Herniated, ruptured and slipped disc are all the same thing. The disc is made up of an outer ring composed of cartilage (annulus fibrosis). The inner part of the disc is a softer substance called the nucleus propulsus. Over time, the annulus loses some of its ability to hold the inner nucleus in place. This may cause a disc to “bulge.”
If the inner nucleus ruptures through the annulus, the result is a herniated disc. Discs can herniate in the cervical, thoracic or lumbar spines.
Herniation can be due to trauma, but more frequently, it occurs with just bending over, lifting something light or even with sneezing. The disc can cause back pain. The disc rupture can irritate or compress a nerve. The resulting condition is called “radiculopathy.” If this condition occurs in the neck it is termed “cervical radiculopathy,” in the mid back, “thoracic radiculopathy” and in the low back, “lumbar radiculopathy” or more commonly, “sciatica.”
Nerves can be pinched by other structures such as a bone spur, joint cyst and tumors (rare).
Symptoms of Herniated Discs
- Muscle spasms in the back
- Pain on laughing or coughing
- Pain in the arm, leg or trunk
- Numbness in the arm, leg or trunk
- Weakness in the arm, leg or trunk
Only about 20% of people with a pinched nerve or radiculopathy require surgery. Surgery is more likely if there is significant pain, numbness and/or weakness.
Treatment of Herniated Disc
Treatment is usually conservative and includes:
- Medication such as anti-inflammatories, muscle relaxants, pain killers, oral steroids
- Physical Therapy
- Seroids injected into the epidural space around the nerves or into the joints of the spine
- Minimally invasive surgical decompression of the nerve
Sometimes the spinal cord rather than the spinal nerves are affected. If this is the case, surgery may be considered sooner.
Symptoms that should not be ignored are numbness in the groin or perineum; impaired or lost bowel, bladder or sexual function; and painless weakness of the extremities.
You can manage a Herniated Disc
The first line of defense is taking medications (NSAIDs) such as ibuprofen (e.g. Advil, Nuprin, Motrin) or COX-2 inhibitors (e.g. Celebrex) to help reduce the pain caused by inflammation. The next step is oral steroids such as Prednisone or a Medrol Dose Pak; you can take these for no more than a week.
Other ways to cope
- Physical therapy and exercise
- Cervical traction
- Chiropractic manipulation
- Osteopathic medicine