Daryle Ward (and maybe Micah Hoffpauir) gets a shot

It looks like a DL stint is in the Wardosaurus' future. The Cubs premier bat off the bench apparently injured his low back when he took a tumble at first base during spring training and it just kept hurting. This makes more sense regarding his slow start as he was 0-14 as a pinch hitter until his recent run of three game changing pinch hits.

His back pain persisted so an MRI yesterday was obtained and diagnosed a herniated disc. He's agreed to get an epidural cortisone injection to treat this. The treatment means a few days of rest (ie. no baseball activities) and so expect another Iowa callup, most likely power hitting lefty 1B-OF Micah Hoffpauir.

The lumbar spine has 5 bony segments or vertebrae connected by discs which are made of fibrous tissue (the annulus fibrosis) filled by softer gel like material (tha nucleus pulposus). When a disc herniates, the fibrous tissue usually tears and the gel like center of the disc pushes through the tear in the annulus, leading to pressure on the nerve tissue nearby. Disc herniations occur most frequently at the two lowest levels labeled by their vertebral segments (L4-5 and L5-S1, after the 5th lumbar segment is the Sacrum).

Treatment is based on the severity and the pattern of pain. The term radicular is used if a nerve root is pinched and produces pain or numbness that radiates down the leg (also generically called sciatica, after the sciatic nerve which is formed from the most common nerve roots involved in disc herniations at these levels) and if the nerve roots that are pinched control a muscle, weakness such as a dropfoot can occur. If the pain doesn't radiate into the leg (non-radicular) it's only lower back pain that results.

Since they want the speediest of recoveries, it appears they are going to give D. Ward an epidural steroid injection (cortisone shot, aka ESI). The epidural space is the anatomic space just outside of the sac where all the nerve roots are contained (the dura). Putting cortisone there theoretically works on the inflammation/swelling produced by the disc herniation and if it works, which it certainly can, should relieve the pain. It probably won't get rid of the herniated disc but it's the symptoms that count as not all disc herniations cause back or leg pain.

Of course there are other treatments that will be used to treat this including the usual non-steroidal anti-inflammatory medication and specific back related exercises particularly strengthening abdominal muscles but the acute flare up needs to be addressed first and this involves a few days of rest. If there is no leg pain or weakness, it's unlikely that surgery will be involved.

Here's to a speedy return for a professional hitter.

(drop) footnote: Micah Hoffpauir was 2-4 last night for Iowa including a 3 run HR and 5 rbi's. If you hear a knocking sound out there Micah, it's Mr. Opportunity.