3 Insights for Patients with Disc Problems

Getting an accurate clinical diagnosis for the underlying cause of one's pain is often a trying process. To help patients navigate the diagnostic and treatment process, here are 3 pieces of advice that are helpful to know:

  1. Having a disc disorder does not equate to having pain
    While this is contrary to common sense, a damaged or diseased disc does not necessarily mean that the patient will experience pain or any symptoms at all. In fact, a relatively high percentage of the population over the age of 40 has some sort of disc problem that is evident on an MRI scan. This is similar to other disorders that often cause no symptoms, such as a heart murmur, which is a heart defect that often causes no symptoms.

    In addition, the severity of the disc problem that is on an MRI scan does not correlate to the amount of pain or symptoms the patient experiences. For example, one person with a large herniated disc can have no symptoms or very few symptoms, while another with a small, almost insignificant disc herniation can suffer burning, searing pain that radiates all the way down the leg.

    This distinction is important because if a disc problem shows up on an imaging test but is not the cause of the patient's pain, then obviously it will not be helpful to treat the disc problem. In the worst case scenario, a patient might undergo surgery to treat a herniated disc or degenerated disc, only to find that after the surgery the pain is the same and has not improved at all.

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  1. Diagnostic testing does not usually identify the source of pain
    The spine specialist's interview with the patient about his or her medical history, combined with an assessment of the patient's symptoms, will usually result in a clinical diagnosis determining the cause of the patient's pain.

    A radiographic test, such as an MRI scan, X-ray or CT scan, may then be used to confirm the diagnosis and gain more information for treatment options. This type of test is often especially helpful if surgery is being considered. However, the radiographic test is rarely used as a basis for a diagnosis - it is mainly used confirm or rule out possibilities.

  2. Deciding on disc surgery is a complicated process
    When deciding on a treatment option for pain caused by a disc problem, it is important to consider the nature of the surgical solution rather than either ruling out surgery completely or jumping to it as an ideal solution.

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    For example:

    • The typical surgery to address radiating leg pain for a herniated disc is a microdiscectomy, a surgery with a high success rate in immediately relieving the leg pain with a relatively short recovery time.
    • On the other hand, a spinal fusion to address lumbar degenerative disc disease has less reliable outcomes and a much longer recovery time. Moreover, within types of surgery, there are also a large number of considerations. For example, a multilevel fusion of any type will take longer to heal and will cause more stress to be relayed to the other non-fused spinal segments than a one level fusion. Multilevel fusions therefore deserve more cautious consideration than a one level fusion.

    Given the many considerations involved, patients are well served to become as educated as possible about their surgical options before making any decisions.

Above all, it is important for patients to educate themselves on their condition to help ensure that they receive an accurate diagnosis and are informed of possible treatment options and the relative benefits and drawbacks of each option.

Further Reading: Diagnosing Disc Problems
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