FAQs on Herniated Disc

The most common cause of spine-related pain is a herniated disc. Occurring most often in the lower back, herniated discs can lead to nerve compression and irritation, which produces leg and foot pain. When a cervical (neck) disc herniates, it can cause arm and hand symptoms.

What are discs?

Intervertebral discs are fibrous, cushions that are quarter sized. These structures lie between each vertebra along the spine. Inside the disc is a soft, gel-like center (nucleus pulposus), and the tough outer layer is called the annulus.

How common are herniated discs?

The prevalence of herniated lumbar disc is around 1-3% in the United States. The highest prevalence incidence is among people aged 30-50 years of age. Herniated discs occur in men more than women, and around 95% of herniated discs occur in the lower lumbar spine (low back region).

What causes a herniated disc?

Disc herniation occurs when the gel-like central material pushes through the outside layers of the disc. This is often due to wear-and-tear of the disc (degenerative disc disease) or from a sudden injury. Herniated discs are common among athletes and people who have labor-intensive jobs.

Who is likely to develop a herniated disc?

Certain risk factors increase the likelihood of a herniated disc. These include:

  • Gender – Men ages 30-50 are the most likely to develop disc herniation.
  • Improper lifting – Using back muscles instead of legs with lifting.
  • Weight – Being overweight or obese.
  • Frequent driving – Sitting for long periods of time in a car or truck.
  • Repetitive activities – Any activity that puts strain on the spine.
  • Smoking – Lower oxygen supply to the discs causes degeneration.

What are the symptoms of a herniated disc?

When the disc material compresses or irritates one or more spinal nerves, extremity pain occurs. For herniated cervical discs, shoulder, arm, and hand pain occurs. For lumbar (low back) herniated discs, hip, buttock, leg, and foot pain occurs. While it rarely occurs, patients can experience loss of bowel and/or bladder control due to nerve root compression.

How are herniated discs diagnosed?

The doctor will take a medical history, inquire about your symptoms, and conduct a detailed medical examination. The gold standard for diagnosing herniated disc is a magnetic resonance imaging (MRI) test.

How are herniated discs treated?

Herniated discs are often difficult to treat. Treatment is aimed at relieving pain and associated symptoms and improving quality of life. Options include:

  • Medications – First-line therapy is medications, which include anti-inflammatory agents and narcotic analgesics.
  • Physical therapy – The therapist teaches the patient exercises to strengthen the back. For pain relief, the therapist uses ultrasound, heat therapy, electrical stimulation, and cold packs.
  • Epidural steroid injection (ESI) – This procedure involves injecting the space around the spinal cord (epidural space) with a steroid and long-acting anesthetic.
  • Dekompressor discectomy – This treatment involves inserting a tiny tube into the disc to relieve pressure and decompress the disc. In a study involving patients with herniated discs who had discectomy, 92-98% reported that the treatment was successful.
  • Disc-FX – This procedure reduces the size of the gel-like material in the disc to alleviate pressure on nerves.
  • Intradiscal electrothermal therapy – To shrink and repair tears in the outer disc layer, the doctor uses a small catheter and heated wires.

Resources

Buttermann GR (2004). Treatment of lumbar disc herniation: epidural steroid injection compared with discectomy. A prospective, randomized study. Journal of Bone Joint Surgery, 86(4). 670-679.

Corrado P, Alperson B, & Wright (2006). Perceived success and failure of intrathecal infusion pump implantation in chronic pain patients. Neuromodulation, 11(2), 98-102.

Jordon J, Konstantinou K, & Dowd J (2009). Herniated lumbar disc. BMJ Clinical Evidence, 1118.