposium; Clearwater, Florida
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