Condition 101 About Herniated Disk

What is the definition of Herniated Disk?

A herniated (slipped) disk occurs when all or part of a disk is forced through a weakened part of the disk. This may place pressure on nearby nerves or the spinal cord.

What are the alternative names for Herniated Disk?

Lumbar radiculopathy; Cervical radiculopathy; Herniated intervertebral disk; Prolapsed intervertebral disk; Slipped disk; Ruptured disk; Herniated nucleus pulposus: Low back pain - herniated disk; LBP - herniated disk; Sciatica - herniated disk; Herniated disk; Disc - herniated

What are the causes for Herniated Disk?

The bones (vertebrae) of the spinal column protect nerves that come out of the brain and travel down your back to form the spinal cord. Nerve roots are large nerves that branch out from the spinal cord and leave your spinal column between each vertebra.

Skeletal

The spinal bones are separated by disks. These disks cushion the spinal column and put space between your vertebrae. The disks allow movement between the vertebrae, which lets you bend and reach.

With herniated disk:

  • The disk may move out of place (herniate) or break open (rupture) from injury or strain. When this happens, there may be pressure on the spinal nerves. This can lead to pain, numbness, or weakness.
  • The lower back (lumbar area) of the spine is the most common area affected by a slipped disk. The neck (cervical) disks are the second most commonly affected area. The upper-to-mid-back (thoracic) disks are rarely involved.

A herniated disk is a cause of radiculopathy. This is a condition that affects the spinal nerve roots.

Slipped disks occur more often in middle-aged and older men, usually after strenuous activity. Other risk factors may include:

  • Lifting heavy objects
  • Being overweight
  • Repetitive bending or twisting the lower back
  • Sitting or standing in same position for long hours
  • Inactive lifestyle
  • Smoking

What are the symptoms for Herniated Disk?

The pain most often occurs on one side of the body. Symptoms vary, depending on the site of injury, and may include the following:

  • With a slipped disk in your lower back, you may have sharp pain in one part of the leg, hip, or buttocks, and numbness in other parts. You may also feel pain or numbness on the back of the calf or sole of the foot. The same leg may also feel weak.
  • With a slipped disk in your neck, you may have pain when moving your neck, deep pain near or over the shoulder blade, or pain that moves to the upper arm, forearm, and fingers. You can also have numbness along your shoulder, elbow, forearm, and fingers.
Sciatic

The pain often starts slowly. It may get worse:

  • After standing or sitting
  • At night
  • When sneezing, coughing, or laughing
  • When bending backward or walking more than a few yards or meters
  • When straining or holding your breath, such as when having a bowel movement

You may also have weakness in certain muscles. Sometimes, you may not notice it until your health care provider examines you. In other cases, you will notice that you have a hard time lifting your leg or arm, standing on your toes on one side, squeezing tightly with one of your hands, or other problems. Your bladder control may be lost.

The pain, numbness, or weakness often goes away or improves a lot over weeks to months.

What are the current treatments for Herniated Disk?

The first treatment for a slipped disk is a short period of rest and taking medicines for the pain. This is followed by physical therapy. Most people who follow these treatments recover and return to normal activities. Some people will need to have more treatment. This may include steroid injections or surgery.

MEDICINES

Medicines can help with your pain. Your provider may prescribe any of the following:

  • NSAIDs for long-term pain control
  • Narcotics if the pain is severe and does not respond to NSAIDs
  • Medicines to calm the nerves
  • Muscle relaxants to relieve back spasms

LIFESTYLE CHANGES

If you are overweight, diet and exercise are very important for improving back pain.

Physical therapy is important for nearly everyone with disk disease. Therapists will teach you how to properly lift, dress, walk, and perform other activities. They teach you how to strengthen muscles that help support the spine. You will also learn how to increase flexibility in your spine and legs.

Take care of your back at home:

  • Reduce activity for the first few days. Slowly restart your usual activities.
  • Avoid heavy lifting or twisting your back for the first 6 weeks after the pain starts.
  • After 2 to 3 weeks, gradually start exercising again.

INJECTIONS

Steroid medicine injections into the back in the area of the herniated disk may help control pain for several months. These injections reduce swelling around the spinal nerve and disk and relieve many symptoms. They do not solve the underlying problem and your pain may return after weeks or months. Spinal injections are an outpatient procedure.

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SURGERY

Surgery may be an option if your symptoms do not go away with other treatments and time.

One such surgery is diskectomy, which removes all or part of a disk.

Discuss with your provider which treatment options are best for you.

What is the outlook (prognosis) for Herniated Disk?

Most people improve with treatment. But you may have long-term back pain, even after treatment.

It may take several months to a year or more to go back to all of your activities without having pain or straining your back. People who work in jobs that involve heavy lifting or back strain may need to change their job activities to avoid injuring their back again.

What are the possible complications for Herniated Disk?

In rare cases, the following problems can occur:

  • Long-term back pain or leg pain
  • Loss of movement or feeling in the legs or feet
  • Loss of bowel and bladder function
  • Permanent spinal cord injury (very rare)

When should I contact a medical professional for Herniated Disk?

Call your provider if you have:

  • Severe back pain that does not go away
  • Any numbness, loss of movement, weakness, or bowel or bladder changes

How do I prevent Herniated Disk?

To help prevent back injury:

  • Use proper lifting techniques.
  • Maintain a healthy weight.
  • Do exercises to keep your abdominal (core) and back muscles strong.
  • Evaluate your setup at work. Sometimes a standing desk or changing the location of your computer screen can help your condition.

Your provider may suggest a back brace to help support the spine. A brace may prevent injuries in people who lift heavy objects at work. But using these devices too much can weaken the muscles that support your spine and make the problem worse.

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Lumbar
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REFERENCES

Gardocki RJ, Park AL. Degenerative disorders of the thoracic and lumbar spine. In: Azar FM, Beaty JH, Canale ST, eds. Campbell's Operative Orthopaedics. 13th ed. Philadelphia, PA: Elsevier; 2017:chap 39.

Magee DJ. Lumbar spine. In: Magee DJ, ed. Orthopedic Physical Assessment. 6th ed. St Louis, MO: Elsevier Saunders; 2014:chap 9.

Sudhir A, Perina D. Musculoskeletal back pain. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 47.

Top Global Doctors For Herniated Disk

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Mark P. Arts
Westeind, ZH, NL
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Yong S. Ahn
Incheon, KR
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Jung H. Lee
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Sang-ho R. Lee
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Latest Advances On Herniated Disk

  • Condition: Far Lateral Lumbar Disc Herniations
  • Journal: Ideggyogyaszati szemle
  • Treatment Used: Transforaminal Epidural Steroid Injection
  • Number of Patients: 37
  • Published —
The aim of this study was to evaluate the effect of transforaminal epidural steroid injection (TFESI) on the improvement of both pain control and functional capacity in patients with far lateral lumbar disc herniations (FLDH).
  • Condition: High-Grade Migrated Lumbar Disc Herniation
  • Journal: BMC musculoskeletal disorders
  • Treatment Used: Full-Endoscopic Spine Surgery
  • Number of Patients: 58
  • Published —
The study researched the outcomes of full-endoscopic spine surgery for treating high-grade migrated lumbar disc herniation.

Clinical Trials For Herniated Disk

Clinical Trial
  • Status: Not yet recruiting
  • Phase: N/A
  • Intervention Type: Device
  • Participants: 40
  • Start Date: March 1, 2021
Lateral Cord Electrical Stimulation Can Improve Spasticity in Chronic Spastic Cerebral Palsy
Clinical Trial
  • Status: Recruiting
  • Phase: N/A
  • Intervention Type: Device
  • Participants: 146
  • Start Date: November 20, 2020
Retro-prospective Clinical Study to Evaluate the Efficacy of the Stand-alone Cervical Interbody Cage C-CURVE (Peek and Titanium) Manufactured by MEDICREA®