Skip to main content.

Treatment Options for a Lumbar Herniated Disc [Podcast]

Posted March 02, 2023 by Paul Hartzfeld, M.D.

Listen to this episode of the Healthy Vitals Podcast.

Pain and symptoms from a spinal lumbar herniated disc can be easily mistaken by patients. Summa Health neurosurgeon Dr. Paul Hartzfeld answers some of the most commonly asked questions about treatment for lumbar herniated disc.


Featured Guest:

Paul W Hartzfeld, M.D.

Paul Hartzfeld, M.D., is a member of the Summa Health Neuroscience Institute and has special interests in neck and back pain, stroke, brain tumors and head injury.

A graduate of Toledo’s Medical College of Ohio, Dr. Hartzfeld completed a neurosurgical residency at Henry Ford Hospital in Detroit, MI. He has received board certification from the American Board of Neurological Surgery and is a current member of the Congress of Neurological Surgeons, American Association of Neurological Surgeons, Michigan Association of Neurological Surgeons and American Medical Association. 

Dr. Hartzfeld enjoys golf, reading fiction and cooking.

Transcription:

Scott Webb: Back pain is very common and something that many of us live with and deal with and often don't speak to our providers about. But we may have a lumbar herniated disc, and though that's a very common condition, it's also highly treatable. And joining me today to tell us more about it is Dr. Paul Hartzfield.

He's a neurosurgeon at Summa Health. This is Healthy Vitals, a podcast from Summa Health. I'm Scott Webb. Doctor. Thanks so much for your time today. I know that back problems, maybe I'm just speaking about myself, but just back issues in general, very common, also very treatable, and we're gonna learn about something specific today about that, what it is and how you treat it. So let's do that. Let's get started here with, a really baseline What is a lumbar herniated disc? What is that exactly, and how does it happen?

Dr. Paul Hartzfeld:
I agree with you, one of the most common reasons people will see us in the office are for back pain, complaints, and it's probably thing that we deal with most often, and the thing that's most bothersome to patients when they see us. A herniated lumbar disc is a condition where one of the disks, which is the cushion between the bones of our or vertebral bodies in our low back. The cushion between those vertebral bodies is a disc and a herniated disc is a lump of disc or lump of disc material that has become extruded from its house or the disc space.

And become in contact with one of the nerve roots in the low back. And that results in having some back pain and some leg pain and or numbness. Commonly that leg pain is commonly called sciatica. So a lot of people come to see us saying they're having sciatica pain, and that is likely the result of. Disc pressing on a nerve in the low back.

Scott Webb:
And is this generally wear and tear, is this just something that sort of happens over time, maybe sort of like osteoarthritis where it's just years of use and abuse or whatever? Or are you also seeing patients that have suffered some sort of acute injury?

Dr. Paul Hartzfeld:
Most of the time, patients, when we ask them like, can you identify anything that caused this? They say no. They just woke up with it one day. In those cases, it's just the result of bad luck and wear and tear changes. Just being alive your whole life, working hard and using your back.

Scott Webb:
Yeah. Yeah.

Dr. Paul Hartzfeld:
Sometimes people will say, you know, I was shoveling snow the previous day, or we had just moved a bunch of boxes in my house, or whatever it may be, where I was doing a lot of bending or lifting or twisting, and I felt a pop in my back. And then the next day, my leg really started to hurt. So sometimes people can identify an inciting event, but most of the time they can't come up with anything specific. It just sort of happened.

Scott Webb:
Yeah, just as you say, being a person. Live in a certain number of years, lift in boxes, shoveling snow, whatever it is. It just happens over time. You mentioned there a little bit, so some pain, numbness, but wondering if you can help listeners, when we think about the signs and symptoms of that herniated disc what are they most likely to experience?

Dr. Paul Hartzfeld:
Most of the time the classic symptoms of herniated disc pressing on a nerve in the low back would be I woke up or I was lifting something and my back was really bothering me. And then a day or so later, my back felt better. But I had this lightning, I had this fire, I had this numbness that was traveling down my leg from my buttock into my thigh and then past my thigh and my calf, or in my shin and then into my foot in some way. Those are the classic symptoms of nerve pressing on or nerve being pressed on by a disc in the low back.

Scott Webb:
And then for you, sort of as the expert in the room, when folks come in, you get patient history and you do a physical exam, how do you diagnose the condition?

Dr. Paul Hartzfeld:
Some of it is clinical, just listening to the story, doing an exam. Do they have a weak foot like, a, a foot drop, or that doesn't even have to be a foot drop, but just pushing their foot down or pulling it up. Is it weaker than the opposite side that doesn't hurt? Those are all findings that are suspicious to us that there's gonna be a disc issue in the low back. The best way to diagnose that when we have that suspicion is to get an MRI of the low back that would clearly show the spinal canal, the discs, the nerves. And is there one impressing on a nerve in the low back?

Scott Webb:
Yeah. And as one of the challenges, even for someone like yourself in terms of herniated disc versus other spine conditions is one of the challenges that the signs and symptoms well, it could be this, it could be that it's something in your back, but it might be a herniated disc or it might be something else. Is that one of the challenges is just differentiating between herniated discs and something else.

Dr. Paul Hartzfeld:
Yes, That's why we like to hear a good story from the patient. And for instance, if they come in and say, my back bothers me, my leg doesn't bother me. They may have a problem in their back, but it may not be a disc pushing on a nerve. It could be a compression fracture or just a wear and tear fracture in a vertebral body that's causing them back pain, but not necessarily leg pain cuz that doesn't involve a disc pressing on a nerve. That's why eventually imaging really helps us out to make those appropriate diagnoses and differentiate one from another.

Scott Webb:
Yeah, you'd be speculating in the office based on the patient history and what they're saying. But obviously in the end, imaging, MRIs, that's the, probably the gold standard in terms of diagnosis. It's been really, yeah, it's been really helpful and educational today. I think the thing on my mind and probably the minds of listeners, doctor, is what can you do to help? What are the treatment options?

Dr. Paul Hartzfeld:
The treatment options can range from simple things that involve conservative nonsurgical options like physical therapy, chiropractic care, acupuncture, water therapy. All the way to more invasive options like cortisone shots or nerve root blocks. And finally, an operation that goes and unpinches the nerve by removing the disc material that's in contact with it. And depending on the clinical situation that helps us tell the patient what the best option for them is. For instance, if they're just having back and leg pain, they don't necessarily have weakness associated with that nerve being pinched.

A lot of the times we'll suggest, why don't we try to get you by without surgery? Let's do some physical therapy, chiropractic care, things of that nature, and if that solves the problem, excellent. If it doesn. Surgery is still an option or we could go to the next step, a little more invasive and have a nerve root block done and just get some cortisone, some steroid around the nerve root to see if we can make it calm down and feel better. And hopefully over time the disc will just regress back into the disc space and not put pressure on the nerve.

And finally, if that doesn't work or the conservative treatments don't work, then an operation where we go unpin the nerve by removing not the whole disc, but the piece of disc, which is already where it's not supposed to be would be the next step.

Scott Webb:
Yeah, it's always good as patients to know there's options, you know, sort of lofi, minimally sort of invasive type options. But as you say, surgery is an option. If it's indicated, if you've tried everything else, it's an option, of course. And you and your partners, you had the expertise to do that. It's Summa Health. So Dr. Thanks so much. You stay.

Dr. Paul Hartzfeld:
Yep. Thank you. Thanks for your time.

Scott Webb:
And to make an appointment with a Summa Health neurosurgeon, call 330.576.3500 or visit summahealth.org/brain to learn more. And if you found this podcast to be helpful and informative, please share it on your social channels and be sure to check out the full podcast library for additional topics of interest.

This is Healthy Vitals, a podcast from Summa Health. I'm Scott Webb. Stay well, and we'll talk again next time.


About the Author

Paul Hartzfeld, M.D.

Vitality eNews Sign Up

Receive the Summa Health eNewsletter for the latest health tips, advice and updates.

Related Blogs

View all Flourish Blogs

Navigating the World of HIV and AIDS [Podcast]

Dr. Hite discusses HIV and AIDS, explains how the infection progresses, answers frequently asked questions, and reminds viewers about prevention and treatment options.

New Wave of Weight Loss Drugs Aren’t One Size Fits All [Podcast]

Obesity drugs like Wegovy and Ozempic have ushered in a new age medical weight loss. In this episode, obesity medicine specialist Dr. Kenneth Wells, explains how these medications work, how they should be used and what patients should know when considering this treatment.

How Does Radiation Therapy Work? [Podcast]

Dr. Desai answers your questions about radiation therapy and discusses advancements in treatment technology.

What is Breast Density and Why is it Important? [Podcast]

This podcast episode delves into breast density, covering its types, detection methods, significance for screenings, misconceptions, and risk reduction. Learn about dense breast screenings, recent Ohio legislation expanding coverage, and proactive measures for breast health. 

HIV Prevention with PrEP Medications: Key Facts and Benefits [Podcast]

Join us as we explore PrEP (Pre-Exposure Prophylaxis), a powerful tool in preventing HIV infection. We'll cover its definition and remarkable effectiveness in reducing the risk of HIV transmission.

What Will I Learn at a Rainbow Tour? [Podcast]

In this episode, we explore the Rainbow Tour, a groundbreaking initiative aimed at promoting education and awareness about the proper use of pronouns and understanding SOGI (Sexual Orientation and Gender Identity). Visit summahealth.org/rainbow and fill out the form to get involved.

Torn Rotator Cuff? Try These 4 Non-Surgical Treatments That Really Work

Do you feel a dull ache deep in your shoulder that worsens at night or with particular arm movements? Do you have weakness when lifting or rotating your arm above your head? If you answered yes to either of these questions, you might be dealing with a torn rotator cuff.

The rotator cuff is a series of muscles and tendons that keeps the shoulder joint stable, while allowing the arm to rotate. Rotator cuff injuries are very common and increase with age. Injury, degeneration or…

Putting Your Best Foot Forward This Summer

As the weather gets warmer, more and more people will be outside participating in a range of summer activities, from sports to hikes and even gardening. While this is certainly good for your health, summer can also lead to a number of foot and ankle injuries.

Ankle Sprains

A sprained ankle occurs when the ankle rolls towards the outside of the foot, most often during physical activity, and it is one of the most common foot injuries. While a mild sprain is often nothing to…

Ashley Krul: Wellness in the Workplace [Podcast]

Wellness has become a buzzword we hear a lot about, but maybe we don’t know precisely what it means. It can also mean different things to different people. Today’s guest, Ashley Krul, program coordinator of employee wellness at Summa Health, discusses the many dimensions of wellness and how they impact our lives. She also shares how Summa Health focuses on keeping employees well in the workplace. 

Lung Cancer Screening and the Advancements in Lung Cancer Detection and Treatment [Podcast]

Dr. Aziken, a cardiothoracic surgeon at Summa Health, reviews the importance of lung cancer screenings, who is at risk of developing lung cancer, some of advancements in the treatment of lung cancer and debunks common myths.

How to Care for Aging Parents or Loved Ones [Podcast]

In this episode, Dr. Gabrielle Ruff leads a discussion focusing on advice for caregivers of aging parents/relatives.

Minority Health Month and the Social Determinants of Health [Podcast]

Iriel Hopkins: Summa Health System Director of Community Relations and Diversity, and Marlo Schmidt: Summa Health System Director of Community Benefits, discuss the social determinants of health.

An Introduction to Mindfulness and its Health Benefits [Podcast]

In this episode, Certified Mindfulness Teacher and Life Coach Shannon Speaks leads a discussion focusing on the practice of mindfulness, and the many health benefits of this practice.

Sports Injury? Check Out 5 Non-Surgical Treatments That Offer Quicker Recoveries

A sports injury can be scary, especially if you're facing surgery that could keep you sidelined for weeks, if not months.

Fortunately, surgery isn't always the best option when you suffer an injury from playing a sport, exercising, or participating in recreational activities. A wide range of non-surgical treatments are available today that effectively treat muscle pain, joint pain, and lack of mobility. 

A sports injury encompasses the musculoskeletal system, including…

Celebrating Women in Healthcare [Podcast]

In this episode, we are celebrating women physicians. Dr. Cheryl Johnson and Dr. Jacqueline Tulodzieski-Ahlstrom lead an interactive discussion focusing on what brought them to their careers in medicine, and what they love about working at Summa Health.

Treatment Options for Tinnitus or Ringing in Ears [Podcast]

In this episode, Dr. Deanna Nickerson leads a discussion about tinnitus and the treatment options available.

Vasectomy 101 and Summa Health's Vas Madness [Podcast]

Dr. Kevin Spear leads a discussion on what you need to know about vasectomies, including the procedure itself and post-procedure care.

5 Ways to Reduce Joint Pain and Stiffness This Winter Season

Do frigid temperatures cause slow, achy joints that make it difficult for you to get moving? It’s not just your imagination. People living with joint pain related to conditions, such as: arthritis, rheumatoid arthritis, lupus or fibromyalgia, often report when temperatures drop, their joint pain acts up. 

It’s true, cold weather causes muscles to tense, which can lead to less mobility and flexibility in the joints. Some studies also associate joint pain with…

How Strong Are Your Bones? Get the Facts on Osteoporosis

How strong are your bones? You may have no idea until you break one doing some mundane activity, such as bumping into furniture, coughing or sneezing.

Osteoporosisis a bone disease that occurs when your body breaks down more bone than it creates. Bone is living tissue that is constantly broken down and replaced. The disease causes your bones to become weak and brittle, and breaking a bone doing seemingly ordinary activities is typically the first sign of osteoporosis.…

Securing the Safety for Healthcare Employees [Podcast]

Violence is rising in the healthcare setting. According to the American Hospital Association, 44% of nurses reported experiencing physical violence, and 68% reported experiencing verbal abuse nationwide during the COVID-19 pandemic as of June 2022.

Unfortunately, we know this reality to also be true at Summa Health. It is estimated that 3% of patients are considered violent on a daily basis. Violent situations make it more challenging for nurses and other staff to provide quality patient care, especially when they fear for their safety.

We have asked our nurses and frontline staff to share the stories of their experiences with patients being violent or abusive. Their stories deserve to be heard. The policy needs to change.

Joan Riemer: How to Become a Leader [Podcast]

In this episode, we will hear from Joan Riemer, System Director of organizational development and training HR employee development. She will lead an in-depth discussion on what she believes are the skills, practices, and values that make a good leader.

Michelle Bisson: Teamwork & Defining Success - Advice for Women in Healthcare Leadership [Podcast]

In this episode, Michelle Bisson, Senior Vice President of Marketing and Business Development, discusses the importance of having female leaders and shares her core values and practices.

Total Joint Replacement Trends: Technology Advances Are Increasing Surgical Rates and Patient Satisfaction

Do you have a bad hip? Achy knees? If you’re suffering from chronic joint pain, a total joint replacement can provide you with a better quality of life that includes less pain, improved motion and strength that you require for an active lifestyle.

Cartilage in joints naturally protects the bones from rubbing together. But when cartilage deteriorates due to injury, aging or disease, such as arthritis or obesity, bones begin rubbing together while in motion. This results…

Vaccines for Pregnant Individuals [Podcast]

Director of Obstetrics, Dr. Meghan Mehl discusses vaccinations for pregnant individuals and those planning to become pregnant.

The Importance of Advance Directives in End-of-Life Care [Podcast]

In this episode, Dr. Kyle Yoder and palliative care social worker Ellen Saal-Patterson lead a comprehensive discussion on preparing for end-of-life care.

Grief Counseling: A Personal Experience That Fueled a Passion for Helping Others [Podcast]

Shannon Blower, Chaplain and Director of Pastoral Care Services, shares his personal experience with grief and provides tips and resources for anyone coping with grief.

Erectile Dysfunction: Symptoms, Causes, Treatment and More [Podcast]

Elizabeth Boes, D.O. provides an educational overview of erectile dysfunction. Learn about symptoms, causes, treatment, and more.

Shoulder Pain: Causes, Injuries, and Treatment [Podcast]

Dr. Ryan Urchek gives an overview of shoulder pain from common causes, injuries, and treatment options.

Juneteenth: What It Is and Why It’s Celebrated [Podcast]

Dr. Yoleetah Ilodi & Iriel Hopkins discuss Juneteenth and its importance. Listen and learn more in this episode of Healthy Vitals.

Multiple Sclerosis: Symptoms, Treatment, and More [Podcast]

Dr. Dmitri Kolychev, a neurologist at Summa Health, discusses the influx of Multiple Sclerosis diagnoses in the United States. Learn about MS symptoms, treatment options, and more in this episode of Healthy Vitals.

Nurses Week: Celebrating Nurses and Their Commitment to Our Community [Podcast]

Tiffany Collins discusses her journey and passion for nursing.

Getting Help for Long-Term Post-COVID Symptoms [Podcast]

While most people with COVID-19 recover and return to normal health within a few weeks, others have symptoms that linger for months after recovery. Even people who have had mild versions of the virus can experience persistent or late symptoms. These people are often referred to as "long haulers" and the condition has been termed post-COVID syndrome or "long COVID-19."

Maternal Health in the Black Community [Podcast]

Dr. Cheryl Johnson leads a discussion focusing on empowerment in the African American community, especially maternal health.

Testicular Cancer: An Overview from Prevention to Treatment [Podcast]

Dr. Dankoff provides an overview of testicular cancer. Learn about symptoms, prevention, and treatment options.

What Makes a Great Doctor - Personal Insights, Advice, and Why they Chose Medicine [Podcast]

Dr. Shanu Agarwal and resident Kortnie Broschinsky discuss their journey into healthcare.

Occupational Therapy: What Is It, How Does It Help, Who Should See An OT [Podcast]

Craig Wood leads a discussion focusing on occupational therapy, its benefits, and why he got into the field.

Our Commitment to Creating a Healthier Community [Podcast]

Iriel Hopkins and Marlo Schmidt discuss ways in which Summa Health System contributes to a healthier community.

Sudden Infant Death Syndrome – What You Need to Know [Podcast]

Karen Frantz DeSeptis and Ericka Malone lead a discussion on SIDS, and important information you need to know.

An Overview of Osteoporosis: Prevention to Treatment [Podcast]

Natalie Hiltbrand, an Osteoporosis Specialist at Summa Health, leads a discussion on osteoporosis treatment, as well as prevention.

An Overview of Osteoporosis: Prevention to Treatment [Podcast]

Natalie Hiltbrand, an Osteoporosis Specialist at Summa Health, leads a discussion on osteoporosis treatment, as well as prevention.

Pelvic health 101: 6 common vulvar disorders

When women experience pain or discomfort in their pelvic region, many times their first thought is the dreaded yeast infection. That’s not a surprise because most women — as many as 75 percent — will be diagnosed at least once with a vaginal yeast infection during their lifetimes.

However, there are vulvar disorders other than yeast —  that can cause similar symptoms, including redness and swelling, intense itching, discolored discharge, blisters…

Addressing Common Pelvic Health Issues [Podcast]

Dr. Megan Cesta and senior physical therapist Amy Senn discuss common pelvic health issues women may experience.

Addressing Common Pelvic Health Issues [Podcast]

Dr. Megan Cesta and senior physical therapist Amy Senn discuss common pelvic health issues women may experience.

Pain Relief After Total Joint Replacement Surgery: Reducing the Need for Narcotics and Opioids [Podcast]

Healthy VitalsDr. Kiel Pfefferle discusses how Summa Health is moving away from opioids and narcotics as the primary pain relief after joint replacement surgery.

All About Sleep Apnea [Podcast]

Dr. James Bavis & Dr. Ketan Deoras explain sleep apnea as well as signs, symptoms, and what to expect.

FAQ: Partial knee replacement surgery

If you’re like one in five Americans, you’ll eventually develop arthritis of the knee. This means the cartilage that cushions the bones of your knee begins to degrade, causing those bones to painfully rub together. When that pain becomes too much or restricts activities you once enjoyed, it’s time to talk to your doctor about treatment, including knee replacement surgery.

What’s the difference between a partial and a total knee replacement?

Sometimes…

Does Weather Affect Joint Pain?

Have you ever heard from someone that they can predict when a storm is coming because their joints hurt? It’s pretty common for people to blame joint pain flare-ups on changes on the weather, but scientists and doctors have yet to pinpoint exactly what it is about cold, rainy, or humid weather that makes joints stiff and achy.

Leading Theories

While joint pain isn’t directly correlated with dropping temperatures, the thought is that the change in barometric pressure…

Breast Cancer: The Importance of Knowing Your Risk [Podcast]

Dr. Keristen Brantley & Dr. Victoria Van Fossen discuss Breast Cancer Prevention and Treatment.

Alzheimer’s Awareness: Symptoms, Stages, and Support [Podcast]

Amanda Harvan sheds light on the symptoms, stages and support of Alzheimer's.

Men’s Well-Being: All About Prostate Health [Podcast]

Dr. Kevin Spear discusses men's health and different risk factors and how to ensure optimal well-being.

The Latest Updates on COVID-19 [Podcast]

Dr. Thomas File shares the latest updates on COVID-19.

Can Obesity be Considered a Disease [Podcast]

Dr. Adrian Dan discusses obesity as a metabolic disease.

Breaking the Stigma of Mental Illness [Podcast]

Emily Hionides-Horner discusses 7 ways to overcome mental health stigma.

The Modern Guide to Heart Health [Podcast]

Dr. Peter Bittenbender shares his insight on the modern guide to heart health.

Tips on Maintaining Fitness and Physical Health During the Pandemic [Podcast]

Dr. Cipriani discusses tips on maintaining physician health during the pandemic.

Tips for Managing Anxiety [Podcast]

Dr. Leslie Zaynor discusses tips for managing anxiety.

Plantar Fasciitis – It’s Not Just For Runners

If you are a runner, chances are you’ve heard of plantar fasciitis. It’s one of the most common causes of heel pain. However, any job or activity where you are on your feet for long periods of time can put you at risk as well.

An introduction to plantar fasciitis

A thick band of tissue - plantar fascia - connects your heel bone to your toes. This tissue acts as a shock-absorber on the feet. If tension and stress start to cause small tears, this ribbon-like tissue…

Osteoporosis: Don't Be Broken

6 Proactive Simple Steps You Can Take

Osteoporosis is a bone disease in which the bones become weak and brittle. Osteoporosis is a disease in which there is an increased risk of fracturing a bone from a non-traumatic fall or even simple actions such as sneezing.

According to the National Osteoporosis Foundation, 54 million Americans have osteoporosis or low bone mass. Studies also show that 50% of women and 25% of men around age 50 are at risk for breaking a bone secondary to…

[{"RootId":"ba198066-3078-4dcd-8e69-28251bebb940","RootUrl":"/glossary/"}]

Options to Request an Appointment

If your situation is an emergency, call 911.