A herniated disc, also referred to as a slipped disc or ruptured disc, is a problem with the shock absorbing discs that lie between each vertebra—the bones that make up the spine. Each of these discs are like jelly-filled donuts, with a gelatinous inner layer and firm outer layer. When the firm outer layer is ruptured and the jelly-like inner layer spills out, the disc is said to be herniated. A herniated disc may or may not cause pain or dysfunction depending on several factors including where the herniation occurs and where the inner disc material spills into. The good news is that most herniated discs do not require surgery.
Lumbar Herniated Disc
When a herniated disc occurs in the low back (lumbar spine) it is referred to as a lumbar herniated disc.
Cervical Herniated Disc
When a herniated disc occurs in the neck (cervical spine) it is referred to as a cervical herniated disc.
Spinal Discs–Small but Essential
The vertebrae that make up the spine are stacked on top of each other with shock-absorbing discs between each bone. The jelly-like inner layer of the disc, called the nucleus, has no direct blood supply and needs alternating compressing (think: sitting) and decompressing (think: physical activity such as walking) forces to receive nutrients from the body and stay healthy.
What Causes Pain from Herniated Discs?
Spinal nerves exit the spinal cord and extend into the surrounding area. When the herniated disc material touches or compresses a spinal nerve, back pain or dysfunction can result. This is what is often meant by a “pinched nerve”. For a lumbar herniated disc, depending on which nerve is affected, pain can be felt along the nerve path in the buttock, leg or foot. When the pain is along the path of the sciatic nerve its referred to as “sciatica”. For a cervical herniated disc, depending on which nerve is affected, pain can be felt along the path of the nerve in the shoulder, arm or hand. It’s important to note: just because you have findings of a disc herniation on an MRI or X-ray, it doesn’t mean that is the cause of your pain. In fact, many people with findings of a disc herniation on imaging studies have no pain. Sometimes the compressed nerve can cause loss of sensation or function in the areas to which the nerve supplies function. This can manifest as tingling, numbness or loss of strength in a muscle or muscles.
Treatment for Herniated Disc
With the right exercise program and healthy spine habits, most herniated discs will resolve on their own in 6 to 12 months. For those with severe pain, loss of sensation, or especially loss of function, surgery or injections may be required. Post-surgery or post-injections, it is crucial to change habits and build the muscles that support the discs so that a re-injury or additional disc herniation at another level doesn’t occur.
Written by Dr. Jeremy James. Dr. James founded and was director of the Aspen Club Back Institute in Aspen, Colorado, is the coauthor of the bestselling The Younger Next Year Back Book and earned his Doctor of Chiropractic from the University of Western States. Learn more about Dr. James here.