A herniated disc (also called a ruptured or slipped disc) is a damaged "cushion" between two bones in the spine (vertebrae). Normally, the gelatinous discs between the vertebrae hold the bones in place and act as shock absorbers, permitting the spine to bend smoothly. When a disc protrudes beyond its normal parameters, and its tough outer layer of cartilage cracks, the disc is considered "herniated."
When a disc bulges through torn cartilage, it can press on a nerve in the spinal canal. This results in back pain; if pain extends to the buttocks and travels down the affected leg, it is called "sciatic" pain. Herniated discs occur most frequently in the lumbar (lower) region of the back, and are one of the most common causes of back pain. Cervical (neck) discs also herniate, resulting in pain in the neck and shoulders.
Causes of a Herniated Disc
During the normal process of aging, the discs in the back lose flexibility and wear down. Additional stress, whether from obesity, smoking, heavy lifting or sudden traumatic injury, can then cause herniation.
Symptoms of a Herniated Disc
In addition to pain emanating from the herniated area, patients can experience numbness, tingling, muscle spasms or weakness. The pain that results from a herniated disc is usually worsened by moving, and improved by rest. Sudden motions, such as bending or coughing, can elicit sharp, shooting pain.
Diagnosis of a Herniated Disc
In order to make a diagnosis, a patient's medical history is taken, and a determination made as to whether pain has been increasing gradually or was precipitated by a traumatic injury. A comprehensive physical exam, which includes a check of reflexes, sensation/numbness, posture and muscle strength, helps in assessing the situation. Usually, the patient is examined sitting, standing and walking.
In most cases, imaging tests are administered to provide a more precise visualization of the spine. They are used to determine whether there is a disc injury and, if there is one, to delineate its size and location. Tests include X-rays, MRI or CT scans, electromyograms (which measure nerve impulses), and myelograms (in which contrast dye highlights the affected region).
Treatment of a Herniated Disc
Conservative treatment for herniated discs usually begins with bed rest, and taking anti-inflammatory and pain medications as needed. Applying hot or cold compresses, sometimes alternately, may be recommended. Muscle relaxants may be prescribed to diminish muscle spasms in the back. Sometimes, a course of physical therapy to stretch and strengthen back and abdominal muscles provides relief. Epidural injections of a corticosteroid may be administered to reduce nerve irritation and facilitate healing. For some patients, chiropractic care or some type of alternative medicine provides relief.
When the condition does not respond to these measures, and the patient is still experiencing pain, surgery may be necessary. This is true in approximately 10 percent of herniated disc cases. The type of procedure performed depends on where the herniated disc is located, and the severity of the damage. There are several surgical options. All of these operations are performed in the hospital under general anesthesia:
- Laminotomy
- Discectomy
- Arthroplasty
- Spinal fusion
During laminotomy, the protruding portion of the disc is excised, whereas during discectomy, the entire disc is removed. During arthroplasty, the herniated disc is replaced with an artificial disc. In more severe cases of herniation, spinal fusion may be necessary. During this procedure, vertebrae are fused using a bone graft or metal rod.
What is a more complete list of the causes of herniated disc?
1.) Gender. Men between the ages of 20 and 50 are most likely to have a herniated disk.
2.) Improper lifting.
3.) Excessive body weight.
4.) Repetitive activities that strain your spine.
5.) Frequent driving.
6.) Sedentary (not active) lifestyle.
7.) Smoking.
Can a herniated disc heal itself?
Herniated disks get better on their own over time or with nonsurgical treatment for 9 out of 10 people. If other treatments don't relieve your symptoms, your healthcare provider may recommend other treatments, including surgery.
Is walking good for a herniated disc?
Regular walking helps strengthen the core muscles, including those that support the spine. Stronger muscles can provide better support for the spine, potentially reducing pressure on the herniated disc and improving overall spinal stability.
What's the difference between a bulging disc and a herniated disc?
A bulging disc is like letting air out of a car tire. The disc sags and looks like it is bulging outward. With a herniated disc, the outer covering of the disc has a hole or tear. This causes the nucleus pulposus (jelly-like center of the disc) to leak into the spinal canal.
What will worsen the symptoms of a herniated disc?
Certain activities and movements, particularly those involving forward bending, can make the pain worse, especially in the morning when disc pressure is heightened. Seek the help of a back doctor if you suspect a herniated disc, as intervention may be needed to keep the condition from getting worse.
How not to sit if you have a herniated disc?
It is proper to sit up straight without slouching. When you slump, you put extra pressure on the discs in the spine and can aggravate your herniated disc. Additionally, you want to ensure your knees are level with your hips. Your hips should be slightly above your knees if you sit at a desk.
How long does it take for a herniated disc to heal?
As soon as you seek treatment for your herniated disc, you can start your healing journey. In most cases, pain from herniated discs will subside within two to 8 weeks. However, in some cases, your herniated disc might take up to six months to fully heal.
What foods should I avoid with a herniated disc?
Some foods can actually worsen the inflammation and pain. Foods to avoid include all foods high in sugar, trans and saturated fats, and high fructose corn syrup. People should also avoid processed foods high in nitrates.
