Learn about Herniated Disc Pain

Herniated Disc Pain: Why Does It Switch Sides? Hi! I am Dr. George Best of Best Health and Wellness in San Antonio, Texas, and on this video, I am going to give you a little explanation of something I get a lot of questions about in my practice. A lot of people will have sciatica and back pain and other things that relate to disc herniations. And in some cases the symptoms will actually switch from one side to the other. And that's something a lot of people have trouble understanding. So I am going to do a little demonstration, that explains why that happens. I am going to change into some other clothing, make it really easier for me to move around, and then, I'll get started with the demonstration. I am going to use these curtains to demonstrate what happens when a disc pushes hard against the nerves. The curtains are going to represent the nerves and the spine, and I am going to be actually representing the disc in this situation. Now under normal circumstances the disc and the nerve orientation, it's kind of like what you see right now. If we are looking at the back of the spine, if you are standing over there and looking at the back of the spine the nerves would be slightly in front of the disc, and the disc is not going to be touching the nerves, it will be just in very close proximity, but not actually creating any touching and not narrowing the openings of the nerves come out. But in the case of a disc it gets damaged. What will happen is it will start to push up against one or both of the nerves. And in many cases what will happen, so push primarily off to one side and so you'll always have the symptoms on that one side. But in some cases you'll have, what's called the central protrusion or sometimes you'll see, it refer to as a broad-based protrusion or a herniation, where it kind of spreads out into that opening where the nerves are and it will actually put, a little pressure on both nerves or may just simply narrow the openings around those nerves. And what will happen is, whichever side is getting the worst pressure typically that's where you are going to feel the symptoms. So if it's a little bit worse off to this side, that's where you get the symptoms. If it's a little worse off to this side, that's where you get the symptoms. But in some cases, the disc will actually shift side-to-side depending on the mechanical stresses involved because the disc on the inside is a gel, and that gel can kind of ooze if you will, from one side to the other, depending on what mechanical stresses are present. So in the case where you've got some narrowing on both sides, let's say, it starts out where it's putting more pressure over here, and what will happen is that, the body will contort somewhat and twist around, and also you are probably going to move a little differently because you are in pain. And what happens is, you shift some of the stress off of this side and this gradually oozes over, and it may center out, and for a time you may have no symptoms or you may have some symptoms on both sides or it may shift over and actually start creating more pressure on the other side, and that's why you start getting symptoms there. So this is what happens with disc symptoms that change, so you have the disc it's actually going to shift based on the mechanical stresses in the spine and that is somewhat out of your conscious control and somewhat -- it's due to the movements and positions you get and to try to ease up the symptoms on one side. Sometimes, you'll then wind up shifting it over to the other side. So that's what's going on. In addition to that, I am going to use this high-tech demonstration, using this plastic bag. The plastic bag is going to represent some of the surrounding soft tissues, the ligaments and the supporting structures inside the spine. And in addition to the disc, you'll have some of these other structures there. But under normal circumstances, they are nice and flat, kind of like that. But when you start to have damage to the area, damage to either the disc or to some of those other tissues what will happen is you start to get information, and essentially what information is like, is if we get air in that bag and in case of inflammation, it's actually fluid, but you get the idea from the air in the bag, is that now, you've got the swollen tissue and that can start to press up against the nerve even if the disc, is not, it's self touching it. So what will happen is you can get some fairly significant symptoms due to inflammation. And this is where medication and also spinal injections come in, that they are trying to get rid of the inflammation. And if it's effective, what happens is that they are able to gradually shrink that inflammation down and get the pressure off the nerve that way. So that's the various things that can happen and why the symptoms will change -- and sometimes change rather dramatically and irrelatively short span of time, with disc types and problems.