What is a herniated disc?
The discs are located between the bones of your spine (vertebrae). They are spongy and act as shock absorbers to your spinal joints. The gel-like center of the disc is surrounded by layers of fibrous walls that give the disc strength. A herniated disc, also known as a ruptured or slipped disc, is when the outer layers of these walls break or tear, possibly allowing some of the gel to leak out and into the area of the nerves.
Symptoms of a herniated disc depend on what structures are involved. If no nerves are involved you may have only back pain, achiness or stiffness. If a nerve is irritated or inflamed, you may experience leg pain, numbness, tingling or burning. If a nerve is compressed or pinched you may experience leg weakness.
Disc herniation is commonly the result of wear and tear of the spinal joint (including the disc) that happens with the natural aging process referred to as spinal degeneration. As the disc ages it becomes more dehydrated, less flexible and more susceptible to tearing or herniating. Injury from a trauma can also cause a disc herniation.
Examination and Diagnosis
To receive a diagnosis, a qualified musculoskeletal expert will first take a medical history and conduct a physical exam. X-ray or MRI scanning may be required.
If you experience bowel or bladder changes and/or saddle (groin) numbness, please contact your physician.
While disc herniation may be very painful for the first few weeks, a high percentage of them will heal and resolve over time. Despite pain, initial treatment includes resuming your normal daily activities per toleration as soon as you can. Gentle stretching and physical therapy may also be helpful to keep you moving, prevent stiffness and deconditioning and help with pain. Over the counter non-steroidal anti-inflammatories and corticosteroids orally or by injection may be indicated to help with the pain and inflammation associated with the disc herniation.
Surgery may be recommended if pain is severe and persistent, or if there is nerve damage shown by progressive weakness (weakness gets worse over time). The goal of surgery is to relieve pressure on the nerve by removing the disc or other structures involved to create space in the joint. Surgery types include discectomy (removal of the disc), laminectomy (removal of a part of the bone), or some combination of both. Physical therapy may be recommended following surgery to restore flexibility and strength.