Herniated Disk

What is a herniated disk?

Your spine (backbone) is made up of 26 bones called vertebrae. In between each of these vertebrae are soft disks. These disks act like cushions and keep the bones of the spine in place. They also let your backbone move so you can bend and stretch.

These disks can start to break down over time. Sometimes, they even rupture. The soft, jelly-like center of the disk pushes out of the disk. When this happens, it’s called a herniated disk. (The word “herniate” means to bulge or to stick out.) This is also called a ruptured disk, a slipped disk, or a bulging disk. These disks become a problem when the center of the disk pushes against a nerve or the spinal cord. This causes you pain that can vary from mild to severe.

Herniated disks are most common in the lumbar spine — the lower part of your backbone, between the bottom of your ribs and your hips. They can also happen cervical area (your neck). The disks in your upper-to-mid back (thoracic area) are rarely involved.

Symptoms of a herniated disk

When part of a disk presses on a nerve, it can cause pain. Often the pain occurs on one side of your body. Where the pain is located depends on where the herniated disk is located.

A slipped disk in the cervical section of your spine can cause pain in your neck and arms. You could experience:

  • Pain when moving your neck.
  • Pain near the shoulder blade.
  • Shooting pain down the arm and into the fingers.
  • Numbness in the shoulder, elbow, forearm, or fingers.

A slipped disk in the lumbar part of your spine can cause pain in the back and legs. It is often referred to as sciatica. This is because the disk pushes on the sciatic nerve, which runs down your leg. Symptoms include:

  • Pain in the leg, hip, or buttocks.
  • Numbness in these areas.
  • Pain or numbness in the back of the calf or sole of the foot.
  • Weakness in one leg.

How bad the symptoms are depends on how much of the disk is pressing on the nerve.

The pain from a herniated disk is usually worse when you’re active and gets better when you’re resting. Coughing, sneezing, sitting, driving, and bending forward may make the pain worse. The pain gets worse because these movements put more pressure on the nerve. People who have painful herniated disks often try to change positions to reduce the pain.

What causes a herniated disk?

As you grow older, the disks in your spine weaken and become flatter (less cushiony). If a disk becomes too weak, the outer part may tear. The inside part of the disk then pushes through the tear and presses on the nerves beside it. You could be at higher risk of getting a herniated disk if you:

  • are middle-aged or older
  • lift heavy objects
  • are overweight
  • do repetitive actions involving bending or twisting
  • sit in the same position for a long time regularly
  • live an inactive lifestyle
  • smoke.

How is a herniated disk diagnosed?

Your doctor will ask you questions about your symptoms and give you an exam. He or she will check you for numbness, weakness, reflexes, and pain. They will probably order X-rays or other pictures to see whether you have a herniated disk. These could include a CT scan or an MRI. These will take pictures of your spine and show if you have a bulging disk. There are also nerve tests your doctor can order. These can determine what nerves are involved, if there is nerve damage, and how well your nerves are conducting feelings.

Can a herniated disk be prevented or avoided?

There’s not much you can do to prevent a herniated disk. It is often caused by natural aging and deterioration. To keep your disks and back in good working order, work on living a healthy lifestyle:

  • Maintain a healthy weight.
  • Exercise regularly.
  • Strengthen your back and abdomen muscles.
  • Avoid repetitive movements.
  • If you sit all day, get up and walk around every hour.
  • Practice safe lifting and bending techniques.

Herniated disk treatment

There are a number of steps that can be taken to treat a herniated disk.

Medicine – Your doctor may recommend over-the-counter pain medicine like acetaminophen (Tylenol) or ibuprofen (Advil). He or she may prescribe you pain medicine, such as a narcotic, to help with severe pain. They may also give you muscle relaxants to help relieve muscle spasms that can increase pain.

Physical therapy – Certain exercises can be helpful for a herniated disk. The goal of exercise is to make your back and stomach muscles stronger. This will ease the pressure on your disk and make you hurt less. Ask your doctor about exercises for your back. Your doctor may want you to see a physical therapist to learn about safe back exercises.

Steroid injections – If medicine and physical therapy aren’t helping, your doctor may suggest steroid injections. These are shots of steroids that are injected directly into your spine. The steroids reduce the swelling around the disk and can lessen the pain. Sometimes 1 injection is enough. Often they are given in a series of shots over a few weeks. These injections can bring relief for weeks or months at a time.

Surgery – If nothing else is helping your pain, your doctor may want to do surgery. He or she will remove all or part of the damaged disk so it no longer presses on the nerve.

Home treatment – You can practice good home care to treat your disk, as well. Good posture can help your back by reducing the pressure on your disk. Focus on standing up straight, sitting straight, and lifting with your back straight. Follow these tips to do what you can on your own to ease your symptoms.

  • Bend your knees and hips when you lift something, and keep your back straight.
  • Hold an object close to your body when you carry it.
  • If you stand for a long time, put one foot on a small stool or box for a while.
  • If you sit for a long time, put your feet on a small stool so your knees are higher than your hips.
  • Don’t wear high-heeled shoes.
  • Don’t sleep on your stomach.

Living with a herniated disk

Your chances of getting better are good. Most people who have a herniated disk are better in about 4 weeks. Sometimes it takes longer. If you still have pain or numbness after 4 to 6 weeks, or if your signs get worse, talk with your doctor. Sometimes it takes surgery to relieve pain.

Call your doctor right away if you have any of the following symptoms:

  • trouble going to the bathroom
  • Loss of bowel or bladder function
  • Loss of feeling in the feet or legs
  • weight loss
  • severe pain at night
  • more pain or weakness than usual in your backbone.

These could be signs of complications or a more serious problem.

Questions to ask your doctor

  • Will I always have a herniated disk?
  • Am I at risk of another herniated disk?
  • How can I prevent getting another herniated disk?
  • What can I do to treat a herniated disk?
  • What can I do about the pain?
  • What types of medicines are used to treat herniated disks? Are there side effects?