How Common are Disc Herniations?

August 14, 2017 by Dr. Shim2
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Surprisingly,  I am rarely asked  questions about frequency of disc herniations.  But the answer is, it is very common. The better question is, “Is the disc herniation seen on the MRI the cause of my pain?”.  The answer to that question is maybe.

Research has demonstrated that findings of disc protrusions, disc hernations, and disc degeneration are very common finding in most people over the age of 50.  Because of these findings,  we often find ourselves blaming our pains on these disk anomalies.  While that may be true, in other scenario’s, it is not the case.

In fact, there has been studies on the incidence of these findings in our more active, or athletic population.  Surprisingly,  some studies have shown the incidence of advanced degenerative disk problems is not different from our less active population.

MRI’s have been very commonly used.  Without editorializing on the necessity of using this test,  we now have more and more information on the incident of spinal conditions in our population.  It turns out that there is a plurality of patients that have disc protrusion/hernation/degeneration.  Likewise,  we know that within your life time,  there is an 80% chance that each and everyone of us will have an episode of back pain that will limit our abilities to work,  and change our lifestyles for at least a few weeks.  But,  we still may not know if you back pain is caused by the findings on the MRI.  Usually, you will need a detailed examination to determine if the back pain is more that a pulled muscle, versus a significantly pinched nerve.

So,  when you have an episode of back pain,  while it is not a consolation at the time,  please understand that is an common experience by most of humanity.

But,  in rare occasions,  this back pain can be a more serious problem.  If you have severe pain, with associated weakness of the legs,  numbness, or loss of control of your bladder/bowels,  you must discuss this situation with your physician immediately. In the worse case scenario,  you need to be emergently admitted to the hospital for testing, and possible surgery.

If you do not have the above,  sometimes your physician may recommend some medications and gentle exercise or physical therapy.  But,  if you do not make improvement within a few weeks,  you should consider getting  further evaluations by a spine specialist.

Thankfully,  most episodes of back pain, and disc herniations usually can be managed with medications, activities modifications and therapy.  If you have questions,  please contact your physician.

 

Citations

  • Al-Ryalat NT, Saleh SA, Mahafza WS, Samara OA, Ryalat AT, Al-Hadidy AM. Myelopathy associated with age-related cervical disc herniation: a retrospective review of magnetic resonance images. Ann Saudi Med. 2017 Mar-Apr;37(2):130-137. PubMed PMID: 28377542
  • Liu C, Huang CC, Hsu CC, Lin HJ, Guo HR, Su SB, Wang JJ, Weng SF. Higher risk for cervical herniated intervertebral disc in physicians: A retrospective nationwide population-based cohort study with claims analysis. Medicine (Baltimore). 2016 Oct;95(41):e5055. PubMed PMID: 27741118

2 comments

  • Anthony Castelli

    February 10, 2013 at 9:34 pm

    Dr Shim

    As a personal injury lawyer I’m interested in proving if a disk injury was caused by trauma. Is there any way to objectively prove this . Most Doctor’s just give the reason as the history of the patient .

    Reply

    • Dr. Shim

      February 10, 2013 at 10:47 pm

      Mr. Castelli,

      I did write you a response on the Google+ Spine Surgery Community. But, to your specific point, in the most perfect scenario, there is an MRI of the spine prior to the trauma. Then there is an MRI immediately after the trauma. There is then evidence that there is a change in the disk, which, if there is corresponding pain, can be objective evidence that the disk change was caused by the trauma. Rarely, however, is there evidence of acuteness of the disk, such as hemorrhage, or soft tissue edema around the disk. Usually, if this happens, there is an associated fracture or dislocation, or instability of that disk level, that would be evident on x-rays, and on flexion/ext views. Sometimes, secondary to spasms, Flexion/ext views are not possible. But, to your point, it usually does come down to history in relationship to the timing of development of disk related pain. In the end, it usually comes down to history, and credibility.

      Reply

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Last modified: August 15, 2017