Herniated disk injury can affect the low back, neck, or upper back - almost anywhere along the spine. Herniated disks often occur in the low back, though, because we bear most of our weight in that area. The compression may cause the outer fibers of the spinal disk in the lumbar area to fray, which weakens the disk and leaves it susceptible to injury. Herniated disks in the mid and upper back are rare, but they do happen. Here's an overview of herniated disk injury.
Herniated disk is an injury in which one or more spinal disks rupture. In a herniated disk, all or part of the nucleus pulposus, the soft, centrally located, shock-absorbing material, is forced out of the disk. A condition known as an annular tear provides the place of exit for the nucleus.
Often, herniated nucleus pulposus material lands on a nerve root in the back of the spine. When this happens, you'll likely feel a lot of pain. Depending on which level of the spine is affected, you may get other symptoms such as numbness, weakness, or an electrical shock or tingling down a leg (sciatica) or arm. When a herniated disk affects a spinal nerve root, the associated symptoms are called radiculopathy.
Herniated disk symptoms may vary according to location. But in general, you’ll probably have one or more radicular symptoms, which were introduced above.
You’ll get radicular symptoms down a leg or arm because spinal nerve roots branch off into nerves that go all over the body. Each nerve root is assigned a particular area of the body, to which it transmits sensations (called dermatomes) and movement impulses (called myotomes).
Disk herniation most often affects men between the ages of 30 and 50, especially men with physical occupations. Men are almost one and a half times more likely to herniate a disk than women. Disk herniation occurs less frequently in older people. This is because as we age, disks dry out. Older people tend to get degenerating disks and diskogenic pain, rather than a herniated disk.
The main causes of a herniated disk are disk degeneration; loading and/or compression of the spine when it’s bent forward; trauma, including a lot of microtrauma over time; and injury.
To diagnose a herniated disk, your doctor will take a medical history and give you a physical exam. During the history, the doctor will ask you to describe your symptoms in detail.
The doctor will also check your spinal alignment, reflexes and muscle strength. She will thoroughly check the sensations you have at each dermatome. By locating the symptoms affecting a spinal nerve root (called radicular symptoms) in the dermatome, she can trace those symptoms back to the specific spinal nerve root or roots that are affected.
Your doctor may also order one or more diagnostic imaging tests. These tests may help confirm the cause of your pain.
Although diskectomy surgery is often effective for relieving pain due to a herniated disk, waiting it out with the help of physical therapy may be another option. Consult with your doctor to determine the best route for you.
Conservative treatment for a lumbar herniated disk may include rest; taking pain medication, muscle relaxers and/or anti-inflammatory medications; having an epidural steroid injection; and/or physical therapy. The goal is generally to reduce the pain from irritated nerve root(s) and to get you in better shape. Conditioning your muscles may help protect your back and enable you to do more with less pain.
If your herniated disk symptoms continue to interfere with your daily activities after you've tried conservative care for 6 weeks, your doctor may suggest surgery. Generally, either a diskectomy and/or a spinal fusion is done. Having back surgery for a herniated disk may result in faster recovery and pain relief than waiting for the body to heal itself, which takes about a year.