What is a Herniated Disc? Causes, Symptoms, & Treatment

A herniated disc is a condition that can be underestimated only by those who have never experienced it.

This condition can be quite painful in the affected area. Chronic pain is much worse than given credit for, and it’s not just your body that’s paying the toll. It can also affect your mood, and if untreated, it can even affect your mental health.  

Limited mobility, especially bending, can become a difficult task. You probably don’t realize how many times you bend in a day until you experience a disc problem. You’ll never notice (let alone count) these instances until you develop a herniated disc.

Still, what is a herniated disc, and why is it so bad?

Here’s what you need to learn about this condition to recognize, treat, and reduce the chance of it appearing in the future. 

What is a herniated disc?

When a disc fragment is pushed out of the annulus (the tough outer layer of the disc), it is herniated. Under normal circumstances, these discs are nestled between each vertebra, acting as our spine's shock absorbers, cushioning the impact of our daily movements. 

The spine is one of the skeleton's most mobile and flexible structures. While everyone knows about the spinal bones (vertebrae), few people know much about discs. These cushion-like structures enable vertebrae to move without grinding against each other. 

While a herniated disc can happen anywhere along the spine, they’re far more common in the lower back (lumbar spine). The other likely spot is the cervical spine (in the neck).

What are the symptoms of a herniated disc? 

A herniated disc typically starts as a pain in the affected area (lower back or neck, depending on whether it’s lumbar or cervical). 

After this, you’ll likely feel numbness or tingling in the shoulders, arms, and upper back (if it’s cervical) or legs and feet (if it’s lumbar).

People with herniated discs might also struggle to bend or straighten their backs and experience muscle weakness to the affected arm or leg.  

Like most conditions, a herniated disc evolves over time. Different herniated disc stages may give different symptoms, which is also worth considering. 

Just remember, knowing what a herniated disc is and learning how to recognize symptoms doesn’t make you an expert, and it doesn’t mean that you can accurately self-diagnose. To do this, you need to go to a doctor. 

How to diagnose a herniated disc?

While you may suspect that you have a herniated disc, the only way to confirm this is to visit a doctor. For instance, during the early stages of a herniated disc, it could be pretty hard for a non-specialist to tell whether it’s a herniated disc.  

A specialist will leverage their rich experience in treating this condition and use several techniques, such as imaging tests (X-rays, CT scan, MRI, Myelogram, etc.) and nerve tests (nerve conduction study or electromyogram).

This way, they’ll know with greater certainty and can proceed with the treatment. This brings us to our next point…

How to treat a herniated disc?

The treatment of a herniated disc is usually conservative in the initial stage. 

It is advised to take it a bit easier; however, unlike other orthopedic problems, bedrest is not recommended. Instead, you need to maintain regular low-intensity activity for several weeks. It is important to avoid activities that place a lot of pressure on the spine such as heavy lifting and extreme forward or backward bending. 

Ultimately, your doctor will prescribe physical therapy as an essential treatment for this problem. This can include massage, ice, and heat therapy, ultrasound, electrical muscle stimulation, and even some mild stretching exercises. The goal is to strengthen the core and muscles of the back to support the underlying spine and help reduce the inflammation created by the herniation.  A combination of pain medication and muscle relaxants are used to aid in this treatment. 

Nonsteroidal anti-inflammatory medications are frequently used to augment treatment and reduce inflammation surrounding the irritated nerve causing the painful symptoms; this is routinely used in all situations where these medications are safe for the patient.

Your doctor may also recommend an epidural steroid injection, which utilizes a spinal needle under the X-ray guidance. This way, it will be administered at the exact level of the disc herniation and act as a local anti-inflammatory. 

Herniated disc surgery

If the pain is intense and no other form of conservative treatment helps, a doctor may recommend surgery. Before the procedure, the doctor will discuss all the options and outcomes with the patient and explain the procedure, its benefits and risk, as accurately as possible. 

More often than not, the indications that the injury will require surgery are scenarios where:

•  The pain limits normal activity and quality of life.
• There's difficulty in standing and walking.
• Medication and physical therapy are ineffective.
• The patient is healthy enough to go through the surgery. 
• There’s a loss of normal bowel and bladder function.
• The neurological deficits are worsening (weakness or numbness in extremities).

As we’ve previously mentioned, depending on the location of the injury, this could involve lumbar or cervical spine surgery. Even these two have variants. For instance, a lumbar spine surgery could be a lumbar decompression and removal of the herniated disc(laminotomy), artificial disc replacement surgery, or fusion surgery. Still, the latter is a lot trickier, and only a small percentage of candidates qualify for it and usually only in the setting of multiple disc herniations in the same location. 

Herniated disc recovery time

Many people feel better after a few weeks. Still, this depends on the nature of the injury, symptoms, and personal circumstances. For instance, young, healthy people tend to heal far quicker.

Some of the signs that a herniated disc is healing are an increase in mobility and a reduction in pain. This can happen very early on; however, this doesn’t mean that the disc is healing independently, and you can stop with the therapy. 

With the right treatment, most people with herniated discs feel better within the first 12 weeks. 

Herniated disc prevention

There are a few things that you could do to prevent herniated discs from becoming more frequent and severe. 

First, you need to focus on two major issues:

Next, you must strengthen the area, which you can do with herniated disc exercises and stretches.

Lastly, you need to learn how to lift heavy objects properly. In other words, lift with your legs, not your back. As the old gym saying goes, every exercise is a lower back exercise if you do it wrong enough. 

Unfortunately, herniated discs are not always preventable. However, the tips we’ve listed in this section do make a difference. 

Wrap up

So, now you know what a herniated disc is and how inconvenient it is, you’re ready to start taking this condition more seriously. Go to the doctor as soon as you notice the early symptoms, have them diagnose you, and recommend the right course of treatment.

You can find a herniated disc specialist at the Orthopedic Institute of NJ.