The spine is made up of about 24 small bones called vertebrae, which form a long column down the center of the back. But that’s not all that the spine contains; in between these bones are small, cushion-like disks, which act as shock absorbers for the bones.
Over time, these disks undergo significant wear and tear – and sometimes, they can be pushed straight out of the spinal column. This is known as a herniated disk, and it can be an incredibly painful experience.
If you are suffering from a herniated disk, it’s important to understand what is happening to your spine, how to treat it, and whether your condition merits a visit to the doctor.
Causes of Herniation
In most cases, a herniated disk is simply the result of age. Over time, the jelly-like disks in our spines degenerate and wear down, which makes them particularly susceptible to tearing or rupturing with sudden movements. Elderly people have a greater risk of herniated disks, which can occur when they lift heavy objects, twist and turn during exercise, or even do something minor like sneeze.
There are other factors that can increase your risk of a herniated disk. These include:
- Obesity (excess weight puts stress on the spine)
- Repetitive movements (e.g., lifting boxes at work)
- Smoking (smoking limits the oxygen supply to the disks, which causes them to wear down quicker)
Individuals can also suffer herniated disks after an injury such as a car accident. The sudden, jerking movements from this kind of drama can put too much pressure on the spine ultimately push a disk out of position, causing it to compress a nerve near the spine.
Symptoms of a Herniated Disk
For some individuals, a herniated disk will show no symptoms at all. in this case, the desk will often heal by itself and no medical intervention is required. For others, however, a herniated disk can be incredibly painful with a myriad of symptoms.
While there are disks throughout the spine, most herniated disks happen in the lower back. For this reason, lower back pain — particularly lower back pain that worsens with movement — is typically the first sign of a herniated disc. Other common symptoms include:
- Sciatica (a shooting pain that runs from the buttock down the back of the leg)
- Numbness in the leg or foot
- Foot drop (a condition that makes lifting the foot while walking or standing difficult)
Diagnosing a Herniated Disk
A herniated disk has four different stages:
- Disk degeneration: When the nucleus of the disk weakens, and the disk becomes less able to absorb shock
- Disk Prolapse: When the disk begins to protrude or bulge around the spinal cord
- Disk Extrusion: When the nucleus of the disk begins to break through the disk wall
- Disk Sequestration: When the nucleus moves outside the spinal canal
Each of these stages can present their own array of pain or discomfort – but you’ll need to visit your doctor to determine the stage of your herniated disk.
During your doctor’s visit, the doctor will ask you about your medical history and your symptoms. After a physical exam, the doctor will determine whether you need more testing based on the severity of your symptoms. These tests could include a neurological exam (to check for loss of sensation), a straight leg raise (SLR) test, or even an MRI to get a clearer picture of the spinal canal.
Treatment for Herniation
In some cases, individuals can treat a herniated disk at home, without medical intervention. Some OTC medication and a few days of bed rest can help relieve the pain, and minor changes to your daily life (such as taking rest breaks and lifting extreme physical activity) can help keep the pain under control while protecting the disk from further degeneration.
For more extreme cases, an individual may want to use physical therapy to strengthen their back muscles. This can help relieve the pain of a herniated disk while also strengthening the back and spine overall. Others can request steroid injections from their doctor to provide short-term pain relief.
Finally, individuals who are suffering from severe herniation may need a discectomy, or disk removal surgery. In this procedure, a surgeon makes a small incision at the level of the disk and then removes some or all of the disk that is putting pressure on the spinal cord. If necessary, the surgeon may fust two vertebrae together to provide more long-term stability in the spine.
A discectomy is a common procedure. It usually requires one to four weeks of recovery time, with the individual returning to normal daily activity after six to eight weeks.
Hospitalization for a Herniated Disk
If the pain from a herniated disk feels severe or lasts longer than a few days, it’s time to pay a visit to your doctor. But how do you know if the pain warrants immediate medical attention? You should go to the emergency room right away if you experience any of the following:
- Pain or numbness that is severe enough to interfere with daily life
- Loss of bladder or bowel control
- “Saddle anesthesia,” or a loss of sensation around the inner thighs, back of legs, and anal region
These symptoms can point to a more severe condition – for example, a herniated disk that compresses multiple nerves.
Individuals with a history of metastatic cancer should seek medical attention at the first sign of a herniated disk. This is because spinal tumors often mimic the pain of a herniation. It is vital to have your spine examined right away to allow for early intervention in the event of a tumor.
Prognosis
For most individuals, a herniated disk is not a major injury. Most herniations occur do to aging, and long-term effects do not differ from the typical effects of entering our golden years. However, it is still necessary to maintain a healthy body (through regular exercise, good posture, etc.) if you want to stave off the pain of a herniated disk.
If a herniation is severe, however, going untreated can have long-term consequences. A severe slipped disk can cause permanent damage to the compressed nerve, which can result in permanent loss of sensation or control of the bladder and bowels.
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