What is Disc Herniation?

Round cushions protect the bones that form the spine along the back with a tough, outer layer called annulus. These discs are located between each of the vertebra in the spinal column, acting as “shock absorbers” for the spinal bones.

Unfortunately, those discs can become herniated, which may indicate the early stages of degeneration. The spinal canal has limited space, which is inadequate for the spinal nerve and the displaced herniated disc fragment. As a result, a painful compression and “pinching” of the nerve can occur. Herniated discs are more common in the lower back (lumbar spine), but also occur in the neck (cervical spine).

Ruptured or herniated disc - As the disc continues to break down, or with continued stress on the spine, the inner nucleus pulposus may actually rupture out from the annulus. This is a ruptured — or herniated — disc. The fragments of disc material can then press on the nerve roots located just behind the disc space. This can cause pain, weakness, numbness, or changes in sensation.

What Causes Disc Herniations?

Age is the most common risk, because as degeneration from age progresses, a relatively minor strain or twisting movement can cause a disc to rupture. There are other risk factors as well:

• Weak back and abdominal muscles caused by physical inactivity, may not support the spine properly.
• Back injuries also increase when people who are normally not physically active participate in overly strenuous activities.
• Jobs that require heavy lifting and twisting of the spine can also cause back injuries.
• Certain individuals may be more vulnerable to disc problems and, as a result, may suffer herniated discs in several places along the spine.
• Hereditary factors.

Non-Surgical Treatments

• The initial treatment for a herniated disc is usually conservative and nonsurgical.
• Low, painless activity level for a few days to several weeks so that spinal nerve inflammation may decrease.
• Bedrest is not recommended.
• A nonsteroidal anti-inflammatory medication, if the pain is only mild to moderate.

Surgery

A doctor may recommend surgery if conservative treatment options, such as physical therapy and medications, do not reduce or end the pain. The benefits of surgery should be weighed carefully against its risks.

A patient may be considered a candidate for spinal surgery if:

• Radicular pain limits normal activity or impairs quality of life
• Progressive neurological deficits develop, such as leg weakness and/or numbness
• Loss of normal bowel and bladder functions
• Difficulty standing or walking
• Medication and physical therapy are ineffective
• The patient is in reasonably good health