Herniated Disc

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What is a Herniated Disc?

A herniated disc refers to an issue with the disc material that sits between the individual bones making up the vertebrae in the spine. These discs act as shock absorbers and cushions for the bones. The discs are similar to a jelly donut, with a soft center surrounded by a tough, protective exterior. When herniated, some of the “jelly” will protrude through a tear in the exterior, resulting in extreme chronic pain or discomfort.

Herniated discs are common among middle-aged people, and they tend to occur in the lower part of the spine.

Herniated Discs vs. Bulging Discs

Sometimes people use the terms “herniated disc” and “bulging disc” interchangeably, and while they are similar, there are important differences between them. When a disc is bulging, at least 25-50% of the disc’s circumference is protruding and it just affects the outer layer of cartilage, while a herniated disc involves a crack in the outer layer of the cartilage that causes some of the inner layer to protrude. A herniated disc is usually more painful than a bulging disc.

Herniated Disc Symptoms

Herniated discs in the back do not always come with symptoms. Symptoms of herniated disc include:

• Pain that radiates over to the buttocks, feet and legs. This is called sciatica
• Feelings of tingling or numbness in the legs or feet
• Muscle weakness

If the herniated disc is in the neck, symptoms can include:

• Pain near or over the shoulder blade
• Pain that radiates to the shoulder, arm or, in some cases, hand and fingers
• Pain or spasms in the neck that become worse when turning the neck or bending

Herniated Disc Causes

Herniated discs occur when the outer part of the disc becomes weak and tears. Beyond natural wear and tear, the factors that can increase the risk for a herniated disc include:

• Gender. Men between 30 and 50-years-old are the most likely group to suffer from a herniated disc.
• Lifting heavy objects improperly. Lifting heavy objects with the back instead of the legs or twisting while lifting can both increase the risk for a herniated disc.
• Weight. Carrying excess body weight increases the stress on discs.
• Repetitive, spine-straining activities.Certain occupations, including those that involve a lot of pulling, bending or twisting, can place a substantial strain on the spine.
• Being sedentary. Remaining in a sitting position for prolonged periods can increase the strain on the spine. Frequent driving is also an associated risk factor.
• Smoking. Nicotine can restrict blood flow to spinal discs, which can hasten degeneration and inhibit healing. Degenerated discs are less pliable and therefore more likely to tear or crack.

Diagnosing a Herniated Disc

Imaging tests are the primary way to diagnose a herniated disc – through either observing the protrusions themselves or ruling out other sources of back pain. Imaging tests used include:

• X-rays
• CT scans
• MRI scans
• Myelogram

During a consult at the Adena Spine Center, your doctor may also perform movement tests, including tests to check for:

• Reflexes
• Muscle strength
• Ability to walk
• Ability to feel touches, pinpricks or vibrations

Herniated Disc Treatment Options

For most people, a herniated disc will improve on its own – even if the process is slow. One to two days of rest in bed is normally helpful for addressing severe back pain. For those with persisting pain, conservative treatment options include:

• Oral steroids to decrease inflammation and provide pain relief
• Oral medications for severe pain
• A combination of physical therapy and exercise to alleviate pressure on the nerve root
• Epidural injections to reduce pain and inflammation
• Manual traction to assist in opening up the cervical foramen where the nerve root exits the spinal canal

For other patients, surgery may be the only option to get relief from a herniated disc. In most cases, surgery for a herniated disc involves removing the part of the disc that is protruding. Some of the common types of surgery for this purpose include:

• Anterior cervical discectomy and fusion (ACDF)
• Cervical Disc Replacement
• Cervical Laminoforaminotomy
• Microdiscectomy