(Disc, Herniated; Herniation of Nucleus Pulposus [HNP]; Prolapsed Disc; Ruptured Disc; Slipped Disc)En Español (Spanish Version)
| Risk Factors
Discs are small circular cushions between the bones in the spine. The bones are called vertebrae. The discs are compressible. They act as cushions for the vertebrae. A herniated disc happens when discs in the spine bulge from their proper place. This is most common in the lower spine.
Herniated Lumbar Disc
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Herniated discs can occur when discs lose water content, become flatter, and provide less cushioning. It can also occur when the disc is damaged by trauma.
These factors increase your chance of developing a herniated disc:
- Age: 30s and 40s
from a fall, accident, or sudden twisting
- Strain on the back—either repeated or sudden, as from lifting a heavy weight
- Certain jobs that require heavy lifting
Symptoms may include:
- May be sharp, dull, piercing, aching, burning, or throbbing, depending on the disc and size of herniation
- May spread over the back, buttocks, down the back of one thigh, and into the calf
- May be in one leg or both legs
- Numbness, tingling, or weakness in the legs, feet, or in one or both arms
- In severe cases, inability to find comfort even lying down
- Sudden aching or twisted neck that cannot be straightened without severe pain
Cauda equina syndrome—involves bowel or bladder changes and/or numbness in the groin
This is an emergency, call for medical help right away.
The doctor will ask about your symptoms and medical history. A physical exam will be done. Your spine will be examined. The movement, strength, and reflexes of your arms and legs will be tested.
Images may be taken of your bodily structures. This can be done with:
Staying active may be better than bed rest. Treatments may include:
The following therapies may be used:
Back or neck massage and physical therapy to:
- Relax the neck or back muscles
- Decrease pain
- Increase strength and mobility
- Back and abdominal exercises
- Hot or cold packs to reduce pain and muscle spasms
- Using weights and pulleys to relieve pressure on the discs and keep you from moving around
- A neck collar or brace for a herniated disc in the neck to relieve muscle spasms
Your doctor may advise:
Over-the-counter pain medications, such as ibuprofen or naproxen
- Prescription pain medication
- Muscle relaxants to reduce muscle spasms
Interventional spine care treatments may include:
- Steroid injections into the area around the nerve and disc to reduce pain and inflammation; the injections are used if other medications do not work
Minimally invasive procedures may include:
- Intradiscal electrothermy (IDET)
Surgery may be used for people who fail to respond to other treatments. Immediate surgery is necessary for cauda equina syndrome. Options include:
—removal of some of the bone over the spine and of the problem disc
—removal of fragments of herniated disc through a small incision; this procedure is also known as intervertebral diskectomy
- Spinal fusion
—fusing of vertebrae together with bone grafts or metal rods; this is rarely done for first-time disc problems
To help reduce your chances of getting a herniated disc, take the following steps:
- Practice good posture. Stand and sit straight, and keep your back straight when lifting.
- Maintain a healthy weight.
- Exercise regularly. Ask your doctor about exercises to strengthen your back and stomach.
- Don't wear high-heeled shoes.
- If you sit for long periods of time, use a stool to bring your knees above your hips.
Awad JN. Moskovich R. Lumbar disc herniations: surgical versus nonsurgical treatment.
Clinical Orthopaedics & Related Research. 2006;443:183-197.
When you have a herniated disc.
Am Fam Physician. 2003 May 15;67(10):2195-2196.
http://www.aafp.org/afp/2003/0515/p2195.html. Accessed November 22, 2013.
Last reviewed November 2013 by John C. Keel, MD; Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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