How to Recognize a Herniated Disc and What to Do About It?

Back pain is one of the most common reasons the average person will make a doctor’s appointment. Many people are concerned that their back pain could be related to a herniated disc. This is a term that is commonly used, but often misunderstood. To understand the function and importance of your discs, think of them as cushions between the bones, or vertebrae, of your back. The discs help to stabilize your spine and allow it to move properly. Additionally, the discs help create space for your spinal nerves to exit the spinal column as they continue to their destination (ex: your legs). The discs in your back are made up of two components:
  1. Annulus fibrosus – a tough, but flexible outer ring
  2. Nucleus pulposus – a soft and jelly-like center
A herniated disc, also referred to as a slipped or ruptured disc, occurs when the material in the center of the disc escapes through a crack in the outer ring. This can be caused by simple wear and tear or a sudden injury. This escaped material can press on your spinal nerves, causing pain in the neck and back, often with referred symptoms to the arms or legs. Most herniated discs occur in the lower back, or lumbar spine, but they can also occur in the neck.

Herniated Disc Symptoms:

  • Back pain or neck pain
  • Pain in the arms or legs
  • Numbness and tingling in the arms or legs
  • Weakness in the arms or legs
Often the most obvious symptoms of a herniated disc are not in the neck or back, but in the extremities connected to the affected nerves. A herniated disc in your lower back may cause the most intense pain in your thigh, calf, and buttocks, whereas a herniated disc in your neck may cause the most intense pain in your arm and shoulder. If you are experiencing back or neck pain, especially coupled with pain in the arms or legs, this is your body’s way of signaling you that something is not right and it is time to seek medical attention. A herniated disc can be a complicated health matter and must be addressed as soon as possible to avoid complications and chronic pain.

What Will My Doctor Do to Help?

The first step to treating a herniated disc is a definitive diagnosis. Make an appointment with a back pain specialist (ex: chiropractor, pain management physician, physical medicine and rehabilitation physician, or orthopedic surgeon). Your doctor will perform a thorough orthopedic and neurological exam along with imaging (x-rays and possibly an MRI) to identify the problem area. If you are diagnosed with a herniated disc, there are 4 stages of increasing severity that your doctor will need to assess as this will help determine what type of care is appropriate. In the early stages of disc herniation, your condition can likely be helped by chiropractic care. Chiropractors utilize a safe, gentle, and effective form of non-surgical care called spinal manipulation. If you are a candidate for spinal manipulation, treatment can usually begin immediately and will likely involve flexion-distraction. Flexion-distraction is one of the most beneficial forms of spinal manipulation for a herniated disc. It involves the use of a precision-engineered table. While lying on your stomach the table is set to gently bend at the waist in a specific rhythmic pattern that is based on your condition. All movements are provided and controlled by your chiropractor – not a computer. The bending creates a pumping action that can help the disc return to its normal location and therefore begin the healing process. Your care plan is designed to correct the problem, not mask the symptoms. Multiple sessions, of 10 minutes or less, are required. Coupled with home exercises and ice therapy, this condition can usually be managed well without the need for surgery or medication. There are rare cases, however, where a patient would not benefit from chiropractic care and non-surgical treatment is not enough to correct the problem. These are usually advanced cases which could include arm or leg weakness or numbness over the gluteal area, difficulty walking or standing, and loss of control of the bowel/bladder. These cases should be considered an emergency and should be seen by a qualified spinal surgeon as soon as possible.

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Dr. Vizurraga from TSAOG Orthopaedic & Spine Shares His Joint Replacement Expertise on SA Live

TSAOG proudly announces Dr. Vizurraga’s appearance on the popular news outlet, KSAT12 News SA Live. San Antonio, TX: TSAOG, a leading spine and orthopedic center in Texas, is pleased to share the appearance of their physician, David E. Vizurraga, M.D., on KSAT12 News SA Live. Dr. Vizurraga is a board-certified orthopedic surgeon, certified by The American Board of Orthopaedic Surgery, specializing in joint replacements.  Dr. Vizurraga recently appeared on SA Live, sharing his expertise on hip and knee replacement surgeries. In the program, Dr. Vizurraga talks about the intricacies behind knee and hip replacement surgeries and what special instruments are used for the specific procedures. On SA Live, he also shares the importance of the recovery process and what that may entail after surgery, including physical therapy, pain medication, and more. With recent enhancements and improvements to joint replacement surgeries, many patients can expect to be discharged on the same day of surgery or the next day.  Along with sharing his extensive knowledge of joint replacement procedures, Dr. Vizurraga provided some candid advice on the significance of getting evaluated by a professional if experiencing discouraging, persistent joint pain so that they can receive the necessary treatment for their specific needs. TSAOG invites new and existing patients to schedule an evaluation appointment if they are experiencing any joint discomfort. David E. Vizurraga, M.D. practices at Ridgewood Orthopaedic Center in San Antonio, The Orthopaedic Institute in San Antonio, and Resolute Retail Plaza in New Braunfels, Texas.

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Back Pain Prevention Tips for New Moms

Back pain is a common symptom during pregnancy due to multiple factors, including: weight gain, changes in posture, and sleeping positions. In addition, the changing hormone balance that relaxes the strong ligaments of the pelvis in preparation for childbirth can affect the back.   While back pain during pregnancy is no secret, many women also experience back pain after delivery. Many of the common causes of back pain during pregnancy continue after delivery, but there are also several unique reasons why new mothers experience back pain:
  1. Mothers pick up their babies a lot (dozens or even 50 or more times a day)!
  2. Mothers lift their babies from a bent over position and/or carry them on one side, placing excess and/or uneven strain on the back.
  3. Babies get heavier! Although most average around 7 pounds at birth, babies grow to nearly 20 pounds during the first 6 months.
  4. Some important stabilizing muscles of the back, pelvis, stomach, and thighs (all of which support the spine) are either too tight, too loose, or not in ideal condition after the rigors of pregnancy.
The good news is that most back pain that new Moms experience is temporary and can be relieved with a combination of stretching, exercises, weight loss, good habits, and simple changes in techniques.


The spine is a complex interaction of bones, muscles, tendons, and other tissues. After delivery many of the muscles that stabilize the spine are not in ideal condition. Hip flexors and hamstrings are two sets of powerful thigh muscles that are often too tight after pregnancy. A focused stretching regimen on these muscle groups can have a profound improvement on back pain. On the other end of the spectrum, the abdominal muscles are often stretched out. These important core-stabilizing muscles, in addition to the large lumbar back muscles, will benefit from a focused strengthening program. It is important to discuss with your physician when it is safe after delivery to return to exercise. Returning too early can cause more harm than benefit, regardless of method of delivery. Normally women who’ve had a C-section will need to postpone exercise longer. Once you are safe to begin a stretching and strengthening exercise program, a focused recommendation by your physician or physical therapist can provide dramatic improvement in post-partum back pain.


Although weight loss immediately after delivery happens quickly, especially if you are breastfeeding, the rate often slows down over time. Don’t get frustrated! Just as the weight gain from pregnancy increased over many months, it will often take many months to get back to your ideal pre-pregnancy weight. One pound a week of weight loss is a reasonable goal. The good news is that each pound of weight loss vastly decreases the strain placed on the back.


Sometimes it can be hard to remember proper lifting techniques, especially when the baby seems so small, but the way you lift can have a profound effect on your post-partum back pain. Key times to think about this are when taking your baby in and out of the crib, highchair, or car seat. Follow these safe lifting techniques for best results:
  1. Lift your newborn, or anything at ground level for that matter, from a straight on position. Lifting from a twisted or rotated position puts a huge amount of strain on your back.
  2. No straight arms or legs! If your elbows and knees are in a locked position, you are lifting wrong. While lifting, bend your knees to use your strong thigh muscles and bend your elbows to bring baby closer to your core.
  3. Flex your core stomach muscles while lifting, but avoid holding your breath. This gives extra stability to the back during lifting.


Posture plays an important part of preventing or improving back pain for everyone, but is even more important after delivery. Having good firm support for your back while sitting, driving, and nursing are key. While nursing, make sure to bring the baby to you as opposed to bending over to the baby. You should also avoid carrying the baby on one hip as this can strain the back.


Most back pain after pregnancy is temporary and can be alleviated by following these recommendations. However, you should seek medical attention if your back pain:
  1. Persists longer than several weeks
  2. Radiates from your back to your legs or arms
  3. Involves numbness or weakness in the arms or legs
Additionally, if you notice changes in your bowel or bladder function, fevers, bleeding, or any other concerning symptoms, you should seek medical attention right away.

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What to Expect Before and After Knee Replacement Surgery

If you and your physician have decided that knee replacement surgery is the best course of treatment for you, some preparation will be involved before your procedure. Preparing for knee replacement surgery can be exciting but also stressful. To alleviate any stress or uncertainty, it is best to go into the process with as much information as possible to make your procedure and recovery go as smoothly as possible. By the end of this article, you will be equipped with knowledge of what to do before and after your surgery to speed you along the path to recovery.

What to Know and Expect Before Knee Replacement Surgery

Approximately 30 days before your surgery, you will meet with your surgeon to outline pre and post-surgery expectations. During this time, your surgeon will conduct a variety of pre-surgery tests and outline necessary steps that should be taken before surgery. You and your surgeon may also discuss the following:
  • Recommend pre-surgery exercises such as stretching and strength training
  • Questions about your procedure and potential health complications
  • Accommodations that will need to be made to your daily routine
  • Surgical treatment plan
  • Recovery time
This will give you an insight into what to expect before your surgery and the steps that should be taken to ensure a successful procedure and recovery.

What to Prepare Before Knee Replacement Surgery

Before surgery, it is essential to plan ahead to ensure you are fully prepared for a smooth recovery. Recovering from a total knee replacement can take approximately 8-12 weeks. This can be a lengthy process and one that is difficult to go through alone. For that reason, it is crucial that before undergoing surgery, a support network is established. Your support network can comprise friends, family, or even a neighbor. This support network should be there to support you and help you before and after surgery. The better prepared you are around the house, the easier it will be for you and your caregiver after surgery. Below you will find some helpful home preparations recommended one week before surgery:
  • Make clear walking paths free of obstructions.
  • Place important items in an easily accessible area.
  • Ensure cords are tucked away to avoid a tripping hazard.
Along with preparing your home, there are also some products that can aid in your recovery. You may consider buying items such as:
  • A Shoehorn/Sock Aid Device
  • An Elevated Toilet Seat attachment
  • Cane/Walker/Wheelchair (See if your insurance will assist with this)
  • A Reaching or Grabbing Tool
All of these can be used to improve your ability to function around the house after surgery.

What to Know and Expect After Knee Replacement Surgery

Post-operation, your doctor will give you a protocol for caring for your incision and what activities you should and should not do. Something you should be aware of post-surgery is DVT (Deep Vein Thrombosis). DVT can occur in your lower extremities if you are inactive for prolonged periods and can potentially be life-threatening. To help avoid this do ankle pumps and ask your doctor if compression stockings are appropriate for you to wear. Physical Therapy will be invaluable in helping you maximize your mobility and strength post-surgery. You can expect the first few visits to therapy to be difficult, but well worth it. Doing your exercises in physical therapy alone will not be enough. It’s highly recommended to practice your home exercises as prescribed to you by your physical therapist. As you progress and gain range of motion, your exercises will shift more towards focusing on strength and balance. After surgery, you may need crutches, a walker, or a wheelchair to get around. You may not have the same stamina you did before your surgery, so consider this when taking trips or going out into the community. Once you are cleared, walking frequently can help rebuild this stamina.

What To Do After Knee Replacement Surgery

Immediately after surgery, you will not be able to do much with your affected leg. A Quad Squeeze is a simple exercise that can help you in the long run. Simply contract the muscles above your knee and hold for 5-10 seconds, then relax and repeat this a few times throughout the day. Be sure to go to Physical Therapy consistently and minimize the number of sessions you miss. Keep an eye on your incision, and if you notice unusual redness, swelling, or other discoloration, please call your doctor. Finally, ask questions throughout the process; if something seems off, bring it up to your doctor or therapist and let them know your concerns. If you have any questions about your rotator cuff surgery or recovery process, contact our Joint Replacement Specialists. We can help you plan for the safest and fastest recovery possible.

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