Getting an accurate clinical diagnosis for the underlying cause of disc problems can be challenging, but it is crucial for guiding optimal treatment decisions.
Here are three key pieces of advice to help you navigate the diagnostic and treatment process:
1. Having a Disc Disorder Does Not Always Mean You’ll Have Pain
It might seem counterintuitive, but a damaged or diseased disc doesn't always cause pain or any symptoms at all. A significant portion of people over 40 have some form of disc problem visible on an MRI scan, yet many of them experience no symptoms. This situation is similar to other conditions like heart murmurs, which often have no symptoms.
Moreover, the severity of a disc problem seen on an MRI scan doesn't necessarily correlate with the level of pain or symptoms a patient feels. For example:
- One person with a large herniated disc may have no symptoms.
- Another person with a small, seemingly minor disc herniation might experience severe, burning pain radiating down their leg.
This distinction is crucial because if a disc problem appears on an imaging test but isn't the source of the patient's pain, treating the disc issue might not relieve the pain. In some cases, a patient may undergo surgery for a herniated or degenerated disc, only to find that their pain remains unchanged after the procedure.
2. Diagnostic Testing Doesn’t Always Pinpoint the Pain Source
Typically, a spine specialist's assessment of a patient's medical history and symptoms leads to a clinical diagnosis identifying the cause of the pain. Radiographic tests like MRI, X-rays, or CT scans can then confirm this diagnosis and provide more detailed information for treatment planning, especially when surgery is being considered.
However, it's important to note that radiographic tests are rarely the primary tool for diagnosing the cause of pain. They are mainly used to confirm or rule out possible issues.
3. Deciding on Disc Surgery is a Complex Decision
When considering surgery for disc-related pain, it's essential to carefully evaluate the type of surgery before making a decision. For example:
- The typical surgery for relieving leg pain caused by a herniated disc is a microdiscectomy. This surgery usually has a high success rate and a relatively short recovery period.
- The standard surgery for treating lumbar degenerative disc disease is a lumbar spinal fusion, which tends to have less predictable outcomes and a longer recovery time.
Additionally, even within specific types of surgery, there are many factors to consider. For example, a multilevel fusion (involving multiple spinal segments like L4 to S1) typically takes longer to heal and places more stress on the remaining non-fused spinal segments than a single-level fusion (like L5-S1 or L4-L5). Therefore, multilevel fusions require more cautious consideration.
Given the numerous factors involved, it is wise for patients to become as informed as possible about their surgical options before making any decisions. Above all, educating yourself about your specific condition will help ensure an accurate diagnosis and the best possible treatment options.
Precision Pain Care and Rehabilitation has two convenient locations in Richmond Hill – Queens, and New Hyde Park – Long Island. Call the Queens office at (718) 215-1888 or (516) 419-4480 for the Long Island office to arrange an appointment with our Interventional Pain Management Specialists, Dr. Jeffrey Chacko or Dr. Sonny Ahluwalia.
