Herniated Disc: Overview

Herniated Disc: Overview

This video will provide an overview of herniated discs. The spine is made of 33 bones called vertebrae, that are mainly grouped into the cervical, or neck; thoracic, or mid-back; and lumbar, or lower back regions. The vertebrae surround and protect the spinal cord while also allowing the body to move. Discs made of cartilage lie between the vertebrae to act as cushions and shock absorbers as the spine moves. Each disc has a soft inner portion surrounded by a tougher outer portion, similar to a jelly donut.

A herniated disc means that the inner portion has broken out and is no longer contained within the outer portion. This may occur in any disc, but it is most common in the cervical and lumbar regions. The type of herniation falls on a spectrum, from protruding disc material to fully migrated disc material. A disc herniation can happen either suddenly or over time, in a sudden injury.

The inner portion of the disc can herniate or break through the outer portion with positions and movements that stress the spine, such as heavy lifting, bending and twisting. This occurs most often in the lower back. Over time, the thickness of the discs naturally decreases with age in a process called degenerative disc disease. This weakens the discs ability to provide cushion against stress, making it vulnerable to herniations during repetitive motions or small traumas rather than a single event.

Other factors, such as prolonged poor posture with the neck or lower back slouched, can also contribute to the development of disc herniations. Herniated discs weaken the disc's ability to provide cushioning and absorb shock, often leading to increased stress to the spine at the affected level. This can result in neck or back pain and also increase the chance of developing arthritis in the spine.

Herniated disc material may also put pressure on the spinal cord or nearby nerves that exit from the spinal cord. Depending on the location and type of herniation, this may cause neurological symptoms like pain, weakness, numbness, or tingling that can travel down the arms or legs. Pain and other symptoms can get worse with movements or activities that stress the spine, such as compression, heavy lifting, bending, coughing or sneezing.

However, disc herniations do not always cause pain and many do not cause symptoms. Over 60% of the population may have abnormal discs without any symptoms, but in those with back pain, over 55% may have a herniated disc. Herniated discs are most common between the ages of 30 to 50, and men are typically affected more than women. The risk of a disc herniation may increase with age, obesity, manual labor, stress, and inflammatory diseases.

Furthermore, those with preexisting disc defects or genetic predispositions may be at higher risk. Ways to reduce the risk of disc herniation include exercise, healthy posture, smoking cessation and ergonomic techniques. When diagnosing a herniated disc, a health care provider will review the patient's medical history, asking questions about the patient's symptoms and daily activities.

A physical examination will include sensation and strength testing, as well as tests to apply compression to the spinal cord and nerves to see if they are affected. They may also order diagnostic imaging, including x-rays, to assess the vertebrae and MRI to assess the discs and spinal cord.

To summarize, a herniated disc occurs when the inner portion of a disc breaks through the outer portion. This affects the ability of the disc to provide cushioning and absorb shock, and can also compress the spinal cord and nerves, often resulting in pain and other symptoms. Herniations can occur either suddenly or over time at any disc, but are most common in the neck and lower back. Diagnostic imaging can confirm the diagnosis of a herniated disc.