A herniated disc, where the inner contents of a disc (the nucleus pulposus) leak out of a tear of the annulus fibrosis of the disc, is a difficult problem in the cervical or lumbar spine of athletes. The athlete may or may not remember a specific event that caused the symptoms. It can be a very limiting problem, causing arm pain, numbness, tingling, and weakness with herniated cervical discs or similar problems in the lower extremity of an athlete with a herniated lumbar disc.
Complaints of pain shooting down one of the arms, especially all the way down into some of the fingers, or one of the legs, especially if it shoots down into the foot and toes, can warrant workup for a herniated disc. Other complaints, including numbness, tingling, or weakness with certain muscle groups, can be worrisome as well. The sports medicine or spine physician can perform a thorough evaluation of sensation, strength, and reflexes of the upper or lower extremity and thoroughly examine the neck or the lower back. X-rays are often unremarkable but can show decreased disc space. An MRI will usually show the herniated disc and possible impingement on the nerve root. Occasionally nerve conduction studies can be helpful as well.
Treatment is usually nonsurgical at first. Anti-inflammatory medications or a Medrol Dosepak can be helpful. Occasionally an epidural cortisone shot or nerve root injection can be tried. Physical therapy occasionally can be helpful too. If symptoms persist or worsen, especially if there is a progressive neurologic deficit, surgery is often employed. The surgical treatment really depends on a number of factors. Depending on the sport or activity in which the athlete participates, return to sports can be successful but can take time. Often activity modifications for the sports are necessary.
If you have specific questions about a herniated disc, please Ask Dr. Geier directly.