A disc herniation is a common condition that affects the spine, the column of bones that supports the body and protects the spinal cord. It consists of 33 vertebrae separated by cushion-like discs. As a result of these discs, the spine bends and twists and acts as a shock absorber.
There are times, however, when these discs rupture or tear, causing the inner gel-like material to leak out and press on nearby nerves, resulting in pain, numbness, tingling, or weakness. Even though disc herniations can occur anywhere in the spine, they are more common in the lower back (lumbar spine) and neck (cervical spine).
A disc herniation can be caused by several factors, such as:
Aging: As people get older, the discs lose their water content and become less flexible and more prone to tearing or rupturing with even a minor strain or twist.
Excessive weight: Being overweight puts extra pressure on the lower back discs, increasing the risk of disc herniation.
Repetitive motions: Activities that involve bending, twisting, or lifting heavy objects can stress the spine and cause disc damage over time.
Sudden strain: An injury or trauma to the spine, such as a fall or a car accident, can cause a disc to herniate abruptly.
Smoking: Smoking reduces the blood supply to the discs, making them more susceptible to degeneration and rupture.
Symptoms of disc herniation depend on where the disc is located and which nerve is compressed. The most common symptoms are:
The pain may be sharp, burning, or shooting, and may worsen when coughing, sneezing, or moving certain positions, depending on which part of the spine is affected.
An affected nerve may cause numbness or tingling in the body part it serves.
Muscle weakness or difficulty holding objects may also be caused by the affected nerve.
A disc herniation may also affect the nerves that control bladder function or bowel function, resulting in urinary or fecal incontinence.
You will be asked about your medical history and examined by a doctor to diagnose a disc herniation. Your doctor will assess your back for tenderness, reflexes, muscle strength, walking ability, and sensation. To confirm the diagnosis and rule out other causes of your symptoms, your doctor may order the following tests:
X-ray: This test uses radiation to produce images of your bones and can help detect any spinal degeneration or other problems.
Imaging with magnetic resonance (MRI): This test uses powerful magnets and radio waves to produce detailed images of your soft tissues and nerves. It shows where and how your disc herniation affects your nerves.
A CT scan creates cross-sectional images of your body using X-rays and a computer. A CT myelogram shows your bones and soft tissues in detail. Sometimes a dye is injected into the spinal canal to make your nerves more visible.
A nerve conduction velocity test measures how fast electrical impulses travel along your nerve tissues. It can help determine whether there is any nerve damage or compression.
Most people with a disc herniation improve with conservative treatments within six weeks, depending on the severity of their symptoms. These treatments include:
In order to reduce pain and inflammation, your doctor may prescribe pain relievers, anti-inflammatory drugs, muscle relaxants, or nerve pain medications.
A physical therapist can teach you exercises to strengthen your back muscles, improve your posture, increase your flexibility, and relieve pressure on your spine.
Applying heat or ice packs to your affected area can help relieve pain and relax your muscles.
Your lifestyle may need to be changed to avoid activities that worsen your pain or cause further disc damage. You may also need to lose weight if you are overweight, quit smoking if you smoke, and maintain good posture while sitting, standing, or sleeping.
It is possible to need surgery if conservative treatments do not work or if your symptoms interfere with your normal functioning. There are different types of surgery for disc herniation, such as:
The microdiscectomy procedure involves making a small incision in your back and removing the herniated disc material using a microscope and special instruments.
The laminectomy procedure removes part of the bone (lamina) covering your spinal canal to create more space for your nerves.
A discectomy and fusion involves removing the entire disc and replacing it with a bone graft or artificial device to fuse the adjacent vertebrae.
Replacement of a damaged disc with an artificial one that mimics the function of a natural disc is known as artificial disc replacement.
In order to make an informed decision, you should discuss the risks and benefits of each surgery with your doctor.
It may not be possible to prevent a disc herniation completely, but you can take some steps to reduce your risk and protect your spine. These steps include:
You should aim to engage in moderate physical activity at least 30 minutes a day most days of the week to keep your back muscles strong and flexible, to support your spine, and to prevent stiffness and injury. Avoid exercises with high impacts, such as jumping, twisting, or lifting heavy weights. Choose low-impact exercises that do not place too much stress on your spine. Also, you can do some stretching exercises to prevent muscle tightness and improve your range of motion.
Maintain good posture: Maintaining good posture can help distribute your body weight evenly and prevent extra pressure on your discs. When sitting, keep your back straight, your feet flat on the ground, and your shoulders relaxed. You should sit in a chair that supports your lower back and adjust your computer screen to eye level. Stand with your head up, shoulders back, and stomach tucked in. Do not slouch or hunch over while standing. You can also place a pillow under your knees if you sleep on your back, or between your legs if you sleep on your side.
If you don't use proper technique to lift heavy or awkward objects, you can cause disc injury. When lifting, bend at your knees and hips, not at your waist. Use your legs to lift, not your back. Avoid twisting or turning while lifting or holding the object. Ask for help if the object is too heavy or bulky or use a cart or dolly if it is too heavy or bulky.
You can manage stress by practicing relaxation techniques, such as deep breathing, meditation, yoga, or massage. Stress can cause muscle tension and pain in your back and neck. By seeking social support, participating in hobbies, or getting enough sleep, you can also cope with stress.
Smoking impairs blood flow to your discs, causing them to degenerate and rupture. Quitting smoking can improve your health and reduce your risk of disc herniation.
A disc herniation is a common but treatable condition that affects the spine. By following these tips, you can prevent or reduce the impact of a disc herniation on your quality of life. For more information and guidance regarding disc herniation, speak with your doctor or spine specialist.
