Disc (Disk) Herniation

Overview

Disc herniation, also called a herniated disc, slipped disc, or ruptured disc is an orthopedic condition that may occur when a disc in your spine degenerates or changes position.

The spine is made up of a stacked series of bones called the vertebrae. Cushioning pads called the intervertebral discs live between each vertebra and work to cushion the spine from shock.

If the herniated disc changes position and presses on the surrounding nerves, patients can experience pain and other symptoms.

Herniated discs are more common in men than women and frequently affect people 35 to 55 years old.

Disc herniation causes

Disc herniation, also known as a herniated disc, is an orthopedic condition that may occur as disc material degenerates, and the ligaments holding the disc in place weaken.

A variety of factors can contribute to disc degeneration, including:

• Aging
• Carry excess weight
• Strain from a sudden movement, improper lifting or twisting violently
• Herniated discs appear to exist within families.

Disc herniation symptoms

Symptoms of a herniated disc vary depending on where the disc is located and if the disc is pressing on a nerve. If the disc is not putting pressure on a nerve, you may not experience any symptoms. Generally, you will experience symptoms from a herniated disc on one side of the body.

Common symptoms or signs of a herniated disc include:

• Sharp or burning pain in the legs, shoulders, or arms that shoot down from the affected nerve.
• Numbness or tingling that radiates through the body.
• Muscles surrounding the affected nerve may weaken, affecting your movements.

Disc herniation complications

In rare cases, a patient may need emergency surgery to prevent permanent paralysis as a result of a disc herniation that compresses the spinal canal.

If left untreated complications can arise, including:

• Inability to control your urine flow or bowel movements
• Worsening pain that affects daily activities
• Loss of sensation in your extremities

Disc herniation risk factors

There are a variety of factors that can increase your risk of experiencing a herniated disc.

Risk factors include:

• Carrying excess weight
• Careers that require heavy lifting, pushing or bending
• Family history of herniated discs or spine problems
• Smoking can decrease the oxygen supply in the body, speeding the degeneration process.

Disc herniation prevention

In some cases, disc herniation can be prevented. Following these steps may help you reduce your risk:

• When lifting heavy objects, use proper lifting techniques.
• Sleep on a firm mattress
• When sitting for an extended period, stand up and stretch as often as possible.
• Wear flat, comfortable shoes (no high heels).
• Avoid smoking
• Eat healthy meals
• Exercise regularly to strengthen your back, stomach, and legs.
• Maintain a healthy weight

Disc herniation diagnosis

Your doctor can diagnose a herniated disc during a physical exam. During the exam, your doctor will take a full medical history as well as perform a neurological exam to evaluate your muscle strength, reflexes, ability to walk, and your ability to feel light touches.

Diagnostic imaging

An MRI is the most effective imaging test used to diagnose a disc herniation. An MRI can produce 3-D images of the affected area. The technology can help your doctor more fully examine the spinal cord, nerve roots, and surrounding areas.

X-ray exams are not typically used if your doctor suspects you have a disc herniation. Soft tissues are not visible in X-ray images.

Other imaging tests your doctor may order include:

• Computed tomography (CT scan)
• Myelogram
• Electromyogram (EMG)

Disc herniation treatment

Most patients experience symptom relief with in-home conservative therapies such as lifestyle modifications and nonsteroidal anti-inflammatory medications.

Nonoperative therapies that may be prescribed to treat a herniated disc include:

• Pain medications such as Advil, Aleve, or Tylenol can be purchased over the counter (OTC)
• Corticosteroid injection into the spinal nerves to relieve pain that is not responding to oral OTC medications.
• Muscle relaxers may be used to treat muscle spasms.
• Prescription pain meds may be used for severe pain associated with a herniated disc.
• Physical therapy to strengthen the muscles in the affected area.

Surgical treatments

If conservative treatment options are not effective, your doctor may evaluate surgical treatments for your case. Your doctor will carefully outline the benefits and risks with you before proceeding.

You may be a candidate if nonsurgical therapies have not been effective, and your pain is severely impacting your quality of life, you are losing control over your bowel and bladder, you have problems standing.

Your doctor typically will remove the herniated section of the disc. In rare cases, the entire disc will need to be removed. In this surgery, your doctor will need to fuse your vertebrae with a bone grate and insert metal hardware in the spine to stabilize.

When to Seek Care

Most herniated discs can be treated with nonoperative care. Over time, symptoms of a herniated disc will improve by minor lifestyle modifications.

If you are experiencing any of the following symptoms, seek care as soon as possible:

• Severe pain
• Significant weakness in the affected area
• Loss of sensation in the genital area
• Inability to control your bladder or bowel movements
• You have a history of metastatic cancer

Next Steps

Most patients will gradually experience full symptoms of relief with conservative treatments. Within six weeks, most patients are able to return to their normal activity level. Some patients experience back pain after treatment.

If you had surgery, follow your doctor’s post-discharge instructions carefully to ensure a full recovery.

If your symptoms intensify or change, contact your doctor to determine the next steps.