5 Bulging Disc Symptoms You Should Know
It’s a popular misconception that bulging discs are the same as herniated (or “slipped”) discs. And, as far as spinal problems go, each issue does fall within the same category. The conditions even boast similar symptoms, and in some cases, they share the same root causes.
Considering these facts, it’s no wonder that people often confuse the two for one another. At the end of the day, however, follow this simple piece of advice: Seek out medical treatment if your symptoms persist over a period of two weeks or more.
Naturally, the most common similarity between these conditions is the area of the body that they affect. As you have perhaps guessed, each of these ailments results in damage to the body’s discs. For context, intervertebral discs are spongy structures that rest between the bony vertebrae of the spine. They are essentially akin to jelly donuts. They have a hard outer shell with a softer filling in the center.
Similar to how synovial fluid lubricates your joints, discs serve as a special type of cushion in between your vertebrae. These rubber spacers increase the flexibility of your spine and safeguard it from damage. When these structures suffer injury, however, it can result in a slew of painful symptoms.
Luckily, there are plenty of both conservative and surgical treatments available for bulging discs. Usually, surgery is not necessary, but if less invasive methods prove ineffective, then your doctor may consider a special procedure to treat your symptoms. For more information about your options, please contact Orthopedic & Laser Spine Surgery at (855) 853-6542.
What Causes Bulging Discs?
A lot of problems involving the discs of the spine are traceable to natural degenerative processes. Your spine is a complex structure with many moving parts that work in tandem to achieve even the most basic forms of movement. Like all things mechanical, repetitive use of any system eventually results in the parts becoming damaged. Of course, you have no choice but to use your spine on a daily basis. Degeneration just comes as a natural part of the aging process.
It would be incorrect to assume, however, that degeneration is the only way to fall victim to a bulging disc. While everyone experiences some form of age-related wear and tear that doesn’t mean everyone develops a bulging disc. That being said, you may experience a bulging disc because of trauma from events such as a car accident or fall. Additionally, there are other risk factors that contribute to the formation of bulging discs. These include factors such as genetic predisposition and congenital disc deformities, for example.
So, what exactly is a bulging disc? A bulging disc refers to an instance in which outside pressure on the structure results in the disc ballooning outward. Similar to a herniated disc, this distension can cause pressure on adjacent nerve endings, or in some cases, even the spinal cord itself. In rare instances, this causes no symptoms at all, meaning that you could have a bulging disc and not even know it. In other instances, however, the patient may experience a slew of negative symptoms that interfere with his or her everyday life.
Signs That You May Have a Bulging Disc
Bulging discs typically occur at the cervical (neck) and thoracic (mid) levels of the spine. The location of the condition is relevant, as it affects the symptoms you may experience. Generally speaking, however, you should watch out for the five following symptoms:
- Pain: This should be obvious, but it is important to note that pain in and of itself has interesting properties—especially when it comes to issues regarding the spine. Pain for a bulging disc may have a sudden or delayed onset. Additionally, depending on which nerves are pressured, it may even feel as if the pain is coming from elsewhere in the body, such as the extremities or your heart and kidneys. The pain may even appear to move around and radiate to other areas in the body, such as the arms and legs.
- Loss of Bladder/Bowel Functions: This is quite rare, but if you notice this symptom, seek out medical attention immediately. This symptom can indicate oncoming (and potentially permanent) paralysis of the limbs.
- Paralysis: You probably won’t experience this with your bulging disc, but if you do, your legs are more likely to be affected than your arms. If you experience this symptom, contact a doctor immediately.
- Muscle Weakness/Numbness: There is a good chance that the nerves affected by a bulging disc innervate muscles elsewhere in the body. When this happens, the muscles served by these nerves may weaken and lose sensation.
- Neurological Symptoms: Bulging discs are also known to cause tingling or “pins and needles” sensations in one or both legs. This is quite common, however, and not considered a serious complication like some of the items above.
How Are Bulging Discs Diagnosed?
If the doctor suspects that you have a bulging disc, there is a general set of steps that he or she will take to confirm a diagnosis. First of all, your doctor will ask you a series of questions involving your medical history as well as the nature of your symptoms.
After this questionnaire, your doctor will likely conduct a physical examination. This serves as a bit of an elaboration to the questions regarding your symptoms. Your doctor will evaluate your condition by performing specific motions or applying pressure to certain areas. Doing so allows your doctor to determine the location and severity of your pain. In addition, your doctor may also check the reflexes in your arms and legs to test for atrophied muscles.
Once your doctor has established a general idea of what is going on, he or she will order a series of diagnostic tests. Usually, with bulging discs, this means either a simple X-ray test or an MRI. Tests such as these not only confirm a diagnosis (once symptoms have been established), but they will also provide your doctor with an unobstructed view of the damaged structures.
Bulging Disc Treatment Options
As with most medical problems, bulging disc treatments can be divided into conservative and surgical options. Again, most of the time surgery is not necessary and typically your doctor will exhaust all conservative options before opting for a procedure. As far as conservative treatments go, there are a variety of viable options. For example, nerve root blocks and steroid injections will provide the patient with temporary relief for up to one year. (And, of course, this is a repeatable treatment). Over-the-counter pain medications may also provide adequate relief for patients with a bulging disc. In some cases, your doctor may even install a spinal cord stimulator to lessen the painful symptoms that occur with bulging discs.
But what if these methods don’t work? Generally, there are two common surgical procedures that doctors perform for bulging discs. Minimally invasive decompression surgery is a popular option that has a high success rate. As you might imagine, the goal of this procedure is to lessen the pressure that a bulging disc causes on adjacent spinal nerves. Your doctor accomplishes this feat by removing either infringing soft tissues (such as disc material) or offending bone matter (such as the lamina). By removing these structures that cause pressure on nearby nerves, negative symptoms begin to dissipate.
The other common procedure doctors perform for bulging discs is fusion. This shares a similar goal with decompression surgery. For instance, the doctor will remove damaged disc tissue that presses on nearby nerves. However, fusion also involves fusing bones together in order to increase stability in the spine. As you can guess, this naturally requires more specialized hardware. Like decompression surgery, this procedure may also be performed in a minimally invasive fashion. If possible, this offers a faster recovery time and is considered generally safer than traditional open surgery.
Are you experiencing any of the negative symptoms mentioned above? If so, it’s not a bad idea to get in touch with Orthopedic & Laser Spine Surgery. At our facilities, you will find highly trained, board-certified surgeons as well as a passionate medical staff. Our team will work tirelessly to ensure that you receive an individualized treatment plan that works best for the specifics of your case. Don’t hesitate to get in touch with us today. We will make sure that you are able to return to your normal activities as soon as possible.
6 Types of Spinal Decompression Surgery
Spinal nerve compression can cause pain, weakness, and other serious neuromuscular issues. For some, the best answer to ensure symptom relief is surgery.
Of course, surgery can be intimidating—especially when it involves the spine. What exactly happens when you undergo surgery for your spinal nerve compression? Spinal decompression surgery actually refers to a variety of procedures. The best procedure for you will depend on the cause of your symptoms.
Let’s take a look at what causes spinal nerve compression. Then, you can get a better understanding of the types of surgeries that can relieve this painful (and sometimes dangerous) condition.
What is Spinal Nerve Compression?
A variety of factors can cause spinal nerve compression. In general, doctors refer to any condition that applies pressure to the spinal cord or nerve roots as spinal nerve compression.
As you probably know, the spinal cord is a bundle of nerves that carries messages between your brain and the rest of the body. The spinal cord is protected by a series of bones known as vertebrae. Collectively, these bones make up the spinal column. The spinal column contains a “tunnel”—known as the spinal canal. This passageway houses the spinal cord. In addition, nerves radiate outward from the spinal cord to the rest of the body through openings in our vertebrae.
Sometimes known as spinal stenosis, spinal nerve compression occurs when the spinal canal narrows. This reduced space can cause a pinched nerve ( known as radiculopathy). In general, this process occurs in older adults as the bones and joints start to suffer from wear and tear—a condition referred to as osteoarthritis. Other factors can affect the narrowing of the spinal canal including:
- Injuries or trauma to the spine
- Spinal tumors
- Rheumatoid arthritis
- Spinal infections
- Misalignment of the spine
- Bulging or herniated disc
- Degenerative disc disease
Symptoms of Spinal Nerve Compression
In the case of osteoarthritis, symptoms may take years to develop. Other forms of spinal compression, however, can have a relatively quick onset of symptoms. The most common symptoms of compression include:
- Pain in the neck or back
- Radiculopathy—radiating pain that spreads to other areas of the body
- Sciatica—burning pain that originates in the buttocks and spreads down the legs
- Cramping, weakness, or numbness in the extremities
- Difficulty with coordination, especially in the hands or legs
- Foot weakness that causes you to limp (aka foot drop)
Severe cases can cause loss of bowel or bladder control, numbness in the legs, and difficulty walking. If you experience any of these symptoms, seek medical attention immediately. Your symptoms could indicate the onset of cauda equina syndrome—a very serious condition that can lead to permanent paralysis.
Is Spinal Decompression Surgery Right for Me?
Before choosing to undergo surgery, your doctor may recommend several conservative treatments. These may include physical therapy or managing your pain with medications. In fact, surgery is often considered a last resort to nerve pain unless you show signs of cauda equina syndrome or unresolved pain.
Good candidates for spinal decompression surgery often experience:
- Little to no relief after conservative treatments
- Significant and disabling pain
- Weakness or numbness in the leg or foot
- Symptoms that become rapidly worse
- Difficulty standing or walking
- Declining quality of life
- Diagnostic imaging that indicates a narrowing of the central canal
Types of Spinal Decompression Surgery
If your condition warrants surgery, then you will want to consult with a board-certified spine surgeon. Your surgeon will conduct pre-surgical and diagnostic tests to help determine the best procedure for you. The primary goal of these surgeries is to relieve pressure on the affected spinal nerve. The most common decompression surgeries include:
Laminectomy or Laminotomy
The lamina is a bony arch at the back of the vertebrae. It helps to shape the spinal canal. In some cases, abnormal bone growths—known as bone spurs—decrease the opening of the spinal canal. Bone spurs can develop for a variety of reasons, including arthritis of the facet joints, heredity factors, or injuries.
A laminectomy involves removing the entire lamina to make more space for the spinal canal. In addition, your surgeon may elect to only remove part of the lamina—for example, to remove bone spurs. This procedure is called a laminotomy. One significant benefit of a laminotomy over a laminectomy is the decreased chance of developing spinal instability.
Both procedures also remove portions of ligaments—known as the ligamentum flavum, which runsover the spinal nerves and cord.
If your compression involves the cervical (neck) area of the spine, then your surgeon may choose to perform a laminoplasty. This procedure allows for expansion of the spinal canal by cutting the cervical vertebrae such that they swing open like a door. Then, small bone wedges are placed in the open space. Once the bone “door” is closed by the surgeon, the wedges stop it from closing too much.
The natural aging process or trauma can damage the circular discs between the vertebrae. When these discs lose shape, the spine can become unstable. This, in turn, can lead to nerve compression.
During a discectomy, the surgeon removes portions or the entirety of a damaged disc. In some cases, removing only a small piece of a disc may be the best solution. Known as a microdiscectomy, this procedure involves the excision of the parts of a damaged disc that press on a nerve. Microdiscectomies may not require any further surgical intervention. When the entire disc is removed, however, the surgeon may perform additional procedures to stabilize the spine (discussed later).
Nerve roots pass through an opening in the vertebrae known as the foramen. A foraminotomy involves removing some bone on the edge of the foramen to make more space for the nerves. If an intervertebral disc presses against the nerve root, then a portion of it may be removed during this procedure.
Removing discs from one or more vertebrae, as well as other more complicated procedures, may require spinal fusion surgery. A fusion surgery stabilizes the spine with bone grafts and surgical hardware. In time, the vertebrae fuse together as one solid bone. This increases the stability of the spinal column and may prevent further instances of nerve irritation.
Recovery from Cervical or Lumbar Decompressive Surgery
Most of these procedures require general anesthesia. After surgery, you will be transferred to a recovery room where your vital signs will be monitored until the anesthesia wears off. Depending on the surgery, you may spend a day or two in the hospital to ensure that you are stable and the surgery was a success. Before being released from the hospital, you will receive a full set of discharge instructions.
Pain medications may help with any discomfort after surgery. In addition, you may need to ice the incision area a few times a day to reduce pain and swelling. The surgeon will let you know when you can resume normal activities. Physical therapy may also be part of the recovery process.
Following your discharge instructions and any therapy recommendations will increase the likelihood of a successful surgery. A majority of people undergoing spinal decompression surgery report pain relief and better nerve function in the long-term.
Ready to Take the Next Steps for a Better Future?
If you are looking for solutions to your neck or back pain, consulting with an orthopedic doctor can be the first step in helping you live a better life. An orthopedic doctor can accurately diagnose the cause of your pain and empower you to choose the best conservative and/or surgical options.
The team at Orthopedic & Laser Spine Surgery uses the latest research-based treatments to ensure that you receive the care you need. If surgery is necessary, then we specialize in minimally invasive procedures. Using the latest equipment and techniques, we can reduce scarring, internal damage, and postoperative pain. As a result, you feel better quicker and need less time before you can resume your normal activities.
A life-changing consultation is only a phone call away. Call us at (855) 853-6542 and find out how our board-certified experts can help.
Do You Have Femoroacetabular Impingement?
Are you suffering from pain in the groin or hip area? Hip pain can result from a variety of injuries or conditions. Understanding what causes your discomfort is often the first step in treating symptoms and preventing future injuries.
Femoroacetabular Impingement (FAI) occurs when extra bone develops on or near the hip joint. Sometimes referred to osteophytes or bone spurs, these growths can disrupt the movements of the hip bones. Over time, the friction generated by these bone spurs can damage the joint and limit your activity.
How do you know if you have FAI? Let’s take a closer look at the hip joint and how this condition affects your hips. Then, we’ll look at the best treatment options to reduce pain and restore function to the area.
Understanding the Hip Joint
The hip joint is one of the largest joints in the body. It also plays a key role in weight-bearing activities. Walking, running, and other vigorous activities can apply a lot of stress to the joints. Luckily, a healthy hip can support your weight, easily withstanding these stressors. Disease and injury, however, can alter the hip structure which, in turn, affects its function.
The ball-and-socket joint of the hip connects two bones—the thigh bone (femur) and the pelvis. The round femoral head fits snugly into a “socket” known as the acetabulum. Think of the acetabulum as a cup-shaped structure and the femoral head as slightly more than half a sphere. A smooth layer of articular cartilage covers the bones in the joint. The body produces synovial fluid to keep the cartilage slippery so the bones can move past each other without damage. Another ring of strong cartilage—known as the labrum—lines the outer edge of the acetabulum. The labrum deepens the joint, allowing for enhanced range of motion and joint alignment.
In addition, a series of ligaments and muscles hold the hip joint in place, delivering stability. Some of the strongest ligaments in the body are located at or near the hip joint. Muscles allow the bones associated with the hip to bend, straighten, rotate, and move the leg to and away from the midline.
What is Femoroacetabular Impingement?
FAI occurs when abnormal bone growths form around the femoral head or acetabulum. However, the exact cause of FAI is unknown. It’s believed that genetics and pediatric hip diseases, like coxa vara or Legg-Calve-Perthes disease, increase the likelihood of developing FAI. Additionally, participating in high-impact sports such as hockey or basketball during adolescence may play a role. Sports, however, do not seem to cause FAI. They simple hasten the onset and severity of the symptoms.
Furthermore, hip impingement can occur in three different ways:
- Pincer Impingement: Occurs when the bone growth extends over the rim of the acetabulum. As a result, the labrum may become damaged.
- Cam Impingement: Occurs when a bump forms on the femoral head. When the head loses its typical round shape, it cannot move smoothly around the inside of the acetabulum.
- Combined Impingement: As the name suggests, this is when growths are found on both the femoral head and acetabulum.
Symptoms of Femoroacetabular Impingement (FAI)
In minor cases, some individuals may not even realize that they have FAI. In fact, people with FAI can live normal, active lives without experiencing much discomfort. However, others can gradually develop symptoms when damage to the surrounding soft tissues occurs. Symptoms of FAI include:
- Stiffness in the groin, hip, or thigh
- Groin or hip pain—especially after running, exercise, or sitting for extended periods of time
- Difficulty flexing the hip beyond a right angle
- Reduced range of motion including difficulty flexing, rotating, and adducting the hip
- Painful locking, clicking, or instability related to labral tearing
In addition, the damage caused by FAI may also lead to hip osteoarthritis. This occurs when the impingement causes the cartilage to wear off the bones in the hip socket. Likewise, the rubbing together of bones causes swelling, pain, and loss of motion in the joint.
Diagnosing Femoroacetabular Impingement (FAI)
If you’re experiencing symptoms like those discussed above, you may want to get checked out by a doctor. Several other conditions cause similar symptoms, including hip pain. Pinpointing the exact cause of your hip pain makes treating it much more effective.
A doctor’s visit usually begins with a full review of your medical history and overall health. This includes discussing current and previous occupational or recreational activities that may have contributed to your hip condition.
If FAI is suspected, the doctor generally performs an impingement test. The doctor conducts this test while you lie on your back. Your knee is brought to your chest and gently rotated toward your opposite shoulder. If you feel pain or it recreates your symptoms, you may have FAI.
In addition to a general exam and impingement testing, the doctor may order diagnostic imaging to obtain a better view of the area. These tests can include:
- X-rays and computed tomography (CT) scans: Images that allow the doctor to see any abnormalities in your hip joint. CT scans also help doctors to obtain a detailed view of the joint structure.
- Magnetic resonance imaging (MRI) scans: By using a magnetic field and radio waves, this test allows the doctor to observe any damage to the articular cartilage and labrum.
Getting Help for Your Femoroacetabular Impingement (FAI)
Once diagnosed with FAI, both conservative and surgical options are available to relieve symptoms and restore joint function.
Conservative Treatments for FAI
Physical therapy (PT) offers several benefits for individuals who suffer from FAI. Exercise-based physical therapy programs can reduce disability by focusing on muscle strength and flexibility. PT also assists with restoring your range of motion. In addition, a physical therapist can provide education about activity modification, movement pattern retraining, and pain management.
A non-steroidal anti-inflammatory medication, like ibuprofen, can also alleviate pain and inflammation. Depending on your discomfort, the doctor may prescribe pain medications. Always take these as directed as they can become addicting.
Surgical Options for FAI
The goal of FAI surgery is to correct the abnormalities caused by FAI and repair any damaged soft tissues. Surgical options can include:
- Hip Arthroscopy: This minimally invasive surgery uses a tiny camera and surgical tools. These tools allow the surgeon to remove the bone spurs caused by FAI. The surgeon will also repair damage to the articular cartilage and labrum. Hip arthroscopy is the most common surgery for those who suffer from FAI.
- Hip Replacement: If your FAI has caused severe hip osteoarthritis, a total hip replacement may be necessary. Those who are not good candidates for hip arthroscopy may benefit from a hip replacement. While this surgery is more complicated, the outcomes generally eliminate or decrease symptoms and restore function.
As surgical techniques and technologies improve, the reliance on minimally invasive surgery will only increase. Since minimally invasive surgery only requires small incisions, this means less scarring, damage to soft tissues, and blood loss. As a result, you can also recover faster from hip surgery with less preoperative pain.
Ready for an Experienced Team to Help You?
Dealing with hip pain can keep you from doing the things you love. Instead of being sidelined with FAI, maybe it’s time you consulted with a team of doctors who are ready to pinpoint the source of your pain and empower you with the best treatment options.
Our experts at Orthopedic & Laser Spine Surgery will take the time to get to know you, your symptoms, and goals for treatment. We work with you to create a treatment plan geared toward your individual needs and preferences.
Using the latest technology and medical advances, we treat your conditions to ensure accuracy and successful outcomes. Are you ready to take care of your hip pain and return to the things you love? Schedule a consultation with Orthopedic & Laser Spine Surgery today to see how we can help.
Common Symptoms of Degenerative Disc Disease
Your spine is composed of a series of spongy discs, which are sandwiched in-between a tower of vertebrae. In a normal, healthy spine, these structures act as shock absorbers between these bones. This alignment not only gives the spine its much-needed flexibility but also its innate force of resistance. Unfortunately, as is the case with most mechanical systems, our discs wear down with time. Some people experience this degeneration with little to no issues. Others, however, develop a variety of health issues and adverse symptoms. Every individual has their own unique anatomy, which in turn affects the severity of symptoms.
Spinal disc degeneration may occur in a variety of different ways. Most commonly, the discs simply dry out, which flattens them, inhibiting their function. Naturally, a flatter disc also means less shock absorption. In addition, this translates into less padding between the vertebrae, as well as pain.
In some cases, the hard outer shell of the disc may crack, causing the soft inner material to leak out. When this happens, it often applies pain-generating pressure to nearby nerves. Sometimes, the disc may also bulge or slip out of place, likewise inflaming nerve tissue.
Luckily, these are treatable problems that medication, physical therapy, steroid injections, and sometimes surgery can alleviate. Just know that if you have back pain, there are options for you. Always seek out medical assistance if your symptoms affect the quality of your everyday life.
Degenerative Disc Disease & Related Issues
Again, the discs of the spine act as impact cushions between the vertebral bones. In addition, our discs consist of a rubber-like structure that is made up of fibrocartilaginous tissues. The medical community calls the outer layer of an intervertebral disc the annulus fibrosus. Alternatively, doctors refer to the inner core of the disc as the nucleus pulposus. The latter is the portion of the disc that doctors describe as soft and jellylike.
Knowledge of this structure is paramount to understanding just how the discs of the spine degenerate, as well as what affects this process. We already know that discs may dry out over time, leading to less distance between the vertebrae of the spine. Additionally, we also know that changes in the disc’s structure may occur via cracks, tears, bulging, and so on. In some cases, the disc may even fracture into smaller pieces.
But, deterioration doesn’t just end there. When our body undergoes negative changes such as these, it tends to overcompensate in response. As a result of less padding between the vertebrae, the body produces osteophytes, otherwise known as bone spurs. These are bony projections that form on the perimeter of our bones. Unfortunately, this process may result in pressure against the spinal cord or adjacent nerves. This can inhibit the function of these nerves, leading to painful symptoms.
Degenerative disc disease may also cause cartilage breakdown. This poses a significant problem, as cartilage helps to reduce friction in the joints. Likewise, degenerated discs may also lead to herniated or bulging discs, as well as spinal stenosis. The latter here describes an instance in which the space surrounding the spinal canal narrows, potentially causing pain, weakness, and numbness.
Degenerative Disc Disease (DDD) Symptoms
It is vital to note that DDD will happen to some extent in almost everyone. However, not all patients will experience negative symptoms as a result. Yet, others will experience extreme pain which affects their ability to carry out daily tasks. Usually, degenerative disc disease begins with damage to spinal structures. However, over time, this may evolve into problems elsewhere in the body.
Symptoms of degenerative disc disease vary from quite mild to utterly incapacitating. Usually, the symptom with the earliest onset is pain and weakness. You may notice that the pain tends to travel to other parts of the body. Over time, these symptoms may evolve into other conditions, such as osteoarthritis, which leads to even more pain and stiffness in the spine.
The location of the damage in the spine has a natural effect on the nature of the condition’s symptoms. For example, when DDD affects the lumbar spine, painful nerve symptoms and tingling may also arise in the buttocks, upper thighs, legs, and/or feet. Conversely, when the condition affects the cervical spine, symptoms may extend to the shoulder, arm, and/or hand.
Lastly, the body may try to overcompensate for structural instability through muscles spasms. Any of the pain that the condition causes may also be exacerbated during certain activities such as bending, lifting, twisting, or prolonged periods of sitting. Patients may be able to temporarily combat this by walking or laying down.
Degenerative Disc Disease (DDD) Diagnosis
Doctors often begin their diagnostic process with a series of questions that probe the patient’s medical history, prior injuries, and familial trends. Your doctor will also ask questions about the location of symptoms, as well as which activities result in pain. During a physical examination, your doctor may look for the following:
- Muscular Symptoms: The doctor will look for any signs of muscle weakness, atrophy, or abnormalities in movement.
- Pain Triggers: The doctor will ask the patient to perform specific motions in order to figure out which areas the condition is affecting. He or she may also apply pressure to certain areas to determine the existence of degenerated discs.
- Reflexes: Utilizing a reflex hammer, the doctor will test your nerve function to see if there are any compressed nerve roots. In some instances, your doctor may apply heating and cooling techniques to see if the nerves react properly to adjustments in temperature.
Your doctor may also deem it necessary to order diagnostic imaging tests, such as a CT or MRI scan. He or she may also use a discogram, which utilizes dye injections to locate the disc that causes pain.
Degenerative Disc Disease (DDD) Treatment
Treatment for any medical condition typically involves either conservative methods or surgery. Most of the time, doctors prefer to use nonsurgical methods, as these typically end up being sufficient. That being said, there are certainly more severe cases of DDD in which surgery becomes absolutely necessary.
Conservative treatments for DDD include physical therapy, occupational therapy, medications, and weight loss regimens. Doctors may also opt to use steroidal facet joint injections to provide their patients with temporary yet effective pain relief. Sometimes, doctors recommend back braces for patients who struggle with spinal instability. There are also minimally invasive procedures available, including radiofrequency ablation as well as heated catheter insertion.
If the patient does not respond to conservative treatments within 12 weeks, then the doctor will begin to consider surgery. Generally speaking, there are two options that surgeons commonly employ to treat degenerative disc disease. Most commonly, surgeons use spinal fusion to weld two vertebrae together, permanently increasing spinal stability. In other instances, a surgeon may use decompression surgery to remove a portion of the offending joint, relieving adjacent nerve pressure.
Are you experiencing back pain that doesn’t seem to go away on its own? If so, contact Orthopedic & Laser Spine Surgery today at (855) 853-6542. Our facility is staffed with only the most passionate experts who put the patient’s needs above all else. It is our goal to ensure that every patient is given an individual care plan that best suits the specifics of his or her case. You don’t have to live in constant discomfort. Contact us today and begin your journey toward pain-free living!
Choosing Between Shoulder Resurfacing vs. Shoulder Replacement
Shoulder arthritis is a serious condition that compromises our ability to perform day-to-day activities. As you might imagine, shoulder arthritis targets the typically smooth ball-and-socket joint of the shoulder. Under normal circumstances, the surface of this joint is smooth and allows for less friction in between the moving parts of our shoulder. Arthritis changes this fact, eliminating the cartilage in the joint that allows for the free range of motion to which we are accustomed.
Generally speaking, patients with this condition have a couple of options, but this article will focus on the two main ones: shoulder replacement and shoulder resurfacing. Shoulder joint replacement is a bit more well known, and doctors originally used it to treat catastrophic shoulder injuries. Over the years, the procedure has seen a resurgence, with doctors using shoulder replacement to treat more than just that. In fact, shoulder replacement surgery now has important uses in treating other painful shoulder conditions, such as arthritis.
Shoulder resurfacing is viewed more as an alternative to shoulder replacement and doctors typically use it on patients who are younger. Instead of replacing the humerus and scapula, shoulder replacement involves switching out the affected area with a specialized metallic head. Essentially, this replaces the surface of the joint and allows for the majority of the existing bone to remain as is.
The best treatment for you will depend on the severity of your condition. For more information, be sure to communicate regularly with your medical provider.
The Anatomy of the Shoulder
Three bones compose the shoulder joint: the humerus, scapula, and collarbone. Medical experts refer to the shoulder joint as a ball-and-socket joint. The reason for this is because the ball of the humerus fits neatly into the small socket (glenoid) of the scapula.
At the surface of where the bones touch exists a covering of articular cartilage. This is a smooth material that keeps the bones safe and enables them to have a full range of motion. Additionally, there exists a fine, smooth tissue that doctors call the synovial membrane. This membrane envelopes all of the other surfaces inside the joint of the shoulder. In a normal shoulder, the synovial membrane secretes a tiny amount of fluid that helps to eliminate the friction in between the bones of the shoulder.
Lastly, but certainly not least, there are the muscles and tendons that exist around the shoulder to provide structural support. All of these parts work together to form a joint with the greatest range of motion throughout the entire body.
Diagnosis & Evaluation
Your doctor will likely send you in the direction of an orthopedic surgeon for a more in-depth medical evaluation to determine which surgery will benefit you the greatest. Usually, such an evaluation consists of the following elements:
- Medical History: Your surgeon will need information about pre-existing medical conditions as well as the specifics of your case. This includes facts about the extent of your pain and the current functionality of your shoulder.
- Physical Examination: A physical assessment will test a multitude of things. Usually, this involves examining your shoulder’s motion, strength, and stability.
- X-Ray Imaging: As with any imaging test, x-rays will show the doctor the severity of your condition. These images will reveal things such as the loss of joint space, bone deformities, bone spurs, and any other loose articles (such as cartilage or bone) that may be floating around in places they shouldn’t be.
- Other tests: Your surgeon may deem it necessary to order other tests, such as MRIs, blood tests, or bone scans. These tests will help your surgeon determine the important factors of your condition, such as the current state of your soft tissues and bones.
Is Shoulder Resurfacing Right For Me?
You can think of shoulder resurfacing as kind of a “middle ground” treatment. It is most viable for patients who need pain alleviation, but are not quite to the point where they need a total replacement. In patients where the arthritis is mild and limited to the humeral head, it may be more ideal than a total replacement. Usually, doctors use the procedure to treat conditions such as different types of arthritis, rotator cuff injuries, and avascular necrosis.
The procedure is certainly more conservative than total shoulder replacements. That being said, only a highly skilled professional will be able to determine whether or not it is a viable alternative for the patient. In the event that the doctor does see this as a viable alternative, the possible benefits are:
- Anatomical restoration
- Less invasive surgery
- Minimal scarring/less chance of surgical trauma
- Faster recovery time
- Less painful
- The procedure is still possible in lieu of bone deformity
- No risk of fracture
- It is easy to revisit the procedure if necessary
Patients who have a shoulder resurfacing procedure can usually expect to stay in the hospital for a day or two. After a day has passed, the doctor or nurse will remove the wound dressings. Next begins the first phase of recovery, which involves a series of limited exercises. Usually, the patient will have to wear a sling for up to six weeks. After the patient leaves the hospital, they should perform exercises at home for a few weeks to restore the range of motion to the joint. Generally speaking, total recovery tends to wrap up at around three months time.
Am I a Candidate for Shoulder Replacement Surgery?
First of all, there are several different types of shoulder replacement surgeries. In fact, shoulder resurfacing is actually a subtype of shoulder replacement surgery, albeit a less invasive one. So, for the sake of brevity, this article will refer to the most common form of shoulder replacement surgery: total shoulder replacement. Whereas shoulder resurfacing involves simply replacing the surface of the humeral head with a stemless prosthesis, total shoulder replacement involves a metal ball attached to a stem with a synthetic socket.
Perhaps the biggest indicator for the necessity of this procedure is pain that is not alleviated through more conservative methods or less invasive procedures. Additionally, the pain must exhibit a progressive stiffness with accompanying loss of motion range. Typically, patients report an almost grating sensation within their ball-and-socket joint that is quite uncomfortable.
Basically, doctors only consider more traditional open surgeries like these over minimally invasive procedures when there are no other viable options. Minimally invasive procedures and conservative options are always the preferred route to take. However, the nature of how they work sometimes does not allow for proper recovery. For more information, please consult your doctor to see if this procedure is right for you.
If you have shoulder pain that has not abated with more conservative treatments, please contact Orthopedic & Laser Spine Surgery at (855) 853-6542. Our team of spine doctors are leading experts in the field of minimally invasive treatment and surgical care. We will work tirelessly to ensure that you are put on a treatment plan that suits your specific needs. Don’t hesitate, contact our practice today!