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For In-Depth information on herniated discs, see HERNIATED LUMBAR DISC.
Definition
A herniated disk happens when one of the disks in the spine bulges from its proper place. Disks are small circular cushions between the bones in the spine. They are soft and act as cushions for the bones of the spine. Herniated disks press on the nerves around the backbone and can cause severe pain. They are most common in the lower spine.
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Causes
Herniated disks can occur when disks dry out, become flatter and provide less cushioning. If they become too weak, the outer part may tear. The inside part may then push through the tear and press on the nerves next to it.
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Risk Factors
A risk factor is something that increases your chance of getting a disease or condition.
- Age: 30s and 40s
- Trauma from a fall, accident, or sudden twisting
- Strain on the back - either repeated or sudden (as from lifting a heavy weight)
- Growing older
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Symptoms
Symptoms include:
- Pain — the severity and location of the pain depend upon which disk is herniated. Pain may spread over the buttocks, down the back of one thigh and into the calf. Pain may be in one or both legs
- Numbness, tingling, or weakness in the legs or feet
- Sudden aching or twisted neck that cannot be straightened without severe pain
- Numbness, tingling, or weakness in one or both arms
- Bowel or bladder changes
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Diagnosis
The doctor will ask about your symptoms and medical history, and perform a physical exam. The doctor will ask specific questions about the pain and examine the spine. The doctor will also test the movement and reflexes of the arms and legs.
Tests may include:
- X-ray — a test that uses radiation to take a picture of structures inside the body, especially bones.
- CT Scan — a type of X-ray that uses a computer to make pictures of structures inside the body.
- MRI Scan — a test that uses magnetic waves to make pictures of structures inside the body.
- Discography — a test that involves injecting a dye into the center of the disc and then taking an X-ray.
- Electromyography — a test that measure the electrical activity of muscle by placing needle electrodes into the muscle.
- Myelography — a type of X-ray that uses dye to more clearly outline the space containing the spinal cord.
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Treatment
Treatments may include:
NSAIDs — Non-steroidal anti-inflammatory medications (NSAIDs), such as ibuprofen or naproxen, may be prescribed to reduce pain.
Muscle Relaxants — Muscle relaxants may be prescribed to reduce muscle spasms.
Analgesics— Various types of analgesic medications may be prescribed, depending on the level of pain.
Steroid Injections — If medicine doesn't help, steroids may be injected into the backbone to reduce pain and inflammation.
Bed Rest — Bed rest for one or two days is often suggested for severe pain. You should lie flat on a firm mattress.
Back or Neck Massage and Physical Therapy
Back or neck massage and physical therapy can help:
- Relax the neck or back muscles
- Decrease pain
- Increase strength and mobility
Hot or Cold Packs
Hot or cold packs help reduce pain and muscle spasms.
Stretching the Spine
A doctor or chiropractor can help reduce pain by stretching your spine.
Traction
Weights and pulleys may be used to relieve pressure on bones and muscles and keep them from moving.
Neck Collar or Brace
For a herniated disk in the neck, a neck collar or brace may be used to relieve muscle spasms.
Surgery
Surgery may be used for people who fail to respond to other treatments. Options include:
- Laminectomy — removal of the protruding disk
- Micro Diskectomy — removal of fragments of nucleated disk
- Spinal Fusion — fusing of vertebrae (back bones) together with bone grafts or metal rods
- Chemonucleolysis — injection of an enzyme into the herniated disk to dissolve the protruding part
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Prevention
The following strategies may help you reduce your chance of having a herniated disk:
- Practice good posture — standing and sitting straight, keeping your back straight when lifting.
- Maintain a healthy weight.
- Exercise regularly. Ask your doctor about exercises to strengthen your back and stomach.
- Don't wear high-heeled shoes.
- If you sit for long periods of time, use a stool to bring your knees above your hips.
- Don't sleep on your stomach.
Copyright© 2000 HealthGate® Data Corp. All rights reserved.
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