A disc is a soft, rubbery pad that cushions the vertebral bones in the
spinal column. This prevents the bones from rubbing against one another
and allows for movement, such as bending or flexing.
When we look up close at a disc from the top-down, we can see that discs
are made up of an outer ring of cartilage, and an inner ring of a gel-like
substance, where the nucleus resides. This pad sits directly in front
of the spinal canal, which allows the spinal cord to run from the brain
down to the end of the spine.
A herniated disc, commonly referred to as a 'ruptured' disc, can
cause pain in the neck, lower back, arms, or legs.
When the nucleus of the disc expands, it splits or ruptures causing the
gel-like substance of the nucleus to leak out. This can be the result
of daily wear and tear on the spine, incorrect lifting or twisting that
aggravates a weak disc, but it can also be caused by an injury or pinched
nerves that progress in severity over time.
Aging (individuals between 30-50 are at high risk)
- As children, discs in the spinal column have high water content, which
means that discs are more flexible. The water content, however, decreases
with age. As the discs shrink, the cushioning between the vertebrae gets
smaller, weakening them.
Additional conditions that can weaken discs are:
- Excessive body weight that adds stress to the discs, particularly in the
- Improper lifting of heavy objects
- Repetitive physically strenuous activities
- dull or sharp pain
- loss of bladder and/or bowel control, which are indicative of Cauda Equina
- muscle spasm or cramping
- tingling (pins and needles)
one leg - when pain occurs in the lower back
- one arm - when pain occurs within the neck
Medical History: prior injuries, neck/back pain that has gradually increased over time
Physical Examination: used to determine where the pain occurs, while also
assessing what nerve roots are implicated and how seriously.
After nonsurgical treatment, most patients (90%) with herniated discs heal
over time (1-6 months).
- Rest for a period of time, followed by a gradual increase in activity
- Medication to control the inflammation and pain
- Physical Therapy
- Exercises recommended to reduce pain and increase strength in the muscles
that support the spine, preventing further injuries
- Resorption: The body can reabsorb the tissue or fragments from a herniated
disc that has ruptured, essentially healing itself.
- Required in less than 10% of patients who suffer from a herniated disc.
- Surgery may be recommended for individuals who have severe weakness or
numbness, pain that cannot be relieved, or have progressive nerve damage.