Herniated disk - Symptoms and causes (2024)

Overview

What is a herniated disk? A Mayo Clinic expert explains

Learn more from Mohamad Bydon, M.D.

Hello. I'm Dr. Mohamad Bydon, a neurosurgeon at Mayo Clinic. In this video, we'll cover the basics of disk herniation. What is it? Who gets it? The symptoms, diagnosis, and treatment. Whether you're looking for answers for yourself or someone you love, we're here to give you the best information available. Your spine is a stack of bones known as vertebrae, and between these bones are small rubbery disks that act as cushions. They have a soft jelly-like center or nucleus that is encased by a tougher rubbery exterior. Sometimes the exterior of these rubbery disks can tear, and the soft inside slips out. This results in a herniated disk, also known as a slipped disk or ruptured disk. This disk injury can irritate nearby nerves causing pain, numbness, or weakness in an arm or a leg. Many people with a slipped disk never experience symptoms and surgery is rarely required to fix the problem. Nonetheless, there are a range of treatments available to help those who suffer pain or discomfort from a herniated disk.

In most cases, a slipped disk happens because of wear and tear, something known as disk degeneration as you age. Your disks become less flexible and are more prone to tears and ruptures. Most people cannot identify the cause of their herniated disk. It can happen from using your back muscles instead of your leg and thigh muscles to lift heavy a object. Or from awkwardly twisting and turning. That said, there are other factors outside of your age that can increase your risk of slipping a disk. Being overweight increases the strain on the disks in your lower back. Some people may be genetically predisposed to rupturing a disk. Working a physically demanding job, and smoking can decrease the oxygen supply to your disk, causing it to degenerate more rapidly.

It's possible to have a herniated disk without having any symptoms. This happens to a lot of people. They may first learn about a herniated disk while undergoing tests for a different issue. Slip disks can trigger a few classic symptoms. Arm or leg pain often described as a sharp or shooting pain. Pain in your buttocks, thighs, calf, even your foot, numbness or tingling. Your exact symptoms depend on where the herniated disk is located, whether it's pressing on a nerve. Talking to a doctor about the pain that you're experiencing is always a smart move.

Your doctor will usually be able to tell if you have a herniated disk by conducting a physical exam, asking about your medical history. They may ask you to lie flat, move your legs into various positions. They may also check your reflexes, muscle strength, walking ability, see if you can feel light touch, pinprick vibration. If your doctor thinks another condition is causing the pain or needs to see which nerves are being affected by the slipped disk, they may order one or more of the following; an X-ray, a CT scan, an MRI, rarely a myelogram. Your medical team may perform a nerve test like a nerve conduction study or an EMG to help pinpoint the location of the nerve damage.

More often than not, watching your movement, and taking pain medication relieves symptoms for most people. Over-the-counter pain relievers like acetaminophen, ibuprofen, naproxen are great options for mild-to-moderate pain. If your pain is severe, your doctor might recommend a cortisone injection or muscle relaxers. In rare cases, opioids may be prescribed for a short period of time when other treatments have not worked. Physical therapy can also help manage pain with positions, stretches, and exercises designed to minimize the discomfort caused by a herniated disk. Few people with a slipped disk ever need surgery, but when it's necessary, surgeons may perform what's known as a diskectomy. This may be done in an open manner or in a minimally invasive manner. The protruding portion of the disk is removed. Sometimes in cases of spinal instability, a bone graft is needed where the vertebrae are fused together with metal hardware. In rare circ*mstances, a surgeon may implant an artificial disk to replace the herniated one.

If you think you have a herniated disk, talk to your doctor, come prepared, try to figure out when your symptoms started, how you may have injured it, and what, if anything, helps improve your symptoms. Back injuries are incredibly common. Thankfully, most people find a way to manage their pain and are able to return to normal activity in no time. If you'd like to learn more about disk herniation, watch our other related videos or visit mayoclinic.org. We wish you well.

A herniated disk refers to a problem with one of the rubbery cushions, called disks, that sit between the bones that stack to make the spine. These bones are called vertebrae.

A spinal disk has a soft, jellylike center called a nucleus. The nucleus is encased in a tougher, rubbery exterior, known as the annulus. A herniated disk occurs when some of the nucleus pushes out through a tear in the annulus. A herniated disk is sometimes called a slipped disk or a ruptured disk.

A herniated disk, which can occur in any part of the spine, most often occurs in the lower back. Depending on where the herniated disk is, it can result in pain, numbness or weakness in an arm or a leg.

Many people have no symptoms from a herniated disk. For people who do have symptoms, the symptoms tend to improve over time. Surgery is usually not needed to relieve the problem.

Herniated disk

Herniated disk - Symptoms and causes (1)

Herniated disk

The disks that lie between the vertebrae in the spine consist of a soft center (nucleus) surrounded by a tougher exterior (annulus). A herniated disk occurs when a portion of the nucleus pushes through a crack in the annulus. Symptoms may occur if the herniation compresses a nerve.

Symptoms

Most herniated disks occur in the lower back, but they also can occur in the neck. Symptoms depend on where the disk is sitting and whether the disk is pressing on a nerve. Herniated disks often affect one side of the body.

  • Arm or leg pain. If your herniated disk is in your lower back, you'll typically feel pain in your lower back, buttocks, thigh and calf. You might have pain in part of your foot as well.

    For a herniated disk in your neck, you'll typically feel the most pain in your shoulder and arm. This pain might shoot into your arm or leg when you cough, sneeze or move into certain positions. Pain is often described as sharp or burning.

  • Numbness or tingling. People who have herniated disks often have radiating numbness or tingling in the body part served by the affected nerves.
  • Weakness. Muscles served by the affected nerves tend to weaken. This can cause you to stumble or affect your ability to lift or hold items.

You can have a herniated disk without symptoms. You might not know you have it unless it shows up on a spinal image.

When to see a doctor

Seek medical care if your neck or back pain travels down your arm or leg, or if you also have numbness, tingling or weakness.

Request an appointment

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Causes

Disk herniation is most often the result of a gradual, aging-related wear and tear called disk degeneration. As people age, the disks become less flexible and more prone to tearing or rupturing with even a minor strain or twist.

Most people can't pinpoint the cause of their herniated disk. Sometimes, using the back muscles instead of the leg and thigh muscles to lift heavy objects can lead to a herniated disk. Twisting and turning while lifting also can cause a herniated disk. Rarely, a traumatic event such as a fall or a blow to the back is the cause.

Risk factors

Factors that can increase the risk of a herniated disk include:

  • Weight. Excess body weight causes extra stress on the disks in the lower back.
  • Occupation. People with physically demanding jobs have a greater risk of back problems. Repetitive lifting, pulling, pushing, bending sideways and twisting also can increase the risk of a herniated disk.
  • Genetics. Some people inherit a predisposition to developing a herniated disk.
  • Smoking. It's thought that smoking lessens the oxygen supply to disks, causing them to break down more quickly.
  • Frequent driving. Being seated for long periods combined with the vibration from a motor vehicle engine can put pressure on the spine.
  • Being sedentary. Regular exercise can help prevent a herniated disk.

Complications

Just above your waist, your spinal cord ends. What continues through the spinal canal is a group of long nerve roots that resembles a horse's tail, called the cauda equina.

Rarely, disk herniation can compress the entire spinal canal, including all the nerves of the cauda equina. In rare instances, emergency surgery might be needed to avoid permanent weakness or paralysis.

Seek emergency medical attention if you have:

  • Worsening symptoms. Pain, numbness or weakness can increase to the point that they hamper your daily activities.
  • Bladder or bowel dysfunction. Cauda equina syndrome can cause incontinence or trouble urinating even with a full bladder.
  • Saddle anesthesia. This progressive loss of sensation affects the areas that would touch a saddle — the inner thighs, the backs of the legs and the area around the rectum.

Prevention

To help prevent a herniated disk, do the following:

  • Exercise. Strengthening the trunk muscles stabilizes and supports the spine.
  • Maintain good posture. This reduces pressure on your spine and disks. Keep your back straight and aligned, particularly when sitting for long periods. Lift heavy objects properly, making your legs — not your back — do most of the work.
  • Maintain a healthy weight. Excess weight puts more pressure on the spine and disks, making them more susceptible to herniation.
  • Quit smoking. Avoid the use of any tobacco products.

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  1. Mississippi man finds relief at Mayo Clinic for excruciating back painEdward Markle was desperate. Despite receiving nerve blocks from his doctors, Edward says the pain from two herniated discs had become excruciating and unrelenting. He could not sit or walk without pain. He slept on the floor, two hours a night. He was increasingly worried about the future. "It shut my quality of life down to almost zero," he says. "I couldn't move. I could not get out. I could not find a way to…

By Mayo Clinic Staff

Oct. 24, 2023

Herniated disk - Symptoms and causes (2024)
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