A herniated disk, also known as a slipped disk or a ruptured disk, occurs when the soft, gel-like center of a spinal disk pushes out through a tear in its tough, outer layer. The irritated nerves can cause pain, numbness, or weakness in the arms and legs. Herniated disks can occur in any part of the spine, but the lower back (lumbar spine) and the neck (cervical spine) are most common.
The main cause of a herniated disk is aging. As people get older, the spinal disks lose some of their water content and become less flexible and more prone to tearing or rupturing. Other factors that can increase the risk of a herniated disk include:
Injury: A sudden, forceful movement or trauma to the spine can cause a disk to herniate.
Lifting: Lifting heavy objects, especially with improper technique, can put stress on the spine and cause a disk to herniate.
Obesity: Being overweight can put extra pressure on the spine and weaken the disks.
Smoking: Smoking can reduce the blood supply to the disks and make them more susceptible to damage.
Genetics: Some people may inherit a tendency to develop herniated disks.
The symptoms of a herniated disk depend on the location and severity of the disk herniation and the nerve affected. Some people may have no symptoms at all, while others may experience:
Pain: The most common symptom of a herniated disk is pain in the area of the disk herniation. The pain may be sharp, burning, or shooting and may radiate to other parts of the body, such as the buttocks, legs, shoulders, or arms. The pain may worsen with certain movements, such as bending, twisting, or coughing.
Numbness or tingling: A herniated disk can compress or irritate the nearby nerves and cause numbness or tingling sensations in the affected areas.
Weakness: A herniated disk can also affect the muscle strength and function of the affected areas. This can cause weakness or difficulty in moving the arms or legs.
Bladder or bowel problems: In rare cases, a herniated disk can compress the nerves that control the bladder or bowel functions. This can cause loss of bladder or bowel control, which is a medical emergency and requires immediate attention.
The doctor will first ask about the patient's medical history as well as their symptoms in order to diagnose a herniated disk. A physical examination will be performed by the doctor, who will look for signs of nerve damage, including reduced reflexes, muscle weakness, or sensory loss. Some imaging tests may also be ordered by the doctor, including:
X-ray: An X-ray can show the alignment and structure of the spine and rule out other causes of back or neck pain, such as fractures or arthritis.
Magnetic resonance imaging (MRI): An MRI can provide detailed images of the soft tissues of the spine, such as the disks, nerves, and spinal cord. An MRI can show the location and extent of the disk herniation and the nerve compression.
Computed tomography (CT) scan: A CT scan can also show the cross-sectional images of the spine and the disk herniation. A CT scan may be combined with a contrast dye injection, called a myelogram, to enhance the visibility of the spinal cord and the nerves.
Electromyography (EMG): An EMG can measure the electrical activity of the muscles and the nerves. An EMG can help determine the level and degree of nerve damage caused by the disk herniation.
The treatment of a herniated disk depends on the severity of the symptoms and the response to conservative therapies. Most people with a herniated disk can improve with non-surgical treatments, such as:
For relief of the pain and inflammation caused by a disk herniation, the doctor may prescribe some medications. Pain relievers such as ibuprofen and naproxen, as well as muscle relaxants, nerve pain medications, and corticosteroids, may be available over-the-counter or prescription.
A physical therapist can design an exercise program to strengthen back and abdominal muscles, improve posture and flexibility, and reduce spinal pressure. Heat, ice, massage, or electrical stimulation can also be used by the physical therapist to reduce the pain and spasms.
A spinal epidural injection involves injecting a corticosteroid and a local anesthetic into the space around the spinal cord, reducing inflammation and swelling and providing temporary pain relief.
The following lifestyle changes may prevent or reduce the recurrence of herniated disks: maintaining a healthy weight, quitting smoking, avoiding heavy lifting or twisting, and using proper ergonomics when sitting, standing, or working.
Surgical treatment may be recommended if the non-surgical treatments do not provide adequate relief or if the symptoms become severe or progressive. A microdiscectomy is one of the most common types of surgery for a herniated disk, in which the herniated disk is removed through a small incision. It relieves pain and numbness by decompressing the nerve. Surgical procedures such as laminectomy remove part of the bone that covers the spinal canal in order to create more space for the spinal cord and nerves and reduce pressure and irritation. The doctor may also perform a spinal fusion, which involves joining two or more vertebrae together using metal screws, rods, or cages. This prevents further disk herniation and stabilizes the spine.
Although it is not possible to prevent all cases of a herniated disk, some measures can help reduce the risk or delay the onset of the condition. These include:
Regular exercise can help you maintain a strong spine and prevent injuries and stiffness. Avoid high-impact or twisting movements, such as jumping, running, or golfing, and choose low-impact activities, such as walking, swimming, or cycling. During exercise, it is advisable to warm up and stretch afterwards.
Lifting properly: Lifting heavy objects can put a lot of strain on the spine and cause a disk to herniate. To lift properly, bend your knees, keep your back straight, and hold the object close to your body. You should also avoid lifting objects that are too heavy or awkward and request assistance when necessary.
Long periods of sitting can also put pressure on the spine and disks. A good chair supports the lower back, the feet should remain flat on the ground, and the monitor, keyboard, and mouse should be adjusted for the correct height. In addition, it is recommended that you take frequent breaks and change positions every 15 to 20 minutes.
It is important to find a mattress, pillow, and sheets that suit your personal preferences and provide adequate support and comfort when you sleep. Sleeping comfortably can relax the spine and muscles. Sleeping on the stomach can also cause greater stress on the spine and can arches the back.
Herniated disks are common and treatable conditions that can cause pain, numbness, or weakness in the arms or legs. Most people with a herniated disk can recover and resume normal activities by following their doctor’s advice and changing their lifestyles. It is important to seek medical attention if the symptoms persist or are severe.
