Back pain is a common problem that can have many causes. Sometimes it can be difficult to tell what is causing your back pain and whether you need to see a doctor. One possible cause of back pain is a herniated disc, also known as a slipped, ruptured, or bulging disc. This is when one of your spinal discs—the soft structures that cushion your vertebrae and support your body’s weight—tears and the inner material presses on a nerve. Another possible cause of back pain is a muscle strain, which is when you overstretch or tear a muscle in your back.
In this article you will learn how to tell the difference between a herniated disc and a muscle strain, the risk factors and complications associated with each condition, and how to treat and prevent them.
Symptoms of a Herniated Disc
A herniated disc can occur anywhere along the spine, but it is most common in the lower back (lumbar spine) and the neck (cervical spine). The symptoms depend on where the disc is located and which nerve it is pressing on. Some common symptoms of a herniated disc are:
- Pain that occurs on one side of the body, usually in the lower back, buttocks, thigh, calf, foot, shoulder, arm, or hand
- Numbness, tingling, or weakness in the affected body part
- Pain that worsens with movement, coughing, sneezing, or straining
- Pain that improves with rest
Home Tests for Disc Herniation
- Straight leg raise test – Lying on your back, lift one leg at a time while keeping it straight. Pain radiating down the leg during this test may indicate a herniated disc.
- Slump test – While seated, slump forward and then extend one leg at a time. Radiating pain or discomfort may suggest nerve involvement.
How to Treat a Herniated Disc
The treatment for a herniated disc depends on the severity of the symptoms and the location of the disc. Most people with herniated discs improve with conservative treatments, such as:
- Medications – A doctor may prescribe anti-inflammatory drugs (such as ibuprofen), muscle relaxants (such as metaxalone), nerve pain medications (such as gabapentin), or narcotics (such as codeine) to relieve pain and inflammation.
- Physical therapy – A physical therapist can teach you exercises to strengthen your core muscles, improve your posture and flexibility, and reduce pressure on your spine and nerves.
- Epidural steroid injections – The doctor may inject cortisone into the space around your spinal cord to reduce inflammation and pain. This is usually done under X-ray guidance and may provide temporary relief for some people.
- Surgery – If conservative treatments fail, or if you have severe or progressive symptoms, your doctor may recommend surgery to remove the herniated disc material and decompress the nerve. This is usually done through a minimally invasive procedure called microdiscectomy.
How to Prevent a Herniated Disc
To prevent a herniated disc, you can:
- Maintain a healthy weight – Being overweight can put extra stress on the spine and discs.
- Exercise regularly – Physical activity can keep the spine strong and flexible and prevent stiffness and muscle spasms.
- Practice good posture – Avoid slouching, hunching, or bending your neck or back excessively. Use proper techniques when lifting, carrying, or sitting.
- Avoid smoking – Smoking can reduce blood flow to the spine and discs and make them more prone to degeneration and rupture.
Symptoms of a Muscle Strain
A muscle strain can also occur anywhere in the back, but it is more likely to affect the lumbar region and cause lower back pain. A muscle strain is usually caused by lifting something heavy, twisting or bending awkwardly, or overusing the muscles. Some common symptoms of a muscle strain are:
- Pain that occurs in the center of the back or across the lower back
- Muscle spasms or stiffness in the back
- Pain that worsens with movement or stretching
- Pain that improves with rest and applying heat or ice
- Tenderness to touch
Home Tests for Muscle Strain
- Palpation – Gently press on the back muscles. If the pain is localized and intensifies upon touch, it may be indicative of muscle strain.
- Active range of motion – Attempt various movements and stretches. If the pain is primarily felt during these movements and is concentrated in the muscle area, it may be a sign of muscle strain.
How to Treat a Muscle Strain
The treatment for a muscle strain also depends on the severity of the symptoms and the location of the strain. Most people with muscle strains improve with simple self-care measures, such as:
- Rest – Avoid activities that worsen your pain, and give your muscles time to heal.
- Ice – Apply ice packs to the affected area for 15 to 20 minutes several times a day to reduce swelling and pain.
- Heat – After the first 48 hours, apply heat pads or warm compresses to the affected area to relax your muscles and increase blood flow.
- Medications – You can take over-the-counter pain relievers (such as ibuprofen) or anti-inflammatory drugs (such as naproxen) to ease your pain and inflammation.
- Stretching – Gently stretch your back muscles to prevent stiffness and spasms. You can also do some low-impact exercises such as walking, swimming, or cycling to keep your back mobile.
How to Prevent a Muscle Strain
To prevent a muscle strain, you can:
- Warm up before exercise – Do some light cardio and stretching exercises before engaging in any vigorous or strenuous activity.
- Avoid overexertion – Do not lift more than you can handle, use proper techniques when lifting or carrying objects, and take breaks when needed.
- Strengthen your core muscles – Doing exercises that target your abdominal and back muscles can increase your stability and support your spine.
- Increase your flexibility – Doing yoga, Pilates, or other stretching exercises can increase range of motion and prevent muscle tightness.
How to Tell the Difference between a Herniated Disc and a Muscle Strain
While both conditions can cause similar symptoms, there are some ways to tell them apart. Here are some clues that can help you determine if your back pain is caused by a herniated disc or a muscle strain:
- Location – A herniated disc usually causes pain on one side of the body, while a muscle strain usually causes pain in the center or across the lower back.
- Radiation – A herniated disc often causes pain that radiates down the leg or arm, while a muscle strain usually causes pain that stays in the back.
- Duration – A herniated disc usually causes pain that lasts for weeks or months, while a muscle strain usually causes pain that lasts for days or weeks.
- Trigger – A herniated disc usually has no obvious trigger or may be caused by aging or trauma, while a muscle strain usually has an identifiable trigger, such as lifting, twisting, or overusing the muscles.
When to See a Doctor for Your Back Pain
If you have mild back pain that improves with rest and home remedies, you may not need to see a doctor. However, you should see a doctor if you have any of the following signs or symptoms:
- Severe or persistent back pain that does not improve with rest and over-the-counter pain relievers
- Back pain accompanied by fever, chills, weight loss, night sweats, or other signs of infection
- Back pain accompanied by numbness, tingling, or weakness in the legs or feet or loss of bladder or bowel control
- Back pain caused by an injury such as a fall or car accident
- Back pain that interferes with daily activities or quality of life
Back pain can be caused by many factors, but two common ones are herniated discs and muscle strains. Both conditions can cause similar symptoms, but they have different causes, risk factors, complications, and treatments. It is important to know how to tell them apart and when to see a doctor for your back pain. You can also take steps to treat and prevent both conditions by following some simple tips. Remember, if you have any questions or concerns about your back pain, talk to your doctor or healthcare provider.
If you have a herniated disc that is not responding to conservative treatment, a discectomy may be discussed and potentially recommended. Although this is generally a very successful procedure, having a large hole in the outer ring of the disc more than doubles the risk of needing another operation. A new treatment, Barricaid, is a bone-anchored device that closes this hole, and 95 percent of Barricaid patients did not undergo a reoperation due to reherniation in a 2-year study timeframe. This treatment is done immediately following the discectomy—during the same operation—and does not require any additional incisions or time in the hospital.
If you have any questions about the Barricaid treatment, ask your doctor or contact us today.
For full benefit/risk information, please visit: https://www.barricaid.com/instructions.