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What is a Herniated Disc?

What is a Herniated Disc?

Ruptured Disc, Cervical Herniated Disc and Lumbar Herniated Disc

What is a herniated disc? A herniated disc, often called a ruptured disc or prolapsed disc, is a common cause of back pain. In fact, four out of five people will experience low back pain during their lifetime. The term slipped disc is also used but can be misleading as a disc cannot actually slip or slide but rather the disc rips, tears, degenerates or herniates. A ruptured disc does not always cause discomfort as it depends on whether the rupture is compressing the spinal nerve. With age the elasticity of the disc lessens and the discs are more susceptible to a rupture from wear and tear.

Spinal discs are like sponges connecting the individual vertebrae to the spine. Elastic healthy discs keep the spine flexible and act like shock absorbers. Because of these shock absorbers we are able to enjoy running and jumping, twisting and dancing, and everyday life activities. The spongy disc gel-like interior (nucleus pulposus) is encased with a thick elastic outer layer (annulus fibrosus).

disc_herniation_stages
With age or a severe trauma, the outer layer can lose its elasticity leading to cracks and tears. The gel within the interior seeps out and pushes beyond the normal boundary. When the disc ruptures, the gel interior begins to impinge on the spinal cord and the nerves. The herniated disc now puts direct pressure on nerves causing discomfort.

Cervical Herniated Disc

A herniated disc in the neck most often causes arm pain. As traumas are the common cause, the symptoms may also start spontaneously. Most often in ages 30-50, a herniated disc in the neck will begin to press or pinch on the cervical nerve radiating pain all the way down the arm. Numbness and tingling along with muscle weakness can also occur. The cervical spine levels that are most commonly affected are between the sixth and seventh cervical segments (C6-C7) and between the fifth and sixth cervical segments (C5-C6).

Lumbar Herniated Disc

A herniated disc in lower back typically leads to lower back pain and pain in the back of either one or both of legs. Pain sensations can vary from sharp or dull, muscle spasm or cramping, sciatica, or even weakness and the loss of function in the legs. Small things like coughing, sneezing, and bending can intensify the pain. A majority of herniations occur in the lumbar region and most often between the fourth and fifth lumbar segments (L4-L5) or between the fifth lumbar segment and the sacrum (L5-S1).

Herniated disc symptoms will vary from person to person with excruciating pain to almost non-existent. Some people have a herniated disc and do not even know it. This variance is reliant on the pressure the herniation is putting on the spinal nerve. When the ruptured disc begins to pinch the nerve, the result is painful.

Symptoms of a herniated disc are often gradual with repetitive strain. Chronic back pain and back weakness is an early warning sign that you are more susceptible to injury. Everyday movements from bending over to pick up a pen or lifting a heavy box may be the final straw. In general wear and tear comes from improper lifting and too much sitting. It is important to lift using the legs with a straight back rather than bending at the waist, as this is often the cause of a lumbar herniation. A sudden trauma from a fall or accident can also lead to a ruptured disc.

As the pain is typically referred, the patient does not always feel the pain from where it originated in the neck or the back.

Cervical Disc Herniation Symptoms

Cervical disc herniations develop in the neck and most often between the sixth and seventh cervical segments (C6-C7) and between the fifth and sixth cervical segments (C5-C6). The affected areas are from the neck down to the finger tips.

Cervical Disc Herniation Symptoms:

  • Tingling or Numbness in the arms or the hands (or pins and needles)
  • Pain can radiate from the back of the skull down the neck to the upper back, chest, shoulder, arms, or hands
  • Weakness can occur in the arm or hand muscles

The symptoms can be felt in one or both sides and can vary from day to day. The location affected can range from one segment with the hand, wrist, or arm, or the entire area.

lumbar-spineLumbar Disc Herniation Symptoms

Lumbar disc herniations develop in the lower back and most often between the fourth and fifth lumbar segments (L4-L5) or between the fifth lumbar segment and the sacrum (L5-S1). The affected areas are from the lower back down to the toes.

Lumbar Disc Herniation Symptoms:

  • Tingling or Numbness in the lower back and down to the foot and/or toes (pins and needles)
  • Pain in the lower back, buttocks, and into the legs
  • Weakness or loss of reflexes in one or both legs
  • Burning in the low back or the hips and legs

The most common symptom is sciatica, which feels like a sharp or shooting pain from the buttocks on down one leg. This common symptom is from pressure being placed on the sciatic nerve by the herniated disc. Again the symptoms may affect either one or both legs and the location can vary from one specific location to the entire area. The symptoms may also vary from day to day.

A word of caution, if you have a loss of bladder or bowel control seek immediate attention. This is a possible sign of a serious problem called Cauda Equina Syndrome.

 

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