You may have heard the term “slipped disc” used to describe low back pain. Discs do not actually “slip”, they may herniate or bulge out from between the bones. A disc herniation is a condition in which the the center part or nucleus of the disc pushes through a tear in the outer layer or annulus of the disc. Pain results from the tear of the annulus and/or disc material that releases chemical irritants that contribute to nerve inflammation. Significant radiating pain (sciatica) occurs when the bulge touches or compresses a nearby nerve root or the spinal cord.
Disc herniation has some similarities to degenerative disc disease and discs that herniate are often in an early stage of degeneration. Herniated discs are most common in the low back or lumbar spine, but occur in the neck frequently also.
What causes discs to herniate?
Many factors decrease the strength and resiliency of the disc and increase the risk of disc herniation. Life style choices such as smoking, lack of regular exercise, and inadequate nutrition contribute to poor disc health. Poor posture, daily wear and tear, injury or trauma, incorrect lifting , and twisting further stressthe disc. If the disc is already weakened, it may herniate with a single movement or strain such as coughing or bending to pick up a pencil.
How do I know if I have a disc herniation?
Herniated discs are most likely to affect people between the ages of 30 and up. Disc herniations may be present without casing pain. The most common symptom will be pain in the area of the herniation that radiates across the low back and into the buttocks. You may also experience numbness or pain radiating down your leg to the ankle or foot.
If the herniation is large enough, you may notice weakness in the extension of your big toe and you may be unable on walk on your toes or heels. In severe cases of lumbar disc herniation you may experience change in your bowel or bladder function and may have difficulty with sexual function.
How is a disc herniation treated?
Mild to moderate disc herniations can usually be treated conservatively with chiropractic care, electrical muscle stimulation, various types of physical therapy, stretching and exercise therapy. Occasionally, a herniation may be severe enough to warrant surgical intervention. These cases are usually reserved as a last resort when other forms of therapy have failed to relieve pain, or if there is significant compression of the spinal cord or nerves.