A herniated disc is a condition that occurs anywhere along the spine but more often in the lower back. Sometimes it is called a protruding, bulging or ruptured disc. It is a common cause of sciatica and lower back pain. Low back pain will affect between 60-60% of people at one time in their lives. A herniated disc can cause leg pain and low back pain in some people. A herniated disc can be extremely painful but most people feel better after a few weeks to months of non-surgical treatment.
The spine is composed of 24 bones called vertebrae that are stacked one on top of the other. These bones join to form a canal that protects your spinal cord. The lower back is made up of five vertebrae. This is your lumbar spine.
Your spine also includes:
- Nerves and the spinal cord. These cables carry messages between your brains and muscles through the spinal canal. Through openings called foramen in the vertebrae, nerve roots branch from the spinal cord.
- Intervertebral discs. Flexible intervertebral discs are located between your vertebrae. These discs are round and flat, about one-half inches thick.
When you run or walk, intervertebral discs absorb shock. Two components make up the intervertebral discs:
- Annulus fibrosus. This is the outer, tough and flexible ring of the disc.
- Nucleus pulposus. This is the soft, jelly-like middle of the disc.
When the jelly-like nucleus of a disc presses against its outer rings due to wear or injury, a disc will herniate. Lower back pain may result from this pressure on the outer ring. If the pressure is not stopped, the jelly-like nucleus can push through the outer ring of the disc or cause it to bulge. This causes pressure on the spine and nearby nerve roots. This causes nerve inflammation by releasing chemical irritants from the disc. Sciatica is when a nerve root becomes inflamed. This can cause pain, numbness and weakness in one or both legs.
Herniated Disc Cause
Most often, a herniated disc is the result of normal, age-related wear on the spine. This is known as disc degeneration. discs are high in water content, especially for young people. The water content of the discs decreases with age and makes them less flexible. As the discs shrink, the space between the vertebrae gets narrower. The normal aging process makes discs more susceptible to herniation. A herniated disc can also be caused by a traumatic event such as a fall.
Herniated Disc Risk Factors
There are some factors that can increase the risk of having a herniated disc. These are:
- Gender. A herniated disc is most common in men between the ages 20 and 50.
- Improper lifting. A herniated disc can be caused by lifting heavy objects with your back muscles rather than your legs. Your back can be exposed if you twist while lifting. Your spine may be protected if you lift with your legs and not your back.
- Weight. Being overweight places additional stress on your lower back. You should avoid repetitive activities that can strain your spine. Many jobs can be physically demanding. Many jobs require you to lift, pull, bend, twist, and bend constantly. Safe lifting and movement techniques can protect your back.
- Frequent driving. Long periods of sitting and the vibrations from the car’s engine can cause pressure to your spine.
- Lifestyle that is sedentary. Regular exercise is essential for preventing many medical conditions including a herniated disc.
- Smoking. Smoking is thought to reduce oxygen supply to the disc, causing faster degeneration.
Herniated Disc Signs
Low back pain is usually the first sign of a herniated disc. The pain can last for several days before it starts to improve. You may also experience the following symptoms:
- Sciatica. Sciatica is a sharp, sometimes shooting pain that radiates from one’s buttock to the back of the other leg. This is due to pressure on the spine nerve.
- A tingling sensation or numbness in the foot and/or leg
- Weakness in the foot and/or leg
- A loss of bladder control or bowel control. This condition is rare and could indicate a more serious condition called cauda Equina syndrome. The spinal nerve roots are compressed and this condition can be fatal. This condition requires immediate medical attention.
Both Surgical and Conservative Treatments
Conservative (non-surgical)treatments for lumbar and cervical herniated discs can be used for approximately four to six weeks to reduce discomfort and pain. It is not uncommon to have to go through a lot of trial and error before you find the best combination of treatments. Patients might try one treatment or a combination of several. Patients may be able to tolerate pain medications, manipulations and physical therapy better if they are focused on pain relief. Physical therapy can help with recovery and educate patients about good body mechanics, such as proper lifting technique. This helps prevent excess wear and tear to the discs.