The spine is made up of a chain of bones called vertebrae. Between each vertebra are flat, round discs of a jelly like substance whose purpose is to act as shock absorbers. The vertebra and discs are held together by thick ligaments. A herniated disc occurs when a portion of the jelly like material pushes out into the spinal canal. This causes pressure on the spinal nerves, which often results in pain. This occurs more often in the lower (lumbar) spine but can occur in other parts as well.
Risk factors for disc herniation include strain or injury, age and family history. Symptoms of a herniated disc vary depending on the severity of the herniation and its location. Some individuals experience no symptoms while others may have numbness, weakness or pain.
Sciatica is one type of herniated disc. Sciatica describes a herniated disc in the lower back which causes pressure on the sciatic nerve. This pressure results in pain, burning, numbness or tingling that radiates from the buttock into the leg and, sometimes, the foot. Typically one side of the body is affected. Pain may be worse with standing, walking or sitting.
If the disc herniation is in the neck, symptoms usually are pain between the shoulder blades and radiating down one arm or numbness or tingling in the shoulder or arm.
Physicians usually diagnose disc herniation based on a patient's history, symptoms, physical examination and diagnostic studies such as X-ray, CT scan or MRI. Other studies also exist that evaluate nerve and muscle function. Treatment of herniated discs depends on the duration and severity of symptoms. Non-invasive treatments such as rest, pain medications, steroids, injections, stretching or physical therapy will usually be tried first. Surgery is reserved for those patients who do not experience significant relief from conservative treatments.
Several surgical options exist and your surgeon will choose the one that best fits your condition. The surgical options include: artificial disc surgery (replacing the damaged disc with a synthetic one), discectomy (removal of the damaged portion of the disc), laminectomy (removal of part of the vertebra to give the spinal column more room), laminotomy (an opening made in part of the vertebra to relieve pressure from the spinal nerves), spinal fusion (grafting bone into the spine to join two or more vertebra and stabilize the spine). As with any surgery, patients may require physical therapy during the recovery period to regain mobility. It is also important to avoid those movements that may cause another herniated disc as you may be more prone to developing this condition. Squat to lift heavy objects and do not take on more than you can comfortably handle. Exercise, maintaining a healthy weight and eliminating tobacco use are also important factors in keeping your spine healthy.