Spinal Conditions

Disk Hernia

What is a Disk Hernia?

Herniated disks can be called by many names. A slipped disk, ruptured disk, or a bulging disk can all refer to the same medical condition.

Within the spine, a gel-like cushioned disk (nucleus pulposus) absorbs impact like a shock absorber, and separates vertebrae. When the annulus fibrosus tears due to an injury or the aging process, the nucleus pulposus can extrude through the tear. You might imagine a prolapsed disk as something like a doughnut with jelly. Applying pressure forces the nucleus pulposus to squeeze outside of the disk. This can put pressure on nerves and stimulate the symptoms of sciatica, or disk herniation.

Like a tree branching out, major spinal nerves extend out all along the spine to various organs, tissues and extremities. Herniated disks often press against these nerves. These ‘pinched nerves’ cause radiating pain, numbness, tingling, and diminished strength and/or range of motion. Further, when the nerve comes in contact with the inner nuclear gel’s inflammatory proteins, a person may experience significant pain. Nerve-related pain is also known as radicular pain. When the disk protrudes into surrounding vertebrae, it is called Schmorl’s nodes.

Symptoms to Watch

Out of every 50 people, one will experience a herniated disk at some point. For between 10 and 25 percent of people, the symptoms will last more than 6 weeks. Watch for:

  • Sudden pain in your lower back or hip that radiates to the back of your thigh and on your leg may indicate a protruding (herniated) disk pressing on your sciatic nerve.
  • If it feels like a bad leg cramp that lasts for weeks, it could be sciatica. You may have pain when you sit, sneeze, or cough. Feeling numb, weak, burning or tingling, or a pins-and-needles sensation down your leg are also signs.
  • You are more likely to get sciatica if you are 30 to 50 years old. It may result from general wear and tear, and sudden pressure on the disks that cushion the bones (vertebrae) of your lower spine.
  • In rare cases, a herniated disk may press on nerves that cause you to lose control of your bladder or bowel. You may also have numbness or tingling in your groin or genital area. This is an emergency situation that requires surgery. Phone your doctor immediately.

Nonsurgical Treatment

More than 8 out of 10 patients with sciatica or disk hernias get better without surgery.

This condition usually heals itself, given sufficient time and rest. The treatment goal aims to help you manage your pain without the long-term use of medications. Your condition is likely to improve within a few weeks.
Here are a few tips:

  • At first, take a few days of bed rest while the inflammation calms.
  • You may want to take nonsteroidal anti-inflammatory drugs such as ibuprofen, aspirin, or muscle relaxants.
  • Alternating gentle heat and cold on your painful muscles can be soothing.
  • Do find comfortable positions. But try to be active, as moving helps reduce inflammation.
  • Your orthopedic doctor may inject a cortisone-like drug into your spinal area.
  • Start physical therapy with stretching exercises soon. This will help you resume your normal physical activities without sciatica pain. Short walks are good.

Surgical Treatment (Laminotomy with Discectomy)

After 3 or more months of nonsurgical treatment, you should be feeling better. If you continue to have disabling leg pain after this time, your doctor will consider surgery. Surgical treatment removes the part of the herniated disk that is pressing on your nerve and causing pain. Surgeries may be performed with local, spinal, or general anesthesia. If most of the pain is in your leg, your odds of a successful surgery are 90%.

Rehabilitation

For at least one month after surgery, you should avoid driving, lifting, bending forward or sitting for long periods. Perform the exercises your doctor has given you to strengthen your back. Resume your normal lifestyle with your pain under control. Be aware, about 5 percent of people with sciatica will have their disk rupture again after surgery.

Supporting Your Back

If you are a person that sits with poor posture, your spine may be forced out of its proper position. As a result, supportive muscles, tendons and ligaments are strained. Poor posture and body position can result in a bad back. Your orthopedic doctor may recommend a lumbosacral back support. Lumbar supports can be found in various sizes and styles. Fit properly, they help you sit and drive your car in a stable, back-friendly position.

Age and Degenerative Disk Disease

As people age, the nucleus pulposus may naturally dehydrate. Like a tire that loses air, its ability to absorb shock is lessened. The annulus fibrosus weakens and begins to tear. This may not cause pain in some people. In others, it may cause chronic pain, known as axial pain or disk space pain. Gradual dehydration of the nucleus pulposus is called degenerative disk disease.