A herniated disk refers to a problem with one of the rubbery cushions (disks) that sit between the individual bones (vertebrae) that stack to make your spine.
A spinal disk has a soft, jellylike center (nucleus) encased in a tougher, rubbery exterior (annulus). Sometimes called a slipped disk or a ruptured disk, a herniated disk occurs when some of the nucleus pushes out through a tear in the annulus.
A herniated disk, which can occur in any part of the spine, can irritate a nearby nerve. Depending on where the herniated disk is, it can result in pain, numbness or weakness in an arm or leg.
Many people have no symptoms from a herniated disk. Surgery is usually not necessary to relieve the problem.
The rubbery disks that lie between the vertebrae in your spine consist of a soft center (nucleus) surrounded by a tougher exterior (annulus). A herniated disk occurs when a portion of the nucleus pushes through a crack in the annulus. Symptoms may occur if the herniation compresses a nerve.
Most herniated disks occur in the lower back, although they can also occur in the neck. Signs and symptoms depend on where the disk is situated and whether the disk is pressing on a nerve. They usually affect one side of the body.
You can have a herniated disk without symptoms. You might not know you have it unless it shows up on a spinal image.
Seek medical attention if your neck or back pain travels down your arm or leg, or if you also have numbness, tingling or weakness.
Disk herniation is most often the result of a gradual, aging-related wear and tear called disk degeneration. As you age, your disks become less flexible and more prone to tearing or rupturing with even a minor strain or twist.
Most people can't pinpoint the cause of their herniated disk. Sometimes, using your back muscles instead of your leg and thigh muscles to lift heavy objects can lead to a herniated disk, as can twisting and turning while lifting. Rarely, a traumatic event such as a fall or a blow to the back is the cause.
Factors that can increase your risk of a herniated disk include:
Just above your waist, your spinal cord ends. What continues through the spinal canal is a group of long nerve roots that resemble a horse's tail (cauda equina).
Rarely, disk herniation can compress the entire spinal canal, including all the nerves of the cauda equina. Rarely, emergency surgery might be required to avoid permanent weakness or paralysis.
Seek emergency medical attention if you have:
To help prevent a herniated disk, do the following:
During the physical exam, your doctor will check your back for tenderness. You might be asked to lie flat and move your legs into various positions to help determine the cause of your pain.
Your doctor may also perform a neurological exam to check your:
In most cases of herniated disk, a physical exam and a medical history are all that's needed for a diagnosis. If your doctor suspects another condition or needs to see which nerves are affected, he or she may order one or more of the following tests.
Electromyograms and nerve conduction studies measure how well electrical impulses are moving along nerve tissue. This can help pinpoint the location of nerve damage.
Conservative treatment — mainly modifying activities to avoid movement that causes pain and taking pain medication — relieves symptoms in most people within a few days or weeks.
Your doctor might suggest physical therapy to help with your pain. Physical therapists can show you positions and exercises designed to minimize the pain of a herniated disk.
Few people with herniated disks eventually need surgery. Your doctor might suggest surgery if conservative treatments fail to improve your symptoms after six weeks, especially if you continue to have:
In nearly all cases, surgeons can remove just the protruding portion of the disk. Rarely, the entire disk must be removed. In these cases, the vertebrae may need to be fused with a bone graft.
To allow the process of bone fusion, which takes months, metal hardware is placed in the spine to provide spinal stability. Rarely, your surgeon might suggest the implantation of an artificial disk.
Diskectomy is the surgical removal of the damaged portion of a herniated disk in your spine. A herniated disk occurs when some of the softer material inside the disk pushes out through a crack in the tougher exterior. This can irritate or compress nearby nerves and cause pain, numbness or weakness.
Besides taking the pain medications your doctor recommends, try:
Some alternative and complementary medicine treatments might help ease chronic back pain. Examples include:
You're likely to start by seeing your family doctor. You might be referred to a doctor specializing in physical medicine and rehabilitation, orthopedic surgery, neurology, or neurosurgery.
Before your appointment, be prepared to answer the following questions:
Your doctor might ask other questions, including: