Disc Issues in Soccer Players

For soccer players unlucky enough to suffer from one, a herniated disc can be a real game-stopper.

“Some athletes have high pain thresholds, but this one will catch your attention,” said Dr. Michael Hisey, a spine surgeon on the medical staff of Texas Health Spine & Orthopedic Center and in private practice with the Texas Back Institute.

Typically, the pain radiates from the lower back, or one or both of the legs. Some patients will experience a day or two of back pain, which improves, but then the pain arises in the legs. A herniated disc can also occur in the cervical spine, causing neck pain that radiates into the arms.

To explain how this happens, Dr. Hisey has patients picture a pastry. “A disc is like a jelly donut,” he says.

Each disc in the spine has a tough outer layer (annulus) surrounding a jelly-like substance in the center. When a disc becomes herniated, the “soft stuff ” breaks through – like squeezing the jelly out of a donut. That creates pressure on the nerves.

Diagnosing a herniated disc isn’t always easy. Sometimes, the symptoms don’t arise for days, even months, after an injury occurs.

“A herniated disc can occur due to a fall or a twist, or out of nowhere,” Dr. Hisey said. “Herniated discs are funny that way.”

Aging can contribute to herniated discs -- as a person gets older, discs become dehydrated, making them less supportive and more prone to injury.

“But even a healthy, well-hydrated disc can be injured,” Dr. Hisey said.

The first line of treatment for a herniated disc: non-steroidal anti-inflammatory medications (such as ibuprofen) and bed rest or light physical activity. Additional treatment may involve physical therapy or chiropractic care. If pain persists, epidural steroid injections are an option. Only an MRI can definitively diagnose a herniated disc, but typically, “we try some non-surgical treatments for the first couple of weeks before we do an MRI,” said Dr. Hisey. Very severe symptoms, however, do call for immediate medical attention: loss of bladder or bowel control, muscle weakness or severe pain.

If non-surgical options have been exhausted, doctors may recommend a surgery called discectomy, which removes the portion of the disc that’s affecting the nerve. Because the procedure leaves most of the disc intact, this surgery is unlikely to lead to additional problems down the road.

“People assume that once you’ve had back surgery you’ll need to have another surgery,” Dr. Hisey said. “That’s not necessarily true, and with this particular problem, there’s a really good chance we can get it better and it will stay better, without additional surgery."

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