A herniated disk, also known as a slipped disk, is a protrusion of the central portion of one of the flat, circular pads found in the joints between the bones of the spine (vertebrae). A slipped disk can cause symptoms by pressing either on a nerve leaving the spinal cord or on the spinal cord itself.
Each disk has a soft and gelatinous inner portion surrounded by a tough outer ring that allows it to act as a shock absorber between the bones of the spine. Weakness or trauma may allow the inner portion to push through the outer ring, which already may have microscopic tears in it due to the aging process. In some cases, this may compress one of the spinal nerves and cause pain and numbness in the neck or along an arm or leg. A herniated disk may then rupture. In a rupture, the soft gel squeezes through the outer shell and may press on the nerves. The intervertebral disks in the neck and especially the lumbar spine are the most likely to rupture.
What Causes a Herniated Disk?
- Neck or back injury is the most common cause.
- Weak muscles, obesity, or a sedentary lifestyle may put uneven stress on the spine and cause a slipped disk.
- Herniated disks are more prevalent among men under age 45. Risk increases again among the elderly, owing to disk degeneration.
- Excessive strain
Symptoms of a Herniated Disk
- Back or neck pain that worsens with movement, coughing, sneezing, or straining.
- Pain that radiates from the spine down the arm or leg.
- Pain, tingling, or numbness in the buttocks, a leg (sciatica), or an arm, usually on one side.
- Back pain not relieved by over-the-counter pain relievers.
- Severe pain in the neck, arm, or in shoulders.
- Loss of bladder or bowel control.
- Bend and lift objects from the knees, not the waist. Do not strain to lift things that are too heavy.
- Avoid activities that require sudden twisting movements, such as golf and tennis.
- Follow a program of moderate, regular exercise to strengthen back and abdominal muscles.
- Lose weight if you are overweight.
- Patient history and physical examination.
- Electromyogram and Nerve Conduction Studies (EMG/NCS), this will show if there’s ongoing nerve damage
- Myelogram, to locate the disk herniation and to determine its size.
- CT (computed tomography) scans or MRI (magnetic resonance imaging).
How to Treat a Herniated Disk
- Restricting activity by lying flat for a few days may help relieve symptoms. Avoid activities such as lifting or pushing that aggravate symptoms.
- Ice or heat packs should be used for pain. Muscle relaxants and anti-inflammatories may be prescribed by your doctor.
- In some cases, various types of surgery may be done to remove the disk. Rarely, in severe cases, the adjoining vertebrae may be fused.
- During recovery, a supportive collar and an extra-firm mattress may be advised. A back brace may be used to provide support during activity.
When to Call a Doctor
- See a doctor if you have any herniated disk symptoms.
- EMERGENCY Call an ambulance immediately if someone suffers a serious back or neck injury. Keep the patient still until help arrives.
Johns Hopkins Symptoms and Remedies: The Complete Home Medical Reference
Simeon Margolis, M.D., Ph.D., Medical Editor
Prepared by the Editors of The Johns Hopkins Medical Letter: Health After 50
Updated by Remedy Health Media