What is a Herniated Disc?

The spinal column begins at the base of the skull and spans from the cervical spine in the neck through the thoracic spine in the middle back and into the lumbar spine in the lower back. Made up of 24 individual vertebral bodies and several fused vertebrae in the pelvic region, the spinal column is flexible enough to allow for the full range of motion in the neck and back that’s required for daily activity and also strong enough to support the weight of the upper body.

Serving as shock-absorbing cushions for the spine, discs are positioned between adjacent vertebrae to facilitate movement and reduce friction. Each disc has two parts: a thick exterior composed of collagen fiber (annulus fibrosus), which surrounds and contains an inner core of protein gel (nucleus pulposus). These components are high in water content and must remain well hydrated and pliable in order to function properly. For a variety of reasons, the discs can begin to deteriorate and dehydrate over time, becoming brittle and prone to breakage. If a fissure develops in a disc’s annulus fibrosus, some of the nucleus pulposus can pass through its compromised boundary. This condition is referred to as a herniated disc. Pain and other uncomfortable symptoms can develop if displaced inner disc material — which contains inflammatory proteins — irritates or pressures the disc wall, the spinal cord or a nearby nerve root.

Causes of a herniated disc

• The natural aging process. Due to the cumulative effects of an aging body and ongoing wear and tear on the spinal components, the discs gradually weaken and become more susceptible to rupture.
• Spinal trauma. Injuries that result from a forceful blow to the spine can cause immediate disc herniation.
• Repetitive stress. Sitting for prolonged periods or repeatedly lifting heavy objects can cause a series of small tears to develop in a disc’s outer wall, tears that can worsen over time and lead to full disc herniation.
• Unhealthy body weight. The spine must support the majority of the body’s weight, and the pressure of carrying extra pounds, particularly in the abdominal region, can strain and damage the spinal components.
• Poor nutrition. An unbalanced diet can lead to weight gain and also deprive the discs of the nutrients needed to remain supple and strong.
• Tobacco use. Smoking inhibits circulation and interferes with the delivery of essential nutrients throughout the body, including the spine. Cigarette smoke also contains a multitude of toxins that can affect the discs as well as other parts of the body.
• Genetics. A family history of disc herniation and other degenerative spine conditions can increase the likelihood a person will develop similar conditions.

Signs & Symptoms of a herniated disc

While a herniated disc does not always cause symptoms, the condition can create localized pain if the tear affects the small nerves located in the uppermost layers of the outer wall of the affected disc. Additionally, a variety of uncomfortable symptoms can develop if the disc wall or escaped nucleus pulposus exerts pressure on the spinal cord or a spinal nerve root. For instance, some people experience neck or back pain, radiating pain that travels through an arm or leg, muscle weakness, numbness or walking difficulties.

A closer look at herniated disc symptoms
A herniated disc can conceivably occur in the cervical, thoracic or lumbar region of the spine, although it is most likely to develop in the cervical and lumbar spine segments. That’s because the neck and lower back are both highly flexible and responsible for supporting significant body weight, which takes its toll over time. The thoracic spine, by comparison, is far more stable because it is attached to the rib cage.

The specific symptoms associated with a herniated disc also depend on the location of the disc degeneration. Most commonly, this condition is associated with localized pain near the origin of the tear in the disc wall, although symptoms can also extend throughout the body when displaced disc material irritates or compresses a nearby nerve root or the spinal cord. In fact, when nerve root or spinal cord compression occurs, it can result in symptoms that appear far from the origin of the problem, making diagnosis by a physician necessary for effective treatment.

Here are just a few examples of the symptoms that can develop as a result of a herniated disc:

• Cervical herniated disc. Localized pain in the neck; a pins-and-needles sensation, muscle weakness and numbness that travel through the shoulders, arms, hands or fingers; difficulty walking; a feeling of heaviness in the hands or feet; a decline in fine motor skills.
• Thoracic herniated disc. Upper back pain that can radiate into the chest or stomach; back stiffness and muscle weakness; symptoms caused by a herniated disc in the thoracic spine that can also be incorrectly attributed to a problem with the heart, gastrointestinal tract or lungs.
• Lumbar herniated disc. Discomfort in the lower back; pain that travels into the lower body; pain in one or both legs; weakness or tingling in the lower extremities; diminished reflexes and muscle spasms; in rare cases a loss of bowel or bladder control, which can indicate cauda equina syndrome, a condition that requires immediate medical attention.

The symptoms of a herniated disc can vary widely depending on both the location and severity of the damaged disc, and many of the symptoms commonly associated with this condition can also be explained by the presence of additional spinal degeneration, including facet disease, spinal stenosis and spondylolisthesis. In order to effectively manage the symptoms of a herniated disc, the exact cause, location and severity of the condition has to be identified by a medical professional.

Treatments for a herniated disc

Many patients with a mildly herniated disc will find effective pain relief from conservative treatments. When a disc herniates, it flattens and expands under the pressure on the surrounding vertebrae that are squeezing down on the disc. Over time, the disc expands beyond its normal parameters and enters into the spinal canal, sometimes pinching a local nerve root.

The purpose of conservative treatment options for a herniated disc is to reduce pressure on the pinched nerve in the spinal canal, thereby relieving symptoms like pain, numbness, tingling and weakness caused by a herniated disc. Common conservative treatments for a herniated disc include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Hot and cold compresses
• Epidural steroid injections
• Physical therapy
• Strength training exercises
• Posture modification exercises
• Lifestyle modifications

Herniated disc treatment can often be combined to help expedite the healing process. You should always consult a medical professional before making any changes to your treatment plan to ensure your health and safety.

Herniated disc surgery

When weeks or months pass and consistent treatment has not let you return to normal activity, your doctor may start to talk about referral to a spine surgeon. Traditional open back surgery requires large, muscle-disrupting incisions, leading to a two- to five-day hospitalization and a much longer recovery period. Advancements in technology and surgical technique have made a less invasive approach to spine surgery possible. These procedures treat conditions like a herniated disc using smaller, muscle-sparing incisions that have less scarring, less blood loss and a lower risk of infection