What Is a Herniated Disc?
The spine consists of 24 bones called vertebrae (singular: vertebra), stacked one on top of the other. Between the vertebrae are intervertebral discs, made of cartilage and collagen, that act as shock absorbers. When the jellylike inner tissue of one of these discs pokes through the harder outer layer, it’s called a herniated disc. Other names include ruptured disc and bulging disc. The protruding part may push against a nerve or the spinal cord, causing pain and other symptoms.
The main symptom of a herniated disc is pain. Numbness and weakness are two other possible symptoms. How the symptoms manifest depends largely on the herniated disc’s location in the spine.
A herniated disc in the lumbar spine—the lower back—will cause lower back pain and possibly leg pain if it presses up against the sciatic nerve. This is the most common region for a herniated disc.
A herniated disc in the cervical spine (the neck) may cause symptoms in one arm, the shoulders or the neck itself. Herniated discs in the thoracic spine—the mid and upper back—are much rarer than those in either the lumbar or cervical spine.
Disc herniation is most often caused by a process called disc degeneration, where the discs begin to dry out and weaken due to age. This makes it more likely that the soft center of the disc will punch through the hard outer layer and press on a nerve. Other risk factors include:
- Gender: Men are more likely than women to have herniated discs.
- Improper lifting techniques: Lifting with the back instead of the legs increases the risk of a herniated disc.
- Occupation or activity: Some jobs and sports that involve lots of lifting, pulling, twisting or bending can cause herniated discs.
- Sedentary lifestyle: Exercise and activity are important for maintaining spine health.
- Smoking: Smoking may decrease oxygen supply to the discs and make herniation more likely.
- Weight: Being overweight puts more pressure on the spine, which makes a herniated disc more likely.
Many times herniated discs will gradually improve on their own, within three to four months. If not, nonsurgical interventions are usually attempted first. These can include:
- Epidural steroid injections
- Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen
- Physical therapy to strengthen the back and core
If these methods don’t work, surgery may be necessary. The most common form of surgery for herniated discs is a microdiscectomy, where the herniated part of the disc and any other fragments that are pressing on the nerve are removed. Physical therapy after a microdiscectomy is usually not needed, but a doctor might call for a regimen of daily 30-minute walks, plus flexibility training for the back and legs.
Even with disc degeneration, herniated discs are far from inevitable. Follow these tips to keep your discs healthy:
- Avoid repetitive movements
- Get at least 30 minutes of moderate exercise a day, five days a week, as per Centers for Disease Control and Prevention (CDC) guidelines
- Get up and move around at least once an hour if you have a sedentary occupation or lifestyle
- Maintain a healthy weight and body mass index (BMI)
- Practice safe lifting techniques
- Strengthen your back and abdominal muscles
- Use good posture
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