What is a herniated disk?
According to the Mayo Clinic, a disk is a rubbery cushion between the bones of the spine that “stack to make the spine.” These bones are known as vertebrae.
“A spinal disk has a soft, jellylike center called a nucleus. The nucleus is encased in a tougher, rubbery exterior, known as the annulus. A herniated disk occurs when some of the nucleus pushes out through a tear in the annulus. A herniated disk is sometimes called a slipped disk or a ruptured disk.”
The most common location for a herniated disk is a worker’s lower back. A herniated disk can also occur in a worker’s neck.
A herniated disk is also called/spelled a herniated disc.
What are the symptoms of a herniated disk?
The symptoms of a herniated disk vary depending on the location of the disk and whether the disk is pressing on a nerve. Herniated disks usually affect just one side of the body. The symptoms can include:
- A herniated disk located in your lower back. Workers will normally experience pain in their lower back, thigh, calf, and buttocks. Workers may even feel leg, calf, and foot pain. These can feel like “shooting” pains.
- A herniated disk located in your neck. Workers will “typically feel the most pain in their shoulder and arm” according to the Mayo Clinic. “This pain might shoot into your arm or leg when you cough, sneeze, or move into certain positions. The pain is often described as sharp or burning.”
- Numbness/tingling. Workers who have a herniated disk may experience tingling or “radiating numbness” in the affected part of their body, which are usually the extremities.
- Weakness. Any muscles that are dependent on the affected nerves may weaken. Weakness can cause stumbling when it affects the legs, or affect a worker’s ability to lift items or hold items when the arms are affected.
Some workers who have a herniated disk may not have any symptoms.
What types of workplace accidents and conditions can cause herniated discs?
Employees can suffer a herniated disc if they fall or are involved in a vehicle accident such as when an employee is a truck driver making a shipment or a local driver is delivering a pizza. Other causes of a herniated disc include a sudden movement or jarring of the spine such as when construction and warehouse workers lift or move heavy objects. It is often, although not always, accompanied by a sudden “pop” felt in the particular area of the spine that suffers the injury.
Working with heavy equipment such as jackhammers, cranes, and bulldozers can cause a herniated disc. Employees who do any type of bending, turning, or twisting as part of their job may suffer a herniated disk.
A herniated disk can also be due to repetitive twisting, turning, and other motions that are a necessary part of your job. According to the Mayo Clinic, some of the risk factors for a herniated disk include excess weight, genetics, smoking, driving for long periods of time, and being sedentary.
Understand that injuries that occur over time due to repetitive stress are typically not covered by worker’s compensation. The worker must suffer an “injury by accident” for a spine injury to be compensable. That means it must have occurred at a specific place and a specific point in time.
That being said, even if this occurs and a worker suffers a herniated disc from an accident, it is still possible that the employer’s insurance carrier will argue that the herniated disk is due to gradual degeneration over a period of years, or other pre-existing degenerative issues due to wear and tear.
The good news is that in those scenarios, your doctor will usually still be able to say that you suffered an aggravation of a pre-existing condition as a result of the accident, and that your current treatment, including surgery, etc. is either all or partially due to the accident, even though some of the issues were pre-existing. If your doctor can say that, your case should remain compensable.
Moreover, your attorney will typically argue, especially if you were not actively treating for the condition, that you were engaged in full duty work up until the date of the accident, with no ongoing issues.
What are some of the possible complications of a herniated disk?
While it’s rare, it can happen that disk herniation can compress the entire spinal canal “including all the nerves of the cauda equina” which may require emergency surgery to avoid permanent weakness or paralysis.”
The Mayo Clinic recommends that workers seek emergency medical care if their symptoms worsen, they experience bowel or bladder dysfunction, or there is a loss of sensation in the areas “that would touch a saddle.”
Some of the ways that workers can reduce the risk of a herniated disk include strengthening the trunk muscles, keeping good posture, keeping the excess work off, and stopping smoking.
How is a herniated disk diagnosed?
The diagnosis of a herniated disk includes some or all of the following:
- A physical exam. Your doctors will examine your back for tenderness. Your doctors may ask you to lie flat and move your legs into different positions to try to find the source of your pain.
- A neurological exam. Your physician will examine your muscle strength, reflexes, ability to walk, and your ability to feel pinpricks, vibration, and light touches.
Often, the physical exam and oral exam are enough to determine if you have a herniated disk.
Imaging tests
The diagnostic imaging tests that may be used include:
- X-rays. X-rays are used to rule out other causes of your back pain such as spinal alignment problems, broken bones, infections, and tumors. X-rays are not used to diagnose a herniated disk.
- CT scans. This diagnostic test uses a series of X-rays to “create cross-sectional images of the spinal column and the structures around it.”
- MRIs. This diagnostic test uses radio waves and a strong magnetic field to “create images of the body’s inner structures. “An MRI can confirm the location of the herniated disk and to see which nerves are affected.”
- Myelogram. This diagnostic test uses a dye that is injected into the spinal fluid before a CT scan is done. A myelogram can “show pressure on the spinal cord or nerves due to multiple herniated disks or other conditions.”
Nerve tests
In addition to an oral exam, a physical exam, a neurological exam, and diagnostic tests; your doctor may use nerve tests to analyze if you have a herniated disk. Typically these tests are done to measure the extent to which the extremities are being affected by a disc or other part of the anatomy that is pressing on, or otherwise interfering with the nerve signals traveling to those areas of the body. These nerve tests include:
- A nerve conduction study. “This test measures electrical nerve impulses and functioning in the muscles and nerves through electrodes placed on the skin. The study measures the electrical impulses in nerve signals when a small current passes through the nerve.”
- An Electromyogram (EMG). “During an EMG, a doctor inserts a needle electrode through the skin into various muscles. The test evaluates the electrical activity of muscles when contracted and when at rest.”
The Nerve Conduction and EMG tests are usually done together they are “positive” if the test results are indicative of a nerve being affected by a disc or other issue. The person who administers the test—who is usually a neurologist—will typically say in those circumstances that the test shows evidence of radiculopathy in whatever extremity is being affected (in the lumbar spine, that is usually one or both legs, and in the cervical spine, that would be one or both arms). In the lumbar spine, radiculopathy stemming from the sciatic nerve being compressed is typically referred to as sciatica.
Workers’ compensation lawyer Joe Miller has been a strong advocate for injured workers for over 35 years. We have the experience, skills, and resources to show when workers qualify for workers’ compensation in North Carolina or Virginia. We helped many workers obtain the medical and wage loss benefits they deserve. Call attorney Joe Miller, Esq., at 888-667-8295 or fill out my online contact form to schedule a free consultation.
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