Herniated Disc: Causes,
Symptoms & Treatment

A herniated disc is a spinal disc in which the inside portion of the disc (nucleus pulposus) has pushed out through the outer portion (annulus fibrosis). When we are young, the outer ring of the spinal, i.e., intervertebral disc is sturdy and holds the gel-like center intact. If the outer ring fails to hold the central portion of the spinal disc, it “herniates” or pushes past its natural barrier. It may help to think of a hernia in which the intestine pushes out or “herniates” through the abdominal wall. The contents of the herniated disc become inflamed and press on surrounding nerves causing pain and other symptoms.

What is Considered a Large
Herniated Disc?

or some time, researchers and physicians considered a large herniated disc to be any spinal disc that extends beyond its normal anatomy by 6 mm or more, the so-called “6 mm rule.” Many online sources suggest a large herniated disc is 3 mm or larger, but no evidence supports this definition. Regardless, newer research suggests that the size of the herniated disc is not really relevant to the patient’s disease course. A herniated disc is problematic if it causes symptoms, no matter how big it is.

What is a Herniated Disc
in the Lower Back?

Herniated discs that cause lower back pain almost always can be found in the lumbar spine. The lumbar spine consists of five vertebral bones from the bottom of the rib cage to the pelvis (sacrum). A herniated disc in the lower back causes pain in the back and shooting pain down the leg. A herniated lower back disc can cause weakness, “pins and needles,” and numbness in the affected leg.

Herniated Disc in Neck

Herniated discs that cause neck pain almost always can be found in the cervical spine. The cervical spine consists of seven vertebral bones from the base of the skull to the top of the rib cage. A herniated disc in the neck causes pain in the neck, shoulder, and arm. A herniated neck disc can cause weakness, “pins and needles,” and numbness in the affected arm.

Most people with herniated disc symptoms do not need to see a doctor right away, but there are exceptions. A person should see a doctor right away if any of the following occur:

Patients with new neck or back pain who are immunocompromised, take blood thinners, inject drugs intravenously, or have developed a fever should seek medical attention. Likewise, if the neck or back pain causes significant weakness, a spine surgeon should be consulted.

If none of these are present, most individuals can try a course of non-steroidal anti-inflammatory drugs (NSAIDs). If the pain does not resolve within 2 weeks, it is reasonable to schedule an appointment with a spine surgeon to review your case and discuss non-surgical and surgical disc herniation treatment options.

Lose weight: Excess weight is a risk factor for a herniated disc, so reaching and maintain a healthy body weight can reduce this risk.

Keep a good posture: A poor posture, like looking down at your phone or slouching in a desk chair can put surprisingly strong stresses on the cervical and lumbar areas of the spine, respectively. Conversely, maintaining a good posture can minimize these stresses and protect the spinal discs.

Exercise frequently: Low impact exercises and overall physical fitness can improve blood flow and nutrient delivery to the spine. Frequent exercise also strengthens the muscles that support the spine.

Quit smoking: Smoking is terrible for health, including the health of the spine. Smoking speeds up the aging process and desiccates the spinal discs. Aged, dehydrated, discs are at greater risk of disc herniation.

Try not to stay seated too long: While sitting down feels like a relief after a long period of standing, sitting for a long time actually puts your spine at risk. Prolonged sitting tends to weaken the muscles in the lower back, while stressing the lower spine. Give yourself at least five minutes every hour to stand up and walk around.