One of the most common sources of neck or back pain is a herniated disc. You may also hear this referred to as a slipped or ruptured disc. Before we get into the causes, symptoms and treatments for herniated discs, let’s start with what a disc is and what it is means when one is herniated.
Discs are soft, rubber-like pads between each of the vertebrae in your spine. They act as shock absorbers and are what allow your back and neck to bend. In your lower back (lumbar spine), discs are comprised of a thick outer ring of cartilage and an inner gel-like substance called the nucleus. The discs in your neck (cervical spine) are similar, but smaller in size.
A herniated disc occurs when the nucleus herniates or ruptures through the outer edge of the disc toward the spinal column resulting in pressure on the nerves.
Causes
While there are many potential causes for a herniated disc, herniated discs are often associated with attempting to lift a heavy load without enough stability to keep the discs aligned. This is typically when you’ll hear someone say they “slipped a disc” as it mimics the sensation of the disc slipping out of place.
Often, this can be seen in high-level athletes or weight lifters performing movements that load the core and lower extremity. However, it can also be seen in day-to-day life while performing tasks such as yard work or simple household chores.
While it is challenging to prevent altogether, having a strong core and proper lifting mechanics is the best way to minimize the risk of herniating a disc. Additionally, understanding one’s limitations may help prevent from taking on too strenuous of an external load.
In addition to improper lifting, other conditions that weaken the discs include:
- Decreased water content in discs as you age
- Smoking
- Excessive body weight
- Sudden pressure
- Repetitive strenuous activities
Symptoms
The symptoms of herniated discs depend on the locations of the injury. In the lower back, the most common symptoms include:
- Sciatica, sharp or shooting pain that extends from the buttocks down the back of one leg
- Back pain
- Weakness in the leg and/or foot
- Numbness or tingling in the leg and/or foot
- Loss of bladder or bowel control
In the neck, the most common symptoms include:
- Weakness in one arm that may extend to the hand
- Numbness or tingling in one arm that may extend to the hand
- Burning pain in the shoulders, neck or arm
Diagnosis
If you display any symptoms of a herniated disc, you should visit a spine doctor as soon as possible. They will conduct a physical exam and ask you questions about your symptoms and medical history. A variety of diagnostic tests such as x-rays, MRIs, and CT scans may be performed to confirm your diagnosis.
Treatment
Treatment is dependent upon the location and severity of the herniation. As there are different degrees of injury, each with a different and more significant level of associated disability, there are a number of possible treatment options.
In the event of a minor herniation, conservative treatment with anti-inflammatory medication and physical rehabilitation with a focus on core and lumbar strength is often the first line of defense. In this case, the tightening of the local musculature greatly helps to reduce symptoms and instability. Epidural steroid injections may also be an option in some cases.
In the event your pain lasts more than 6 to 12 weeks and does not improve with the help, spine surgery may be recommended such as a microdiscectomy, laminectomy, lumbar fusion or disc replacement.
Learn More
Dr. Nael Shanti of Cary Orthopaedics Spine Center specializes in the diagnosis and treatment of a variety of spinal conditions including herniated discs. For questions or more information, we invite you to contact our office or schedule an appointment.