Herniated Discs

A herniated disc is the result of the nucleus pushing out through a tear in the annulus in the vertebra that stack to make your spine. Commonly referred to as a slipped or ruptured disc, this type of herniation causes irritation of the spine and nearby nerves. Depending on the location of the herniated disc, there can be pain, numbness or weakness in an arm or leg.

Naturally as you age, disc material degenerates naturally and the ligaments that hold the disc in place begin to weaken. As you age, this type of degeneration makes herniation more likely to occur because your disks become less flexible and more prone to tearing or rupturing with minor straining or twisting. Other causes of herniated discs include:

• Straining from lifting a heavy object
• Straining from twisting your back a certain way
• Traumatic injury or fall

Factors which can increase your risk of a herniated disc include:

• Weight. Excess body weight causes extra stress on the discs in your lower back.
• Occupation. People with physically demanding jobs have a greater risk of back problems. Repetitive lifting, pulling, pushing, bending sideways and twisting can also increase your risk of a herniated disc. Additionally, office jobs, where sitting for an extended period of time in the same position, can be a risk factor for herniated discs.
• Genetics. Some people inherit a predisposition to developing a herniated disc.
• Smoking. It is thought that smoking lessens the oxygen supply to the disc, thus causing it to break down more quickly.

Symptoms depend on how bad the herniation is and where on your spine the herniation has occurred. Common areas of the spine that could be affected include:

• Lumbar spine A disc in this area of the lower back is referred to as a herniated lumbar disc and is the most common location for herniated discs. This type of herniation will cause problems in lower parts of the body like the buttocks, legs and feet.
• Cervical spine. A herniated cervical disc will more likely cause problems in the neck, shoulders, arms and hands.

Most herniated discs occur in the lower back; however, they can also occur in the neck. Signs and symptoms depend upon the location of the disc and whether or not the disc is pressing on a nerve, and it usually affects one side of the body. See a doctor if you have the following symptoms:

• Numbness or tingling sensation
• Sharp, burning pain in the buttocks, leg or foot affecting one side of the body (sciatica)
• If the disc is located in the neck, pain can occur in the shoulder or arm
• Pain that shoots in arms or legs when you cough, sneeze or move into certain positions
• Weakness or decreased motor function

In some cases, you can have a herniated disc without symptoms, and may not know it, unless it shows up on a spinal image.

Prevention of Herniated Discs

To help prevent a herniated disc, consider the following habits:

• Exercise. Strengthening the trunk muscles in your back stabilizes and supports the spine.
• Maintain good posture. This reduces pressure on your spine and discs. When sitting for long periods of time, keep your back straight and aligned and when lifting heavy objects make sure to use your legs — not your back — to do most of the work.
• Maintain a healthy weight. Excess weight puts more pressure on the spine and discs, making them more susceptible to herniation.
• Quit smoking. Avoid the use of any tobacco products.

Your Memorial Hermann Mischer Neurosciences provider may also order and conduct tests such as:

• Physical exam: To assesses pain, sensation and the strength and reflexes of the muscle.
• MRI: The most common, accurate imaging test for a suspected herniated disc is an MRI.
• X-ray: Helps to rule out other causes of back or neck pain.
• CT scan: Shows the bones of your spine.
• Myelogram: An injection of dye into your spine using X-ray guidance for a CT scan to reveal the location of the disc.
• Electromyogram (EMG): Helps to determine the nerve the herniated disc affects.

Most herniated discs do not require surgery, so your doctor may prescribe bed rest or advise you to maintain a low, pain-free level of activity ranging from a few days to several weeks.

If the pain is mild to moderate, a herniated disc is frequently treated with nonsteroidal anti-inflammatory medications, such as an epidural steroid injection, which may be performed using a spinal needle under X-ray guidance to direct medication to the exact level of disc herniation.

Your doctor may recommend physical therapy, at which point the therapist will perform an in-depth evaluation, which, combined with the doctor’s diagnosis, will dictate a treatment specifically designed for patients with herniated discs.

Your doctor may recommend surgery if conservative treatment options, such as physical therapy and medications, do not reduce or stop the pain altogether. Based on the specifics of your case, your doctor will help you to determine the procedure appropriate for you. As with any surgery, the benefits of this treatment option are always weighed carefully against the associated risks, such as a patient’s age, overall health and other issues—all of which are taken into consideration when recommending surgery.

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