Back Pain: Herniated Disc

Back Pain: Herniated Disc

As you know, back pain has many causes. One possible cause is a herniated disc​.

What Are Discs? 

Discs​ are the cushions between each bone of the spine (vertebra). The twenty-five discs act as shock absorbers, protecting the vertebrae. They also help support the spine and allow movement.

Discs have three main parts: the inner part called the nucleus pulposus​; the tough outer portion called the annulus fibrosus​; and the endplates, made of cartilage.

The discs are located very near the spinal cord and nerve roots.

  • The spinal cord is surrounded by the vertebra.

  • The nerve roots branch off of the spinal cord, go through holes in the vertebrae, and extend to other parts of the body. 

What Is A Herniated Disc? 

A disc may be out of its normal position - the nucleus pulposus, the inner part, pushes on the annulus fibrosis, the outer part. When this happens the spinal cord and nerve roots may be affected.

Herniated discs may result from an accident or injury to the back. Minor injuries or simple movements may also result in disc herniation. This is more common with degenerative changes of the spine that occurs with aging.

Back pain from herniated discs is most common in people who are in their 30s to 50s. And it is twice as likely to occur in men compared to women.

Disc herniation is most common in the lower back (lumbar spine), followed by the neck (cervical spine).

What Are The Symptoms of A Herniated Disc? 

Herniated disc symptoms vary. They depend on the position of the disc, the degree of herniation, and the level of the spine affected.

The disc may press on the nearby nerve roots (pinched nerve​) or spinal cord causing symptoms. A person may not have any symptoms or they may have mild, moderate, or severe symptoms.

The symptoms of disc herniation in the lumbar spine may include sciatica​ or numbness, weakness, and/or tingling or other sensations in the leg and/or foot; pain in the lower back and/or buttocks; and pain in the leg and/or foot. Symptoms of disc herniation in the cervical spine are similar, but they affect the neck, arm, and hand.

A person with a disc problem in the lower back may also have difficulty bending forward at the waist and worsening pain when sitting or straining, or with sudden movements (e.g. coughing, sneezing).

How Is A Herniated Disc Diagnosed?

Diagnosis of a herniated disc is usually based on a person’s medical history, symptoms, and physical examination. The exam focuses on the musculoskeletal and neurologic systems. Tests like the straight leg raise test, ​ to check for disc problems in the lower back, may be done.

MRI or CT imaging tests are recommended when a person has severe or worsening neurologic symptoms or when other serious conditions are possible. Imaging studies are also done in preparation for injections or surgery.

What Is The Treatment for A Herniated Disc?

The treatment for symptomatic cervical and lumbar disc herniation is usually conservative​ - it does not involve surgery. It may include medicines, like anti-inflammatories, physical therapy, as well as education about self-care. Spinal injections are also a non-surgical option. They may be recommended for short-term pain relief. Most people have relief from pain and other symptoms with conservative treatment.

Surgery is recommended for only a small number of people with herniated disc disease. It may be appropriate when a person continues to have severe or worsening pain or neurologic symptoms. There are both minimally-invasive​ and open surgery techniques.

For More Information

U.S. National Library of Medicine (2016). Herniated Disk​. Retrieved 8-16-2022 from https://medlineplus.gov/herniateddisk.html.