The human spine is a flexible structure made up of a series of small, moving parts that work together to transmit nerve signals between the brain and the rest of the body as well as provide us with the ability to walk upright. The bony structures of the spinal column are called vertebrae and each of them is cushioned from direct contact with the one above and below it by special cartilage discs.
Sometimes these discs can come out of alignment to “Slip” or “Herniate.” This can cause significant pain as well as other nerve-related symptoms. Not to mention hampering spinal flexibility and causing severe inflammation in the surrounding tissues. In some cases, it can even allow painful bone-on-bone contact between the vertebrae.
While ruptured or herniated discs are more common in the lower back or neck, they can happen anywhere along the spine. When they do, the symptoms can be significant and even hamper your quality of life in the short term as well as posing potential long-term complications.
What Is A Herniated Disc?
The term “Herniated Disc” refers to when one of the spinal discs buffering the vertebrae separates from its natural position. This limits the flexibility in that section of the back, with a high likelihood of other symptoms that can range from mild to severe discomfort. In some cases, the gel-like tissues in the center of the disc can “Leak” into the spinal canal, which houses the all-important spinal cord. This can affect the performance of nerves in the area that spreads out to the extremities.
Symptoms Of A Herniated Disc
A herniated disc can occur in any part of the spine, though it is more common in the lower back (lumbar) and neck (Cervical) areas. These two sections tend to be the most flexible parts of the spine, which engages the muscles and discs between the vertebrae. This also means that the discs in these two areas also experience the most wear and tear, which can potentially lead to a loss of fluid volume.
With a mild herniation, the affected disc might not be pressing on a nerve, which might present minimal to no symptoms. Though a more significant herniation that does affect the nerves can cause pain that is severe and unrelenting. Many people who experience a significant herniated disc will experience symptoms that are stronger on one side of the body and may radiate to the nearby extremity. This can cause weakness and numbness in an arm or a leg.
Other possible symptoms of a herniated disc might include one or more of the following:
- A radiating dull ache on one side of the body
- Sharp pain when you cough or sneeze
- Sudden discomfort when you move into specific positions
- Tingling or numbness in an extremity
- A radiating burning sensation from a compressed nerve.
- Pain that worsens when sitting
- Pain that occurs when standing, walking and bending
- Muscle spasm that may affect your ability to lift or hold items
- Problems balancing
- Slow or delayed reflexes
- Difficulty getting up when seated
- Inability to remain in one position for an extended amount of time
- Posture problems
- Loss of bowel or bladder control
Diagnosing A Herniated Disc
An orthopedist or other spinal specialist will need to diagnose a herniated disc, this usually requires a referral from your primary care physician.
The diagnostic process starts with a physical exam that usually involves a “Straight Leg Raise” test. This will reveal any obvious signs of weakness, which typically indicates that the herniated disc is affecting the localized nerves. Make sure to let the physician know about any other symptoms you have been experiencing.
At that point, the physician will likely recommend imaging diagnostics. This might be an X-ray or an MRI to determine the severity of the herniation as well as any other structures that might also be affected. It can also help determine if the internal fluid has started to leak out of the disc.
Risk Factors & Common Causes Of A Herniated Disc
There are several things that can cause or put you at increased risk for suffering a herniated disc.
Age
Age is one of the most influential factors that can increase your risk of suffering a herniated disc. As you age your spinal discs gradually start to lose fluid volume. As it progresses, it can lead to degenerative disc disease. Age can also cause microscopic cracks or tears can form on the outer surface, allowing the cushioning inner fluid to escape into the surrounding tissues.
Trauma
Back or neck trauma is also a common cause of a herniated disc. This could come from something as significant as a car accident or an accidental hard fall, or something as simple as overstressing a spinal disc when you twist or lift a heavy object.
Weight
It’s worth noting that overweight or obese people are also more likely to suffer a herniated disc. This can be related to imbalances in core strength as well as poor posture, which frequently accompanies obesity.
Non-Surgical Herniated Disc Treatment
A mild to moderate herniated disc typically requires minimal or conservative treatment. Sometimes simple rest and taking pain-relieving medication is all that is needed. Though your physician might also recommend physical therapy to help alleviate symptoms.
If you are experiencing significant discomfort your physician might recommend an epidural steroid injection known as an ESI. This is a minimally invasive procedure that can reduce inflammation in the affected nerves and provides up to three months of relief, which will provide time for your body to heal and optimize your physical therapy results.
During this time, you should strongly consider quitting smoking, and losing some weight might also help improve your treatment outcomes. Your physician might also recommend low-impact activities to help maintain your muscles.
Surgical Treatment For A Herniated Disk
If non-surgical treatment strategies have failed to provide sufficient relief of symptoms after three to four-month, you may need to consider surgical intervention. The procedure your physician recommends will be based on the severity of your symptoms as well as the location of the herniated disc.
Microdiscectomy
This surgical procedure is designed to remove a portion of the disc as a way to relieve the pressure on the spinal column and the surrounding nerves.
Laminectomy
During a laminectomy, a portion of the vertebral bone is surgically removed. This provides more space for the spinal cord and nerves, to relieve compression.
Anterior Cervical Discectomy & Fusion Or Cervical Disc Replacement
Also known as ACDF or CDR these surgical procedures are used to address a herniated disc in the neck. This involves removing the affected disc and inserting either a bone graft or an artificial disc to properly stabilize the area.