Herniated Disc

What is a herniated disc?

A herniated disc is a painful medical condition that occurs in your spine (backbone). Your spine is made up of 26 bones called vertebrae. In between each of these vertebrae are soft discs. These discs act like cushions and keep the bones of the spine in place. They also let your backbone move so you can bend and stretch.

These discs can weaken over time. Sometimes, they even rupture. The soft, jelly-like center of the disc pushes outward. When this happens, it’s called a herniated disc. (The word “herniate” means to bulge or to stick out.) This is also called a ruptured disc, a slipped disc, or a bulging disc. These discs become a problem when the center of the disc pushes against a nerve or the spinal cord. This causes mild to severe pain.

Herniated discs are most common in the lumbar spine—the lower part of your backbone, between the bottom of your ribs and your hips. They can also happen in your cervical area (your neck). The discs in your upper-to-mid back (thoracic area) are rarely involved.

Symptoms of a herniated disc

When part of a disc presses on a nerve, it can cause pain. Often the pain occurs on one side of your body. Where the pain is located depends on where the herniated disc is located.

A slipped disc in the cervical section of your spine can cause pain in your neck and arms. You could experience:

• Pain when moving your neck
• Pain near the shoulder blade
• Shooting pain down the arm and into the fingers
• Numbness in the shoulder, elbow, forearm, or fingers
• Weakness

A slipped disc in the lumbar part of your spine can cause pain in the back and legs. It is often referred to as sciatica. This is because the disc pushes on the sciatic nerve, which runs down your leg. Symptoms include:

• Pain in the leg, hip, or buttocks
• Numbness in these areas
• Pain or numbness in the back of the calf or sole of the foot
• Weakness in one leg

How bad the symptoms are depends on how much of the disc is pressing on the nerve. The pain from a herniated disc is usually worse when you’re active and gets better when you’re resting. Coughing, sneezing, sitting, driving, and bending forward may make the pain worse. These movements put more pressure on the nerve. People who have painful herniated discs often try to change positions to reduce the pain.

What causes a herniated disc?

As you age, the discs in your spine weaken and become flatter (less cushiony). If a disc becomes too weak, the outer part may tear. The inside part of the disc then pushes through the tear and presses on the nerves beside it. You could be at higher risk of getting a herniated disc if you:

• Are middle-aged or older
• Lift heavy objects
• Are overweight
• Do repetitive actions involving bending or twisting
• Sit in the same position for a long time regularly
• Live an inactive lifestyle
• Smoke

How is a herniated disc diagnosed?

Your doctor will ask you questions about your symptoms and give you an exam. He or she will check you for numbness, weakness, reflexes changes, and pain. They will probably order X-rays or other pictures to see if you have a herniated disc. These could include a CT scan or an MRI. There are also nerve tests your doctor can order. These can determine what nerves are involved, if there is nerve damage, and how well your nerves are conducting feelings.

Can a herniated disc be prevented or avoided?

There’s not much you can do to prevent a herniated disc. It is often caused by natural aging and deterioration. To keep your discs and back in good working order, follow a healthy lifestyle:

• Maintain a healthy weight
• Exercise regularly
• Strengthen your back and abdomen muscles
• Avoid repetitive movements
• If you sit all day, get up and walk around every hour
• Practice safe lifting and bending techniques

Herniated disc treatment

There are several steps that can be taken to treat a herniated disc.

Medicine – Your doctor may recommend over-the-counter pain medicine like acetaminophen (Tylenol) or ibuprofen (Advil) or prescribe a pain medicine. They may also give you muscle relaxants to relieve muscle spasms that can increase pain.

Physical therapy – Certain exercises can be helpful for a herniated disc. Exercise can make your back and stomach muscles stronger. This will ease the pressure on your disc and make you hurt less. Ask your doctor about exercises for your back. Your doctor may want you to see a physical therapist to learn about safe back exercises.

Epidural steroid injections – If medicine and physical therapy aren’t helping, your doctor may suggest steroid injections. These are shots of steroids that are injected directly into your spine. The steroids reduce the swelling around the disc and can lessen the pain. Sometimes 1 injection is enough. Often, they are given in a series of shots over a few weeks. These injections can bring relief for weeks or months at a time.

Surgery – If nothing else is helping your pain, your doctor may suggest surgery. He or she will remove all or part of the damaged disc so it no longer presses on the nerve.

Home treatment – You can practice good home care to treat your disc, as well. Good posture can help your back by reducing the pressure on your disc. Focus on standing up straight, sitting straight, and lifting with your back straight. Follow these tips to do what you can on your own to ease your symptoms:

• Bend your knees and hips and keep your back straight when you lift something.
• Hold an object close to your body when you carry it.
• If you stand for a long time, put one foot on a small stool or box for a while.
• If you sit for a long time, put your feet on a small stool so your knees are higher than your hips.
• Don’t wear high-heeled shoes.

Living with a herniated disc

Your chances of getting better are good. Most people who have a herniated disc are better in about 4 weeks. Sometimes it takes longer. If you still have pain or numbness after 4 to 6 weeks, or if you feel worse, talk with your doctor. Sometimes it takes surgery to relieve pain.

Call your doctor right away if you have any of the following symptoms:

• Trouble going to the bathroom
• Loss of bowel or bladder function
• Loss of feeling in the feet or legs
• Weight loss
• Severe pain at night
• More pain or weakness than usual in your backbone

These could be signs of complications or a more serious problem.

Questions to ask your doctor

• Will I always have a herniated disc?
• Am I at risk of another herniated disc?
• How can I prevent getting another herniated disc?
• What can I do to treat a herniated disc?
• What can I do about the pain?
• What types of medicines are used to treat herniated discs? Are there side effects?

Resources

National Institutes of Health, MedlinePlus: Herniated Disc