Up to 85% of all Americans suffer from back or neck pain at some point in their life. A herniated disc is a condition where the fibrous tissues surrounding intervertebral discs become damaged and torn. This causes the inside of the disc (a jelly like substance known as nucleus pulposus) to bulge out. There are a variety of causes, including natural wear and tear of the intervertebral discs, causing them to become worn and more susceptible to damage. Trauma to the spine, such as lifting from the back rather than the knees, or sudden twisting of the spine, can also lead to herniated discs. Other causes include repetitive movements such as squatting, sitting and lifting, and previous injury to the spine. Other conditions of the spine such as spinal stenosis, increased body weight, and even smoking have been implicated as predictive factors in developing these conditions. Too little exercise may cause muscles within the back to become weak, leading to less support in this area and making the back more susceptible to developing back problems. Too much exercise may also lead to trauma of the spine.
Symptoms can vary greatly depending on the area of the herniated disc within the spine. Many people do not experience any pain, although if the herniated disc presses on spinal nerves some people experience intermittent pain, followed by periods of no pain, whilst others experience chronic and severe pain. Pain is not only localized to the area of the herniated disc, but may also be felt in the neck, chest, buttocks, thighs, and feet. There may also be a tingling or numb sensation in these areas and, in some cases, even paralysis. Pain can be worsened by particular movements or by standing or sitting in one place for long periods of time.
Diagnosis is often made through a history of the patient’s symptoms, although an MRI or CT scan can also confirm the presence or a herniated disc. For some, herniated discs may heal themselves, with symptoms disappearing after several weeks. However, this is not always the case, as for others further treatment may be required. In the first instance, rest is recommended if pain is severe. However, where possible it is recommended to begin returning to mild activity as soon as possible to stop muscles within the back from weakening and further problems from occurring. Anti-inflammatory such as NSAIDs are often recommended first. Heating pads, hot baths or showers and ice compresses may help to relieve pain. If symptoms continue to persist after several weeks or are becoming worse, your doctor may suggest other treatment options such as muscle relaxants or cortisone injections, also known as spinal injections. These help to reduce the pain and inflammation of damaged nerves caused by herniated discs. Alternatively, physical therapy may help to promote the natural healing process of the body, help with muscle relaxation, and improve circulation. For those who experience no relief and are suffering chronic pain, surgery may be recommended.
