Herniated disc results from the degeneration of spinal disc due to aging or an injury to the spine. It can cause pain, weakness and numbness in the lower back and leg. Read on to know more about symptoms and treatment of herniated disc.

Human spine or backbone is made from 33 bones, known as vertebrae. There are 7 cervical vertebrae, 12 thoracic vertebrae and 5 lumber vertebrae. There is the sacrum (5 vertebrae fused together) beneath the fifth lumber vertebra, followed by the coccyx or tail bone (3 vertebrae fused together). These vertebrae are cushioned by small, soft pads of cartilage. Spinal discs comprise a jelly-like inner layer, called nucleus and a tough outer layer, called annulus fibrosus. These discs act as a shock-absorber and protect the spine from any kind of injury or stress. Spinal discs also allow bending movements of the spine.

If the spinal disc degenerates due to aging or any injury, the soft inner layer may rupture and get herniated through the annulus fibrosus. This can cause irritation of the spinal nerve, leading to pain, weakness and numbness in the lower back, arm and leg. This condition is known as a herniated disc. It is also referred to as compressed disc, bulging disc, prolapsed disc, slipped disc, ruptured disc or herniated intervertebral disc. Herniated disc most commonly occurs in between the fourth and fifth lumbar vertebrae in the lower back (lumbar spine); however, it can also occur in the cervical spine.

Causes of Herniated Disc

Herniated disc when associated with wear and tear due to aging is known as degenerative disc disease. As the water content and elasticity of the nucleus of the disc are reduced with aging, people between the age of 30 and 50 are at higher risk of herniated disc. Lifting heavy objects can also lead to spinal disc herniation.

Sometimes, traumatic events such as a fall or any injury to the spine can cause herniated disc. Smoking reduces the oxygen levels in the body, causing deficiency of vital nutrients in the body tissues, thus increases the risk of herniated disc. Some other risk factors include excess body weight, being tall (men taller than 5 feet 11 inches and women taller than 5 feet 7 inches) and occupations that cause excess stress to the spine.

Symptoms of Herniated Disc

Severity of the symptoms of herniated disc may vary depending upon the position and the size of disc herniation. If the herniated disc is pressing on the nerve roots, then it can cause pain and numbness in the back and legs. If herniated disc is in the lower back, then it causes back pain known as sciatica that spreads to the buttocks and legs. Lower back pain and leg pain may worsen after sitting, sneezing or coughing. If herniated disc occurs at upper back, then it can lead to neck pain that may spread to the shoulders and upper arms.

Some other symptoms of herniated disc are numbness, tingling, weakness and muscle spasms. In some rare cases, herniated disc can lead to cauda equina syndrome, which is caused due to compression of the spinal nerve roots. Emergency surgery is required to relieve the pressure and cure cauda equina syndrome; otherwise it can cause permanent weakness or paralysis. If left untreated, herniated disc can lead to some complications such as increasing pain and numbness in one or both legs, bowel or bladder dysfunction and progressive loss of sensation.

Diagnosis of Herniated Disc

If you experience back pain or leg pain that interferes with normal activities for more than a week, then you should consult an orthopedist. Certain tests are suggested by the doctor for the diagnosis of herniated disc such as straight-leg-raising test, cross straight-leg-raising test and screening neurological examination. Certain imaging tests like X-ray, CT scan, MRI scan and myelogram are performed to confirm the location of the herniated disc and to detect which nerve is affected.

Treatment for Herniated Disc

Treatment for herniated disc is decided depending upon the severity of the symptoms. There are surgical as well as nonsurgical options for the treatment of herniated disc. Nonsurgical methods for herniated disc include pain relievers, anti-inflammatory medications, physical therapy, hydrotherapy, electrical stimulation, cold therapy, heat therapy, bracing, traction and stretching. You can also benefit from certain exercises like dynamic lumbar stabilizing exercises and aerobic exercises with pain-free activities. In some severe cases, surgical options such as minimally invasive and decompression procedures are recommended.

Nonsurgical Treatment: Many a times, herniated disc improves with nonsurgical treatment options. Nonsurgical treatment aims at reducing irritation of the nerve, relieving pain and improving physical activities. Primary treatment is administered for back pain relief. You need to limit or modify the activities like prolonged sitting, lifting heavy objects or bending, which can aggravate the symptoms. Physical therapy and exercises can help increase the strength and flexibility. Pain relievers like acetaminophen and nonsteroidal anti-inflammatory drugs such as ibuprofen and aspirin can help to reduce pain and relieve inflammation of the nerve roots.

Neuropathic pain medications like pregabalin, gabapentin and duloxetine are effective for painful nerve conditions. Lower doses of tricyclic antidepressants like nortriptyline can also help to relieve pain. If you have persistent back spasms, then your doctor prescribes muscle relaxants like methocarbamol, cyclobenzaprine or carisoprodol. If pain is not improved with these medications, then corticosteroids are administered orally or through epidural injection. Some other treatment options including cold or heat therapy, bracing, transcutaneous electrical nerve stimulation (TENS), hydrotherapy and traction are also helpful in relieving pain.

Once pain is relieved, the treatment is given to strengthen and stabilize the spine and restore spinal function. Rehabilitation involves physiotherapy and various exercises such as stretching, aerobics, and dynamic lumbar stabilization exercise. These back strengthening exercises help control pain, correct the posture, strengthen the muscles and improve flexibility.

Surgical Treatment Options: If you don’t experience any improvement with nonsurgical treatment options after a period of time, then surgical options are recommended. Surgical treatment is aimed at relieving pain and preventing irritation of the spinal nerve due to herniated disc. Minimally invasive procedures include chemonucleolysis and endoscopic discectomy. Open decompression involves discectomy, microdiscectomy and spinal fusion.

Herniated disc can also be treated with some alternative treatment options such as acupuncture, massage, spinal manipulation and yoga. You can prevent herniated disc by doing regular exercise, maintaining good posture and healthy weight, and quitting smoking.

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