A herniated disk, also referred to as a slipped disk and disk prolapse, is a common condition and can be extremely painful and debilitating.
Although the symptoms brought on by herniated disks are generally relieved after a number of weeks, a surgical procedure is sometimes required if symptoms persist or get worse.
In this article, we will discuss what a herniated disk entails, its diagnosis, treatment and prevention.
Contents of this article:
Fast facts on herniated disks
Here are some key points about herniated disks. More detail and supporting information is in the main article.
- Herniated disk pain normally clears up within 4-6 weeks
- The human backbone consists of 26 vertebrae
- In some cases, surgery is the best course of action for treating a herniated disk
- If the nerves that descend from the bottom of the spine are trapped, a herniated disk can cause paralysis
- Many people have herniated disks with little or no symptoms
- Other than nerve pain, the symptoms of a herniated disk include numbness and tingling
- Surgery for herniated disks is a last resort but can entail full replacement of the disk
- Ultrasound can relieve disk prolapse symptoms in some people
- Herniated disks do not show up on X-rays but this form of imaging can help rule out other medical problems.
What is a herniated disk?
Herniated disks are also referred to as slipped disks.
The human backbone, or spine, consists of 26 bones called vertebrae. Between each individual vertebrae lie rubbery, cushion-like pads referred to as "disks." These disks help keep the vertebrae in place and act as shock absorbers.
Spinal disks have been likened to doughnuts with a soft, jelly center and a tougher exterior.
A herniated disk occurs when some of the soft interior slips out through a crack in the disk's wall. Most commonly, this occurs in the back, but it can also happen in the vertebrae of the neck.1
The escape of this "jelly" is thought to release chemicals that directly irritate nerves in the surrounding area and cause significant pain. There is also a chance that the prolapsed disk can press up against nerves and cause pain through compression.
A herniated disk can lead to numbness or weakness in one or more limbs. Conversely, some people experience no associated pain with a herniated disk, particularly if the disk does not press on any nerves.
One small study on symptom-free volunteers found that 50% had some degree of herniated disk that did not cause them any discomfort.2
Symptoms of herniated disk
Although some cases of slipped disks are not associated with any symptoms, many are, and they can include:
- Numbness and tingling: this can occur in the region of the body supplied by the affected nerve
- Weakness: muscles being supplied by the affected nerve may become weaker, causing stumbling when walking or the dropping of items
- Pain: with herniated disks in the lower back, the pain is generally in the buttocks, thighs, calves and, possibly, feet; this is often referred to as sciatica because the pain travels along the path of the sciatic nerve. If the problem lies in the neck, the pain normally affects the shoulders and arms. Quick movements or sneezing might induce shooting pains.3
Causes of herniated disks
Herniated disks are often caused by wear and tear.
Often, the cause of a herniated disk is simple wear and tear of the disk itself from repeated movement over time.
With age, spinal disks lose some of their water content; this reduction in fluid means that the disks are less supple and, therefore, more liable to split.
It is not always possible to recall the exact point when a problem with a disk begins; however, it often occurs when lifting objects without bending at the knee or twisting when lifting a heavy item.
Risk factors for herniated disks
Herniated disks can happen to anyone, but they most often occur for those in their 20s and 30s.
Factors that increase the likelihood of a herniated disk include:
- Weight: being overweight puts additional stress on the lower back and makes a slipped disk more likely
- Genetics: a predisposition to herniated disks might be inherited genetically
- Occupation: individuals with physically demanding jobs are at greater risk. Any pastime that involves pushing, pulling or twisting increase the chances of herniated disks.
Complications of herniated disks
Below the waistline, the spinal cord separates into individual nerves, collectively referred to as the cauda equina (meaning "horse's tail"). On rare occasions, this entire set of nerves can become compressed.
If this occurs, it can cause permanent weakness, paralysis, loss of bowel and bladder control and sexual dysfunction; emergency surgery is the only option in such an event.
Seek medical advice if:
- There is any bladder or bowel dysfunction
- The weakness progresses and prevents normal activities
- Numbness around the inner thighs, back of legs and rectum (saddle anesthesia) gets progressively worse.
On the next page, we look at the diagnosis and treatment of herniated disks.