To put it simply: a herniated disc is a physical injury to the spine, while sciatica is a set of symptoms caused by an underlying medical issue. In fact, a herniated disc is often the direct result of sciatica.

Understanding the difference between sciatica vs. herniated discs is the first step toward recovery, but because the symptoms often overlap, self-diagnosis is never recommended. For lasting relief and long-term spinal health, it is vital to be properly diagnosed by an orthopedic specialist.

What Is Sciatica?

Sciatica is not a condition itself but rather a symptom of an underlying issue. It refers to pain caused by irritation, inflammation, or compression of the sciatic nerve, which is the largest nerve in the body.

The sciatic nerve runs from the lower back through the hips, buttocks, and down each leg. When something presses on or inflames this nerve, it can cause pain to radiate throughout these parts of your body. The pain may be mild and intermittent or sharp and debilitating.

Because sciatica is a symptom rather than a diagnosis, a spinal specialist will work to identify the root cause of the nerve irritation so they can recommend effective treatment.

Symptoms of Sciatica

The hallmark of sciatica is pain that radiates from your lower (lumbar) spine to your buttocks and down the back of your leg.

Other common symptoms include:

• Sharp, shooting, or burning pain that radiates from the lower back into the buttocks and down the back of the leg
• Numbness or tingling in the leg or foot
• Weakness in the affected leg
• Pain that worsens with sitting, bending, or twisting
• Electric shock-like sensations during movement

These symptoms usually affect only one side of the body. In more severe cases, sciatica may make it difficult to put weight on the leg or perform normal activities.

Common Causes of Sciatica

Because sciatica is a symptom, it can be triggered by several conditions that place pressure on the sciatic nerve. Common culprits include:

• Herniated Discs: As we will discuss more in a few moments, a herniated disc in the lumbar spine can bulge outward and press directly on the sciatic nerve.
• Spinal Stenosis: Narrowing of the spinal canal reduces the space available for the nerves, causing compression and inflammation.
• Degenerative Disc Disease: As spinal discs wear down with age, they may lose height and cause increased pressure on surrounding nerves.
• Piriformis Syndrome: The piriformis muscle, located in the buttocks, can spasm or tighten, irritating the sciatic nerve that runs beneath it.
• Spondylolisthesis: This condition occurs when a vertebra slips out of place and pinches the sciatic nerve.

Treatment Options for Sciatica

Sciatica treatment depends on what is causing the nerve irritation, but many patients find relief with non-surgical approaches. Common treatment options include:

• Physical Therapy: Guided exercises can reduce pressure on the sciatic nerve and improve long-term spinal stability.
• Medication: Anti-inflammatory medications, muscle relaxers, or oral steroids may be used to calm inflammation and ease pain.
• Epidural Steroid Injections: These injections deliver powerful anti-inflammatory medication directly around the irritated nerve.
• Heat and Ice Therapy: Alternating hot and cold applications can help improve circulation and reduce muscle tension.
• Lifestyle Modifications: Improving posture, adjusting workspace ergonomics, and losing weight (if needed) can all alleviate pressure on the sciatic nerve.
• Surgery (in Severe Cases): If conservative treatments fail or if there is significant nerve compression, surgical intervention may be necessary to relieve the pressure.

What Is a Herniated Disc?

A herniated disc (sometimes called a “slipped” or “ruptured” disc) occurs when one of the soft, cushioning discs between the vertebrae becomes damaged.

Inside each disc is a gel-like material; when the outer layer weakens or tears, the inner material can push out and press on nearby nerves. The result is pain, numbness, or weakness in an arm or leg.

Herniated discs most commonly occur in the lower back (lumbar spine), but they can also affect the neck (cervical spine).

Symptoms of a Herniated Disc

Interestingly, you can have a herniated disc without knowing it; herniated discs show up on MRIs of people who have no back pain at all. However, when the disc presses on a nerve, symptoms arise.

• Localized Back Pain: Unlike pure sciatica, a herniated disc can cause significant, localized pain in the back itself, which may worsen with bending or twisting.
• Arm or Leg Pain: If your herniated disc is in your lower back, you will typically feel the most pain in your buttocks, thigh, and calf (this is where it overlaps with sciatica). If the herniated disc is in your neck, the pain will typically be most intense in your shoulder and arm.
• Numbness or Tingling: People who have a herniated disc often experience radiating numbness or tingling in the body part served by the affected nerves.
• Weakness: Muscles served by the affected nerves tend to weaken. This may cause you to stumble or impair your ability to lift or hold items.

It’s important to note that herniated discs can cause sciatica when the sciatic nerve is compressed, but not all herniated discs lead to sciatic symptoms.

Common Causes of Herniated Discs

Herniated discs are most often the result of gradual wear and tear from aging (this is called disc degeneration). As you age, your spinal discs lose some of their water content, making them less flexible and more prone to tearing or rupturing with even a minor strain or twist.

Other risk factors of herniated discs, however, include:

• Weight: Excess body weight causes extra stress on the discs in your lower back.
• Occupation: People with physically demanding jobs have a greater risk of back problems. Repetitive lifting, pulling, pushing, bending sideways, and twisting can also increase your risk.
• Genetics: Some people inherit a predisposition to developing a herniated disc.

Treatment Options for Herniated Discs

Treatment often begins with conservative, non-surgical methods designed to reduce pain and encourage natural healing. Like sciatica, these may include physical therapy, anti-inflammatory medications, muscle relaxers, epidural steroid injections, and activity modification.

In cases where the herniated disc does not improve with conservative care, surgical options such as a microdiscectomy may be recommended to remove the portion of the disc pressing on the nerve.

Sciatica vs. Herniated Discs: How to Know What You’re Experiencing

Because the two conditions are closely related and often share overlapping symptoms, the best way to determine what you are dealing with is to be evaluated by an orthopedic specialist. At Premier Orthopaedics, our team uses advanced diagnostic methods such as physical examinations, MRI imaging, nerve studies, and X-rays to pinpoint the source of your pain.

Once we have a clear diagnosis, we create a customized treatment plan based on your symptoms, lifestyle, and long-term goals. In this way, we can help you feel better, move comfortably, and regain control of your daily life.

If you’re struggling with back or leg pain and want answers, contact Premier Orthopaedics in Philadelphia, PA, today to schedule an appointment. Getting the right diagnosis is the first step toward lasting relief.

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The two most common ways that a disc can become herniated is the natural degeneration of the disc or through trauma. Sometimes, a herniated disc goes unnoticed as it can cause few to no symptoms. Other times, patients will not have symptoms in their neck or lower back but rather in their shoulders, hands, legs or feet, which will lead them to seek treatment related to the extremities. Finding yourself with a herniated disc does not mean you have to have a surgical procedure. For those with a herniated disc in the neck or lower back, there are several non-surgical options available.

Medication.

When it comes to relieving mild to moderate pain, several different medications can help. There are also a variety of medications that a physician can prescribe to you that are stronger such as muscle relaxants or steroids. Remember, over-the-counter medications only mask the pain from your herniated discs, so it is important to consult with your physician to fully relieve your discomfort. You should also read the medication label and speak with a pharmacist to determine if it is safe to take anti-inflammatories.

Injections.

If there is little to no improvement from oral medications, a physician might recommend cortisone injections as an alternative solution. A Corticosteroid injection can reduce inflammation around an irritated nerve, but it will not reduce the actual size of the herniated disc. The injected medications may include steroids, local anesthetics or saline. The goal of an injection is to numb the irritated nerves which will ultimately relieve the pain symptoms. Injections go straight to the area of injury to deliver the pain-reducing medication to your spine.

Physical Therapy.

Physical therapy may be able to combat some of the painful symptoms associated with a herniated disc. With this injury, a Physical Therapist will utilize exercises that attempt to relieve pressure on the compressed nerves. Another target exercise is core stabilization which in turn helps with spine stabilization. Other practices such as stretching and manual work also might be used to benefit your flexibility. When working with a physician on your herniated disc, your physical therapist will work in conjunction with them to give you the most successful recovery.

When you have a herniated disc, you will want to control your pain management to the best of your ability. These tips may not work for everyone, but in the meantime can be useful to some.

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POSITION 1: Don’t sleep with your head propped up too high, or sinking too low.

This may seem obvious, but if your neck is in an uncomfortable position in the moments you are falling asleep, it’s only going to get worse once you have fallen asleep. While lying on your side, your neck should be parallel to the surface of the bed. You can achieve this by use of a single, moderately firm pillow. If you are a larger individual, 2 pillows may be required.

This will keep your head and neck in proper alignment, reducing stress placed on either side of the neck. The same pillow arrangement will be beneficial while lying on your back.

POSITION 2: Before sleeping, place a folded pillow in between your top arm and side.

Folding a pillow and placing it under your arm will reduce the amount of stretch in your upper trapezius muscle. Your upper traps stretch from the base of your skull to the top of your shoulder. This muscle is often responsible for both neck and shoulder pain. Taking pressure off this muscle will likely relieve any tension and discomfort you feel.

Stretch your neck prior to sleeping.

As previously mentioned, tight neck muscles can create pain while trying to sleep. Stretching out these muscles prior to bed can make you feel much better. Here are two stretches I find helpful. If you have pain with either of these, please stop.

Upper Trap Stretch:

Start by sitting upright on a chair. Next, try to bring your right ear to your right shoulder, you should feel a stretch on the left side of your neck. If you do not feel a stretch, reach down with your left hand and grab the edge of your seat. This will stretch your upper trap further. Hold for 30 seconds on each side, repeat 3 times.

Levator Scapulae Stretch:

The levator scapulae is another muscle that can get tight and create neck pain. Sitting upright in a chair, bring your nose towards your left armpit. This is not a practical joke. You should feel a stretch between your neck and your shoulder blade. Hold 30 seconds, then perform on the other side. Try 3 holds on each side.

Try these tips, and let us know when they improve your sleep!

Chris Donohue, PT, DPT, CSCS
Premier Orthopaedics

Learn more about Premier Physical Therapy here.

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The Link Between Posture and Technology

Simply watching people in the office can give you a good idea of how people sit while using their electronic devices. Hunched over, neck bent down, shoulders slumped is how the average person uses their gadgets in a doctor’s office waiting room. In the office, computer users are often leaning against desks, neck pushed forward to see what’s on the screen with their mouse hand scrunched up on the side. Unfortunately, the human body wasn’t designed to sit in this contorted way and it can have serious side effects.

The biggest problem with what we’ll call “technology posture” is the position of your head. When evenly balanced over your shoulders, the human head on average weighs between 10 and 12 lbs. But with just a 15 degree tilt forward, the weight on the spine spikes up to 27 lbs. Another 15 degrees forward and it weighs 40 pounds on the spine, and at 60 degrees (where the chin is nearly touching the chest) this weight goes all the way up to 60 pounds. The difference in the weight alone is enough to make you question your posture. But it goes farther than that.

Extended excess weight on the upper spine can cause lower spine collapse and cause low back pain. Low back pain can cause knee pain, which can lead to referred ankle pain. And you can easily see how quickly the damage is done.

Change Your Posture, Decrease Your Pain

There are many ways in which you can actively prevent the kind of crippling damage poor “technology posture” can cause. When it comes to setting up your office, you can elevate your monitor so that the top of the screen is at eye level. Choose a chair height that allows your feet to be firmly planted on the floor. Your desk should allow your forearms to be parallel to the floor when your shoulders are relaxed.

When using a mobile device, avoid slouching over and instead use your arm muscles to hold your phone in front of your face. Keep your phone at eye level and when talking on the phone, avoid balancing your phone between your shoulder and your ear at all costs. Keep your head on straight, literally, and you’ll find that you can easily mitigate the effects of technology on your posture.

There are also ways to reverse the effects of long term bad posture such as stretching exercises. Getting up from your sitting position every 30 minutes and going for a bit of a walk and stretching out your limbs can also be incredibly beneficial. And for a real treat try rolling your shoulders forward a few times and then back and rolling your head first in one direction and then in the opposite.

For relief from chronic back pain, talk to your orthopaedic specialist about your treatment options.

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Symptoms of Degenerative Disc Disease

The symptoms of degenerative disc disease vary from person to person because your symptoms depend on what the actual diagnosis is. In general, the symptoms include lower back pain that’s worse when seated, tingling and numbness in the extremities, and pain that radiates from the spine to the hands and arms.

Because the pain is related to disc damage, you may find some relief in movement, such as changing sleeping or sitting positions, or in exercise such as running or walking. On the other hand, twisting, lifting, and bending tend to make the pain worse as the discs are strained during these activities.

Diagnosis: Degenerative Disc Disease

Degenerative disc disease doesn’t happens overnight. In fact, it takes decades before you even see the symptoms of degeneration. Our bodies are built to withstand quite a bit of impact, but after many years of unintentional neglect, you’ll start to see the negative effects. So how is degenerative disc disease diagnosed?

Because it’s not an actual disease with one single cause, diagnosis can be a bit tricky and is more so done by looking at the present symptoms. We’ve outlined a few of the most common below, but in general, all relate to back pain of some sort. If your back pain is manageable and ignored, you may find that, over time, it gets much worse.

Prevention and Mitigation

Because of the variable nature of degenerative disc disease, there are many causes. But prevention and mitigation of the worsening of the disease include living an active and healthy lifestyle.

One of the main causes of degenerative disc disease is actually dehydration or the drying out of the disc. At birth, your spinal discs are roughly 80% water, but over time. they don’t absorb shocks as well because they dry out. Proper hydration, posture, and muscle strength can help to prevent this.

On the other hand, too much high-impact activity can damage to the outer core of the disc and eventually lead to degeneration. However, this doesn’t always lead to back pain. The key is to get proper medical attention at the time of the injury or as soon after as possible to prevent further damage.

Degenerative Disc Disease Treatment

Your orthopaedic physician should examine any injury that causes instability, soreness, or swelling in the back as soon as possible. As with any physical ailment, the key to preventing further damage is early diagnosis and treatment.

Treatments for this collection of symptoms include physical therapy, spinal mobilization, heat and cold therapy, and surgery, including spinal fusion and artificial disc replacement.

For more information on relieving your joint pain, click here to download our eBookThe Patient’s Manual to Joint Replacement.

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By making a few simple changes throughout your work day, you can eliminate the pain you’re currently experiencing or the pain you may experience in the future.

Learn more about how these tips can help you improve your health at work and the easiest ways to incorporate them into your day.

Posture

Focus on keeping your head up and aligning it directly above your shoulders. It’s important to avoid leaning forward because this will strain your back and can cause pain.

Sit Within Reach

If you rely on a mouse during your daily computer use, keep it close to you right next to your computer. If you’re reaching, even a little, you could be twisting your shoulder or wrist which will affect your back over time.

It’s also important for posture that the monitor be about two to three inches away from eye level and that your torso is about an arm’s length from the monitor.

Adjust Your Chair

If you’re uncomfortable in your chair, it’s likely that some part of your back is being strained. Make sure you have a desk chair that provides lumbar support. But if you don’t, get a lumbar support pillow to place behind you. Having the chair’s back slightly reclined will also help your spine be relaxed but supported so you don’t experience pain.

Keep Your Feet on the Floor

Planting your feet shoulder-width apart firmly on the floor will help your knees and ankles relax, thus straining your spine less. Also, position your knees at a 90-degree angle directly over your ankles to keep your spine straight.

Take a Walk

Getting up out of your chair once every hour will help reduce the pressure on the spinal disks and boost circulation. Walking around for a few minutes will relax your muscles, reduce stress levels, and relieve pressure on your back. Take breaks to use the restroom, get a glass of water, or simply to stretch your muscles. Stretching for just 60 seconds can offset the negative effects of sitting all day.

Hold Your Phone Differently

While tucking your phone between your head and shoulder will free up your hands, it will also strain your muscles. The best solution to this problem is to use a headset or the speakerphone mode so your hands will be free to type or write. If you are just on a quick phone call and don’t need to take notes, it’s best to alternate the phone between your left and right hands.

Now that you know about these tips that can help you live a healthier life, cope with your job better, and relieve your back pain, be sure to use them throughout your day.

For information about how rehabilitation and non-operative methods can help relieve your pain, click here to download our eBook, The Patient’s Guide to Non-Operative Care and Rehabilitation.

The post How to Prevent Back Pain at Your Desk Job appeared first on Premier Orthopaedics.

Continue reading to learn more about some of the risk factors for back pain.

Age

Back pain is more common as you get older, starting around the age of 30 or 40. Because the back is used for most daily functions, wear and tear over time can result in conditions that cause neck and back pain such as disc degeneration and spinal stenosis. People between the ages of 30 and 60 are most likely to have disorders related to spinal discs, while those over the age of 60 are more likely to have back pain caused by osteoarthritis.

Occupation

Jobs that require an extensive amount of bending and/or lifting also have a high rate of back injury. Jobs requiring constant standing without a break or long hours sitting in a desk chair also put the individual at a greater risk for back pain. In these positions, the back is not being supported correctly and can age more quickly over time.

Excess Weight

Being overweight puts stress on many of your joints such as the knees, but it also creates a huge amount of stress on the lower back. The excess weight is constantly pulling at your body which causes your spine to strain as it holds you upright. It can also mean that your muscles are weaker and flexibility is limited. Talk to your doctor if you’re experiencing back pain as a result of excess weight. Together you should be able to come up with a healthy diet and exercise regimen to help you get back on track.

Sedentary Lifestyle

Joints need to be moved frequently in order to stay lubricated. When they are not, they begin aging more quickly. A lack of exercise can increase the risk of lower back pain. Not only will those with a sedentary lifestyle be at higher risk for developing back pain, but the severity of the pain will most likely be greater.

Genetics

Research shows that spinal disorders typically have a genetic component such as with degenerative disc disease. If you know that a spinal condition runs in your family, be sure to discuss this with your doctor. Being aware of the problem will help you be better prepared and more proactive if you begin experiencing symptoms.

Poor Posture

Slouching and not keeping your spine straight will also increase your risk for back pain. Work on your posture by sitting upright in chairs instead of hunching over your computer or steering wheel.
If you believe you’re at high risk for developing back pain, talk to a doctor about your options that could include medication, physical therapy, or setting up a workout regimen. They will help you create a plan that will allow you to deal with the pain as it comes.

In some cases, surgery may be your best option. If you’re considering back surgery, download our e-book, The Patient’s Manual to Spine and Back Surgery.

The post Who is Most at Risk for Back Pain? appeared first on Premier Orthopaedics.

Continue reading to find out about the ordinary habits that could be causing your back pain.

Sitting at a Desk

Sitting puts 40 percent more stress on your spine than standing. When your spine is idle or you’re slouching, the inactive joints become less lubricated which causes them to age more quickly. Leaning forward over a computer can tighten your chest muscles, round your shoulders, and cause you to slouch. To rectify this situation, you should make an effort to maintain good posture and take breaks every now and then.

Start by leaning back in your chair slightly when you can. Make it a habit to do so every time you take a phone call or during discussions with a coworker. It’s also crucial that your desk chair be supportive. Your head should be straight rather than leaning forward when you are looking at your computer. It will also benefit you to get up and walk around during the day as often as you can.

The Daily Commute

Just as leaning over your computer will disrupt your posture, the same goes for leaning over your steering wheel. Be aware of your driving posture on the way to and from work, and be sure to sit at a 90-degree angle. Position the driver’s seat so that you don’t have to stretch your arms and legs to reach the steering wheel and pedals.

Lack of Exercise

Daily exercise can do wonders for your body, and your spine in particular. Some people believe that they can’t exercise when they have back pain because it will make the pain worse. However, engaging in any type of exercise, whether it’s jogging, walking, or swimming, will help relieve the stiffness you’re experiencing in the spine.

You’ll also notice that stretching daily will relieve the tension in your back. Be sure to focus on stretching the hamstrings and hips.

Unhealthy Diet

It’s no secret that a balanced diet can do wonders for the body, relieve aches and pains, and make your overall quality of life better. Eating habits that are good for your heart and blood sugar are also good for your back health. With a good diet, nutrients are brought to the spine and inflammation is reduced.

If you would like to eat for improved back health, avoid excess caffeine and processed food, and focus instead on enriched wheat flour, whole grains, nuts, seeds, protein, vegetables, and fruit.

Take these habits into consideration and try to alter your daily routine slightly to begin reducing your back pain. If the pain persists, you may be dealing with a more serious issue. Contact your doctor for an evaluation.

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