Herniated Disc

Herniated discs, or slipped discs, are one of the most common causes of back pain in the United States, affecting about 3 million people every single year.

WHAT IS A HERNIATED DISC?

In a nutshell, a herniated disc occurs when the inner, jelly-like material of a spinal disc pushes through or causes a bulge in the outer layer of a spinal disc, usually as the result of disc degeneration or a sudden, violent injury. This doesn't always cause pain, but it can if the inner disc material puts pressure on the sensitive nerves that surround the spine.

Spinal discs, also known as intervertebral cartilage, are essentially cushions that sit between the vertebrae of your spine and absorb all the shock that your back takes throughout the day. In a healthy spine, these discs are full of a gelatinous-like substance known as the nucleus pulposus which give them their ability to flex and compress. Meanwhile, the rigid outer shell of the disc, known as the annulus, ensures that everything remains contained and provides durability.

A great way to picture a healthy spinal disc is to think of jelly donut. The jelly represents the nucleus pulposus and the pastry represents the annulus.

However, as our bodies age and have experienced decades of constant wear and tear, the annulus of the disc naturally begins to weaken. For many people this isn't a problem, however in some cases this degeneration can cause the disc to collapse, crack or rupture, causing the nucleus pulposus to extrude outside of the disc.

A disc can also herniate as a result of a sudden, violent movement — a car accident, for example.

Depending on the location of the the ruptured disc, the fluid can begin to put pressure on the sensitive nerve roots that exit from the spine. This can cause pain directly in the back or in the location connected to the impacted nerve root.

It's important to note that back pain can be a little tricky to self-diagnose. Most pain that occurs in the back is actually the result of strained, pulled or inflamed structures (like muscles or tendons) that support the spine. Pain in these areas can feel like it's emanating from the back when, in reality, it's coming from a different area entirely. One way you can determine the seriousness of your spine pain is to see how conservative treatments like rest, anti-inflammatory medication like ibuprofen, heat therapy and massages help your spine. If you condition improves after a couple of days, it was likely not a symptomatic spinal condition.

In contrast, pain from an acutely herniated disc can cause pain that may not improve with rest and medications. If you're experiencing daily pain from your spine that is not improving with conservative treatment, it's time to consider visiting a spinal specialist.

Herniated Lumbar Disc

What discs can experience Herniation?

In theory, any disc is technically subject to herniation. However, barring accidents and unexpected, violent injuries, most occur in one of two places: the lumbar spine and the cervical spine.

HERNIATED CERVICAL DISC

A herniated cervical disc occurs in one of the seven cervical vertebrae (C1-C7) directly below the skull. While inflammation of the vertebrae can cause some pain and discomfort, most of the problems caused by a herniated disc result from pressure and friction on the nerves in the affected area.

HERNIATED LUMBAR DISC

A herniated lumbar disc occurs in the lumbar section of the spine, the lowest section of the spine consisting of five vertebrae (L1-L5). While this sounds painful, a herniated lumbar disc doesn’t always result in back pain, since most of the problems caused by a herniated disc result from pressure and friction on the nerves in the affected area.

What are the Symptoms of a Herniated Disc?

Regardless of their location, herniated discs exhibit some common, tell-tale symptoms, these can include:

  • Pain in your arms or legs. The exact location of your pain in your extremities will depend on the location of the herniated disc. Patients who have a ruptured disc in the lower back will typically feel pain in their buttocks, thighs or calves. However, symptoms can stretch all the way down to the foot depending on the location and severity of the herniation. If the herniated disc occurs in the upper neck (cervical spine), patients will often experience pain in their arms and shoulders. This pain is often made worse after standing or sitting for long periods of time or placing excessive pressure on the spine by bending over or leaning.


  • Tingling or numbness. A very common symptom of a pinched nerve is the experience of tingling or numbness. If you've ever had your foot "fall asleep" the feeling is somewhat similar. However, instead of the tingling going away with time, patients with a pinched nerve will often experience continual numbness or tingling in the body part affected by the pinched nerve.


  • Muscle weakness. While somewhat rare, patients suffering from a herniated disc will occasionally experience weakness in their limbs, especially those that are impacted by the affected nerve.

How are Herniated Discs Diagnosed?

Diagnosis of a herniated disc usually requires imaging of the affected area with an MRI or CT scan to determine if the disk is damaged or ruptured, as well as the extent of the damage.

Spine condition visual

Treatment options

Treatment options range from observation and pain regulation to minimally invasive surgery, although treatment differs depending on both the patient and the severity of the herniation. In severe cases where a surgical solution is required, we offer the following options:

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Atlantic Brain and Spine A graduate of both Yale and Stanford, Dr. Jae Lim is a board-certified spine surgeon who specializes in minimally invasive spine surgery and robotic spine surgery, significantly reducing surgical impact and recovery times. (703) 876-4270
8501 Arlington Blvd. Suite 330
Fairfax
Virgina
22031
United States
Jae Y. Lim Ben L. Nguyen