Disk Herniations

Causes

A herniated disc may be caused by:

• The natural aging process (most common cause)
• Genetics
• Poor posture and body mechanics
• Too much pressure on the spine, such as from an inactive lifestyle
• Recent trauma, such as a fall or motor vehicle accident

Risk Factors

A herniated disc is more common in older adults. Other things that may raise the risk are:

• Obesity
• A history of low back pain
• Long periods of standing and bending forward
• Smoking
• Strenuous activities, such as heavy lifting
• Genetic problems related to discs

Symptoms

The main symptom is pain that may:

• Be sharp, dull, piercing, aching, burning, or throbbing
• Spread over the back, buttocks, down the back of one thigh, and into the calf or through shoulders and arms
• Be in one leg or both legs or arms

Other problems may be:

• Numbness, tingling, or weakness in the legs, feet, or in one or both arms
• A sudden aching or twisted neck that cannot be straightened without feeling pain
• Numbness in the groin (rare)
• Bowel or bladder changes (rare)

Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done. It will focus on the spine.

Pictures may be taken of the spine. This can be done with:

• MRI scan
• CT scan

Treatment

Most people start to feel better in a few days or weeks. Staying active may be better than full rest. The goal of treatment is to manage symptoms. Choices are:

• Supportive care, such as not sitting for long periods of time, avoiding things that cause pain, and using cold or warm compresses
• Physical therapy to promote strength, flexibility, and range of motion
• Medicines, such as:
  • Over the counter or prescription pain relievers
  • Steroid injections to ease pain and swelling

People who are not helped by these methods may need surgery. Choices are:

• Laminectomy to remove some of the bone over the spine and problem disc
• Microdiscectomy to remove fragments of herniated disc through a small cut
• Spinal fusion to fuse vertebrae together with bone grafts or metal rods (rare)

Prevention

Physical activity and strength training may help some people prevent herniated discs.