When a Disc Cracks: Herniated, Slipped and Ruptured Disc Problems

The intervertebral discs that separate the vertebrae of the spine let the spine bend, flex, and rotate, and also cushion the movement between the bones. Each disc has a tough outer layer ("annulus fibrosus") and a soft inner layer ("nucleus pulposus"). When a disc cracks, the nucleus protrudes through the annulus, creating a condition that goes by many names, including a "herniated disc," "slipped disc," "ruptured disc," or "prolapsed disc."

Herniated discs often cause no symptoms. However, if the disc irritates a nerve, it can cause back pain, along with numbness or weakness in your back and in your leg or arm.

Risk Factors for Herniated Disc Problems

Discs are largely made of water. As you age, their water content decreases, causing the discs to become less flexible and shrink. This degeneration makes the discs more susceptible to rupture with even a minor strain or twist.

Aside from age, the following factors increase the risk of a herniated disc:

• Height: According to the Mayo Clinic, men taller than 5 feet 11 inches (180 centimeters) and women taller than 5 feet 7 inches (170 centimeters) appear more likely to develop a herniated disc.
• Improper lifting: Improper lifting or repetitive strenuous activities—such as pulling, pushing, bending sideways and twisting—can cause a disc to crack.
• Regular periods of immobility: Prolonged sitting or standing in one position places stress on spinal discs.
• Smoking: Smoking increases the risk of a cracked disc as it decreases oxygen levels in blood, depriving the tissue of essential nutrients.
• Weight: Excess body weight places extra stress on the lumbar discs.

Symptoms of a Ruptured Disc

Herniated discs occur most often in the lower back. The symptoms of a lumbar herniated disc include:

• Numbness, tingling or weakness in the legs or feet.
• Pain in the buttocks, lower back or lower legs.

See a doctor immediately if you lose control of your bladder or bowels, or you have numbness or weakness in one or both legs.

The symptoms of a cervical (neck) herniated disc include:

• A twisted neck that you cannot straighten without severe pain
• Neck pain
• Numbness, tingling or weakness in the neck, chest, shoulder or one or both arms.

Because the neck has so little space for the spinal cord, cervical herniated discs are potentially more dangerous than lumbar herniations.

Thoracic herniated discs that cause symptoms are uncommon, and the specific symptoms depend on where the disc is cracked.

Treatment for a Slipped Disc

Most people with herniated disc symptoms get better in one to two months with conservative treatment. Your doctor may also recommend the following:

• Chiropractic work to help better align the vertebrae and take pressure off the nerves
• Exercises to strengthen the muscles that support the back
• Ice or cold compresses
• Physical therapy; techniques may include exercise, heat, ice, traction, ultrasound, electrical stimulation or massage therapy
• Rest for one or two days, followed by a gradual increase in activity
• Medication to control pain and inflammation; options range from over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, to prescription muscle relaxants and painkillers.

If other treatments don't work, a steroid (cortisone) injection into the area around the nerve and disc may reduce pain and inflammation, but is usually used only in an effort to avoid surgery.

According to researchers at Cedars-Sinai, less than 10 percent of people with a herniated disc may require surgery. Surgery may be appropriate if you have progressive nerve damage or severe weakness or numbness, or if other treatment doesn't relieve your pain.

Resources

American Academy of Orthopaedic Surgeons Staff. (n.d.). Herniated disc. Retrieved March 8, 2010, from http://orthoinfo.aaos.org/topic.cfm?topic=A00334

Cedars-Sinai Staff. (n.d.). Herniated or ruptured disc. Retrieved March 8, 2010, from http://www.csmc.edu/5274.html

DeWitt, D. (n.d.). Upper back pain from http://www.spine-health.com/conditions/herniated-disc/upper-back-pain-a-thoracic-herniated-disc

NYU Langone Medical Center Staff. (n.d.). Herniated disc. Retrieved March 8, 2010, from http://www.med.nyu.edu/conditions-we-treat/conditions/herniated-disc

Mayo Clinic Staff. (n.d.). Herniated disc. Retrieved March 8, 2010, from http://www.mayoclinic.com/health/herniated-disc/DS00893

Ullrich, P. (n.d.). What's a herniated disc, pinched nerve, bulging disc...? Retrieved March 8, 2010, from http://www.spine-health.com/conditions/herniated-disc/whats-a-herniated-disc-pinched-nerve-bulging-disc