A herniated disc refers to a specific kind of injury involving one of the rubbery cushions that sit between the individual bones (vertebrae) that make up your spine.
Spinal discs have a soft, spongy center called a nucleus, encased inside a tough, rubbery exterior called an annulus. Also known as a slipped disc or a ruptured disc, a herniated disc occurs when a piece of the nucleus squeezes out through a tear in the annulus.
A herniated disc, which can occur in any level of the spine, can then put pressure on a nearby nerve. Depending on the location of the herniated disc, it can cause pain, numbness or weakness in an arm or leg.
Symptoms of a Herniated Disc
Most often, spinal discs tend to herniate in the lower back (Lumbar Spine), although they may also occur in the neck (Cervical Spine). Signs and symptoms depend on the location of the affected disc and the impinged nerve.
Arm or leg pain. If a disc herniates in the lower back, patients will typically feel pain in the buttocks, thigh and calf, and possibly the foot as well. If a disc herniates in the neck, patients typically feel the most pain in the shoulder and arm. This pain may shoot down arm or leg when you cough, sneeze or move into certain positions.
- Numbness or tingling. People with a herniated disc often experience radiating numbness or tingling in the body part served by the affected nerves.
- Weakness. Muscles served by the affected nerves tend to weaken. This can cause patients to stumble, or affect their ability to lift and hold items.
Causes of a Herniated Disc
Disc herniation most often occurs due to gradual, age-related wear and tear known as disc degeneration. As you age, the discs lose their flexibility, making them prone to tearing or rupturing with even a minor strain or twist.
Sometimes, using your back muscles instead of your leg and thigh muscles to lift heavy objects can lead to a herniated disc, as can twisting and turning while lifting. Traumatic injury may cause herniated discs, but far less often than other causes.
Treatment For Herniated Discs
Conservative treatment mainly involves modifying daily activities to avoid pain and taking pain medication. In most patients, conservative treatment relieves symptoms within a few days or weeks.
- Over-the-counter pain relievers.
- Cortisone injections. If medication does not relieve the pain, a physician may recommend a corticosteroid injection around the area to reduce inflammation.
- Muscle relaxers. Medication that can reduce muscle spasms.
Physicians may suggest physical therapy to help with your pain. Physical therapists can demonstrate several positions and exercises that can help minimize the pain of a herniated disk.
Only a few patients will require surgery for a herniated disc. The physician may suggest surgery if all conservative treatment fails to improve symptoms after six weeks, especially if you continue to have:
- Numbness or weakness
- Difficulty walking or standing
- Loss of bladder or bowel control
In most cases, surgeons will remove the portion of the disc that protrudes into the spinal column. In these cases where the surgeon must remove the entire disc, they will fuse the adjacent vertebrae together with a bone graft.
To allow the fusion process to safely take place over months, the surgeon will place metal hardware into the spine to provide spinal stability.