Disc herniation happens when the cushion (disc) between the bones of the spine (vertebrae) bulges out through the layer of ligaments that surround the disc. Also known as a "slipped," "ruptured," or "torn" disc, a herniation can irritate nerves in the affected area resulting in pain, numbness or weakness.
Spinal nerve roots run through vertebrae in the spine, which branch off to a specific area of the body. If the protruding disc presses on a spinal nerve, the pain may spread to the area of the body served by the affected nerve.
Most disc ruptures will occur when a person is in his or her 30s or 40s, when the disc is still a gelatin-like substance. Oddly enough, most disc herniations will occur in the morning. The causes of this phenomenon are not entirely known, but are probably due to the physiology of the spine and the changes in the water content of the disc that occur throughout the day.
Symptoms will generally appear in the areas of the body served by the spinal nerve closest to the herniated disc.
- Arm or leg pain
- Numbness or tingling
- muscles served by affected nerves can weaken, causing decreased motor function
Cervical Disc Herniation vs. Lumbar Disc Herniation
Disc herniations can happen in any area of the spine and can send pain signals to any area of the body, depending on which spinal nerve has been affected by the condition. The most common areas of the spine for disc herniations are the neck (cervical) and lower back (lumbar). The symptoms are similar, but affect different areas of the body. Cervical disc herniations are considered more serious - since there is less space in the neck area for disc material, even a small herniation can cause significant pain and other symptoms.
Cervical disc herniation
- Arm pain
- Numbness & tingling down to the fingertips
- Muscle weakness may also be present
Physicians report a success rate of 95-98% in pain relief following surgery for cervical disc herniation. Your physician will determine the best course of treatment, which may or may not include surgery, based on your
current physical condition.
Lumbar disc herniation
- Low back pain
- Leg pain
- 90% of disc herniations are in this part of the spine
Physicians report a success rate of 95% following surgery for lumbar disc herniation. Your physician will determine the best course of treatment, which may or may not include surgery, based on your current physical condition.
A physical exam should provide an accurate diagnosis. However, your physician may recommend:
Often, this condition improves on its' own. While waiting to see if the disc will heal, your doctor may try non-surgical treatments including:
- Over-the-counter pain medications (Advil, Tylenol, Aleve, etc...)
- Narcotic pain medication
- Nerve pain medication
- Muscle relaxers
- Steroid injections
- Physical therapy
Very few patients with herniated disks require surgery. Your physician may recommend surgery if:
- Moderate treatment does not improve symptoms after six to eight weeks
- A disc fragment lodges in the spinal canal and presses on a nerve
- Basic activities such as standing or walking are affected
Approximately 10% of patients will find themselves with another herniated disc at the same place on the spine. This most frequently happens within the first three months following surgery, although it can happen at any time. Surgery can usually fix any future occurrences, but spinal fusion surgery may be recommended after multiple occurrences.