Herniated Disc

A herniated disc, also known as a “slipped disc” or “bulging disc,” is a spinal injury occurring with age or injury and is capable of causing a great deal of discomfort.

Each bone in the spine (known as vertebra) is separated by a gap to allow movement, with the space between the bones being padded by a disc. These discs are similar to jelly donuts sitting between the vertebrae, cushioning the spine during movement. Each disc has an outer fibrous ring layer which protects the jelly-like nucleus that acts as a shock absorber for the spine.

These discs become weaker as we age, and the outer layer can rupture allowing the inner nucleus to leak out into the spinal canal and press on spinal nerves. This rupturing of the “donut” is a herniated disc. It is most common in people between the ages of 30 and 50, and twice as common in men than women. There is a large variation in the size and location of herniated discs, and these factors weigh heavily on the extent and severity of symptoms.

Turn to the back, neck and spine experts of Midwest Orthopedic Specialty Hospital for the proper diagnosis and care of herniated discs.

Common Symptoms of a Herniated Disc

Some people experience no symptoms, as the bulging part of the disc pressing on the spine is small or does not press on nerves. However, spinal nerves are sensitive to even the slightest of pressure, which can lead to moderate to severe discomfort. Local inflammation related to the herniation contributes significantly to nerve pain, also known as radiculopathy. Pain usually starts in the back then extends into one leg.

• Pain — The severity of the pain depends on the degree of rupture within the herniated disc and how much of the disc is pressing on nerves. Pain can be worsened by any motion that puts pressure on the nerves, including involuntary movements such as coughing or sneezing.
• Weakness — The second most common symptom, weakness is directly related to the degree of compression of the spinal nerve which decreases the electrical signals from the brain to the muscle tissue.

Diagnosing a Herniated Disc

Because there are many causes of back pain, your Midwest Orthopedic Specialty Hospital physician will need to obtain a detailed history of your medical conditions and symptoms.

A physical examination will allow your physician to examine your reflexes, determine the location and type of pain you are experiencing, and localize the cause of your pain. Further diagnostic tests may include CT or MRI scans to confirm a herniated disc and better assess structure and stability of your spine. A nerve test may be ordered to evaluate other sources of arm or leg pain.

Treatments for Herniated Disc

Non-Surgical Treatments

In most cases, herniated disc treatment is unnecessary and the condition will resolve on its own – most people are better within a month. If you have significant discomfort, your physician may recommend one of the following:

• Application of heat or ice for pain
• Over-the-counter painkillers such as acetaminophen
• Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) such as ibuprofen or naproxen In the case of more severe pain where OTC painkillers have not been successful, a short course of oral steroids or narcotic painkillers
• Muscle relaxers to decrease pain associated with muscle spasm
• Corticosteroid injections into the spine can help reduce inflammation
• Staying active, such as walking and stretching
• Limiting bending, lifting, pushing, pulling and twisting

Surgery

In the event that you experience more severe symptoms, such as difficulty with walking or standing, progressive muscle weakness or bowel or bladder dysfunction, your physician may recommend back surgery. This occurs in about 10 percent of cases, and may take the form of:

• Open discectomy — The most common type of spine surgery, a procedure to remove all or part of the herniated disc. Generally, only the herniated portion of the disc is removed.
• Prosthetic invertebral disc replacement — Back surgery to replace the herniated disc with a prosthetic device capable of performing the same role (experimental).

How to Prevent a Herniated Disc

If you have suffered one herniated disc, you are at risk of experiencing another. The best prevention includes:

• Careful lifting habits — use the legs, not the back
• Exercising — yoga, walking, swimming, core strengthening exercises
• Losing weight
• Quitting smoking