Overview
What is a Herniated Disk? A Mayo Clinic expert explains.
A herniated disk occurs when a problem arises with one of the rubbery cushions (disks) situated between the vertebrae of your spine. These disks have a soft, jelly-like center called a nucleus, encased in a tougher exterior known as the annulus. When some of the nucleus pushes out through a tear in the annulus, this condition is termed a herniated disk, sometimes referred to as a slipped or ruptured disk.
Herniated disks can happen anywhere along the spine but most commonly occur in the lower back. Depending on the disk’s location, it can cause pain, numbness, or weakness in an arm or leg. Interestingly, many people with herniated disks experience no symptoms, and for those who do, symptoms typically improve over time. Surgery is rarely required.
Symptoms
Herniated disks most frequently occur in the lower back, but they can also affect the neck. The symptoms vary depending on the disk’s location and whether it is pressing on a nerve. Common symptoms include:
- Arm or Leg Pain: A herniated disk in the lower back may cause pain in the lower back, buttocks, thigh, calf, and even the foot. If the herniated disk is in the neck, pain is typically felt in the shoulder and arm, often described as sharp or burning.
- Numbness or Tingling: People with herniated disks may experience radiating numbness or tingling in the areas served by the affected nerves.
- Weakness: The muscles controlled by the affected nerves may weaken, leading to stumbling or difficulty lifting and holding items.
It’s possible to have a herniated disk without experiencing symptoms. Often, it is only detected through imaging tests.
When to See a Doctor: Seek medical attention if neck or back pain radiates to your arms or legs, or if you experience numbness, tingling, or weakness.
Causes
Disk herniation often results from gradual, age-related wear and tear, known as disk degeneration. As you age, your disks become less flexible and more prone to tearing or rupturing even with minor strains or twists.
Many people can’t identify a specific cause for their herniated disk. However, lifting heavy objects improperly, using your back instead of your legs, or twisting while lifting can lead to a herniated disk. Rarely, a traumatic event like a fall or blow to the back can be the cause.
Risk Factors
Several factors can increase the risk of developing a herniated disk:
- Weight: Excess body weight places additional stress on the disks in the lower back.
- Occupation: Physically demanding jobs that involve repetitive lifting, pulling, pushing, bending, or twisting increase the risk.
- Genetics: Some people inherit a predisposition to herniated disks.
- Smoking: Smoking is believed to reduce the oxygen supply to disks, leading to quicker degeneration.
- Frequent Driving: Prolonged sitting combined with vibration from vehicle engines can place pressure on the spine.
- Sedentary Lifestyle: Regular exercise can help prevent a herniated disk.
Complications
The spinal cord ends just above your waist, and what continues through the spinal canal is a group of long nerve roots called the cauda equina. Rarely, a herniated disk can compress the entire spinal canal, including all the nerves of the cauda equina, which may require emergency surgery to prevent permanent weakness or paralysis.
Seek emergency medical attention if you experience:
- Worsening Symptoms: Increasing pain, numbness, or weakness that interferes with daily activities.
- Bladder or Bowel Dysfunction: Incontinence or difficulty urinating with a full bladder may indicate cauda equina syndrome.
- Saddle Anesthesia: A progressive loss of sensation affecting the areas that would touch a saddle, including the inner thighs, backs of the legs, and the area around the rectum.
Prevention
To help prevent a herniated disk, consider the following:
- Exercise: Strengthen your trunk muscles to stabilize and support your spine.
- Maintain Good Posture: Keeping your back straight and aligned reduces pressure on your spine and disks, particularly when sitting for long periods.
- Healthy Weight: Excess weight increases pressure on your spine and disks, making them more prone to herniation.
- Quit Smoking: Avoid using tobacco products.
Safe Exercises for a Herniated Disk
Gentle exercises, stretches, and activities can alleviate pain from a herniated disk. Neck, back, and hamstring stretches may enhance flexibility and reduce the likelihood of recurrence.
While surgery is rarely needed for a herniated disk, physical therapy is often recommended to treat symptoms. Depending on the disk’s location, different exercises may be beneficial. Here are some exercises that may help relieve pain, accelerate recovery, and prevent recurrence.
Neck Stretches:
- Sit upright and move your chin towards your chest, then back against the headrest to stretch your neck.
- Tilt your left ear towards your left shoulder, then the right ear towards your right shoulder. Repeat several times.
Hamstring Stretch:
- Sit in a chair with one foot on the floor and the other extended straight out with the heel on the floor.
- Straighten your back and lean forward over the extended leg until you feel a stretch along the back of the upper thigh. Hold for 15-30 seconds. Switch legs and repeat.
Towel Hamstring Stretch:
- Lie flat on a yoga mat with one leg lifted into the air.
- Wrap a towel around the foot of the leg in the air and gently pull it toward your body. Hold for 15-30 seconds. Switch legs and repeat.
Back Flexion Exercises:
- Lie on your back and hold both knees towards your chest.
- Simultaneously move your head forward until you feel a comfortable stretch across your mid and lower back. Hold for 15-30 seconds. Repeat several times.
Knee to Chest Stretch:
- Lie on your back with your knees bent and both heels on the floor.
- Place both hands behind one knee and gently pull it toward your chest. Hold for 15-20 seconds. Switch legs and repeat.
Piriformis Muscle Stretch:
- Lie on your back with your knees bent and both heels on the floor.
- Cross one leg over the other, resting the ankle on the bent knee.
- Gently pull the crossed knee toward your chest until you feel a stretch in your buttock. Hold for 15-30 seconds. Repeat on both sides.
How Can Exercises Help?
Exercises and physiotherapy play a crucial role in recovering from a herniated disk. While rest is initially recommended, gentle activities strengthen the muscles supporting the spine and reduce pressure on the spinal column, promoting flexibility and reducing the risk of recurrence.
Doctors often recommend starting slowly and gradually increasing activity levels. Always consult with a doctor to determine the best exercises for your specific condition and needs.
Gentle Activities:
- Yoga
- Swimming
- Walking
- Cycling
Perform exercises slowly and avoid any that cause pain. Stop immediately and consult your doctor if you experience discomfort.
Summary
Gentle exercises and stretches can relieve pain and pressure from a herniated disk. Strengthening the back and hamstring muscles can alleviate pressure on the spine, preventing pain and reducing the risk of recurrence. Always consult a doctor before beginning any exercise regimen to ensure it won’t cause further damage or pain.
