.- Can a herniated disc get smaller while you are having more pain and symptoms?


Q: Can a heriated disc get smaller while you are having more pain and symptoms? I had and mri a year ago which showed a severe central herniation at c56 and smaller ones at c34, c45, and c67. My symptoms have been mostly right arm to fingers pain, numbness, tingling,and recently and pins and needles pain. sometimes i have pain in left arm but it is intermittant. I have shoulder pain and neck pain as well as neck pain where it feels like a lot of pressure. I can hardly lay on my back or lean back in a chair for more than a few minutes without this pressure becoming intense. i can sleep basically only on my left side which is less pain but it is still there.I've been to a neurosurgeon a couple times and he offered surgery - fusion at c5-6 as an option as i have tried conservative treatment options already.(chiropractic, pt, injections, meds) I wasn't ready to decide on surgery at that point and decided to give conservative treatment a little longer. Now i feel as if i need to look into surgery as it has not gotten better but seems to be making day to day life challenging more often than not. i had to get another mri because my other was more than 6 mo old. It now showed the c56 to be moderate and others the same. I had my mri's done at different places but brought my older ones as comps. the doctor again saw i have tried conservative treatment for a long time and talked about surgery. i was also told i am not a candidate for adr because it is a central herniation andi have neck pain. I have been told that herniated discs don't become unherniated so i am so confused by this as my symptoms have definatedly stayed the same if not worse. Other than that i am a healthy 42 yr old female 5' 5" and 128lbs. SR


A:    According to your description you have several cervical levels affected and producing neurological symptoms that represent nerve damage, also you have tried conservative treatment and it seemed not effective totally and your doctor is presenting you with a surgical treatment option. It is important for you to know that once that a disc is herniated that condition does not go back by itself.A spinal disk is a little like a jelly donut, with a softer center encased within a tougher exterior. Sometimes called a slipped disk or a ruptured disk, a herniated disk occurs when some of the softer "jelly" pushes out through a crack in the tougher exterior. A bulging disc has intact the fibrous outer layer that contains the softer center, but is bulging and compressing the exiting of the spinal nerve root adjacent. The herniated disc has the fibrous outer layer broken and the filling is extruded mostly toward the near spinal nerve root in the vicinity, generating compression and damage. Bulging disks are more common. Herniated disks are more likely to cause pain. But many people have bulging disks or herniated disks that cause no pain whatsoever. In the younger patients, cervical radiculopathy may be a result of a disc herniation or an acute injury causing impingement of an exiting nerve. In the older patient, cervical radiculopathy is often a result of spinal canal narrowing from bone (osteophyte) formation, decreased disc height and degenerative changes due to aging process. If your condition fails to improve with a comprehensive rehabilitation program and selective injections, you may be considering a re-evaluation by the Orthopedic surgeon to explore other treatment options more aggressive.

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