Summary about Disease
A herniated disc (also called a slipped disc or ruptured disc) occurs when one of the soft cushions (discs) between the bones (vertebrae) in your spine pushes out. This can happen when the outer part of the disc weakens or tears. The protruding disc can then press on nearby nerves, causing pain, numbness, or weakness. It most commonly occurs in the lower back (lumbar spine), but can also affect the neck (cervical spine).
Symptoms
Symptoms vary depending on the location of the herniated disc and the nerve affected. Common symptoms include:
Arm or leg pain: If the herniated disc is in your lower back, you'll typically feel the most pain in your buttock, thigh and calf. It may also extend into part of the foot. If the herniated disc is in your neck, the pain will typically be in your shoulder and arm. This pain may shoot into your arm or leg when you cough, sneeze or move into certain positions.
Numbness or tingling: You might experience numbness or tingling in the area served by the affected nerves.
Weakness: Muscles served by the affected nerves tend to weaken. This may cause you to stumble, or affect your ability to lift or hold items.
Cauda equina syndrome: A rare, but serious, complication is cauda equina syndrome, which can affect bowel and bladder function. This requires immediate medical attention.
Causes
Herniated discs are most often the result of gradual, age-related wear and tear, called disc degeneration. As you age, the discs lose some of their water content, making them less flexible and more prone to rupture. Other factors can increase the risk, including:
Improper lifting: Using your back muscles instead of your legs when lifting heavy objects.
Repetitive motions: Jobs that involve repetitive bending, twisting, or lifting.
Obesity: Excess weight puts extra stress on the discs in your lower back.
Genetics: A family history of herniated discs may increase your risk.
Trauma: A sudden injury, such as a fall, can sometimes cause a herniated disc.
Medicine Used
Medications used to treat herniated disc symptoms often include:
Over-the-counter pain relievers: Ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve) or acetaminophen (Tylenol, others).
Prescription pain relievers: If over-the-counter pain relievers don't help, your doctor might prescribe stronger medication, such as opioids.
Muscle relaxants: These medications can help to relieve muscle spasms.
Nerve pain medications: Such as gabapentin or pregabalin, can help to reduce nerve pain.
Corticosteroids: These medications can be taken orally or injected near the affected nerve (epidural injection) to reduce inflammation.
Is Communicable
A herniated disc is not communicable. It is a structural problem within the spine and cannot be passed from person to person.
Precautions
To help prevent a herniated disc or to manage symptoms, consider the following precautions:
Maintain good posture: Sit and stand up straight.
Use proper lifting techniques: Bend your knees, keep your back straight, and hold the object close to your body.
Maintain a healthy weight: Excess weight puts strain on your back.
Exercise regularly: Strengthen your core muscles to support your spine.
Avoid prolonged sitting: Take breaks to stand and stretch.
Use ergonomic furniture: Ensure your work environment supports good posture.
Stop smoking: Smoking reduces blood supply to the discs.
How long does an outbreak last?
There is no "outbreak" with a herniated disc. The duration of symptoms varies significantly. Some people experience symptoms that resolve within a few weeks or months with conservative treatment (rest, medication, physical therapy). Others may have chronic pain that lasts for several months or years. A small percentage may require surgery if conservative treatments fail.
How is it diagnosed?
Diagnosis typically involves:
Medical history and physical exam: The doctor will ask about your symptoms and perform a physical exam to assess your reflexes, muscle strength, and sensation.
Neurological exam: To assess nerve function.
Imaging tests:
X-rays: Can rule out other causes of back pain, such as fractures.
MRI (Magnetic Resonance Imaging): Provides detailed images of the soft tissues in your spine, including the discs and nerves. This is the most common imaging test used to diagnose a herniated disc.
CT scan (Computed Tomography): Can show the shape and size of the spinal canal and surrounding structures.
Nerve conduction studies and EMG (Electromyography): May be used to assess nerve damage.
Timeline of Symptoms
The timeline of symptoms can vary widely. A general progression might look like this:
Initial Injury/Onset: Some people experience a sudden onset of pain, while others have a gradual increase in discomfort over time.
Acute Phase (Days to Weeks): Intense pain, muscle spasms, and limited mobility are common. This is often when people seek medical attention.
Subacute Phase (Weeks to Months): Pain may begin to subside with rest and treatment. Muscle strength and range of motion may gradually improve.
Chronic Phase (Months to Years): Some people experience persistent pain and functional limitations despite treatment. In some cases, the disc may heal on its own over time.
Important Considerations
Most herniated discs do not require surgery. Conservative treatment is often effective.
Physical therapy is a crucial part of recovery.
Early diagnosis and treatment can improve outcomes.
Lifestyle modifications such as weight management and proper lifting techniques are important for preventing recurrence.
Cauda equina syndrome is a medical emergency requiring immediate attention. Seek immediate medical care if you develop bowel or bladder dysfunction, severe weakness in your legs, or numbness in the groin area.