At some point in time, either you or someone you know has experienced a disc herniation. In fact, disc herniations, also referred to as “slipped discs,” are so common that most people will never know that they had one. It’s not until a slipped disc causes obvious symptoms, like pain or numbness, that things can go awry.
We have discussed this before, but it bears repeating: low back pain is one of the hallmark reasons why millions of people seek medical attention every year. It’s the leading cause of disability around the world and can affect your body in more ways than one.
So what can be done to prevent them from happening to you, and what should you do if you have been diagnosed with a disc herniation? We will tackle these questions and more in this article, so keep reading. But first, let’s begin by explaining what happens when someone has a disc herniation or slipped disc.
What Is a Disc Herniation?
Normally, the intervertebral discs sit between each vertebra and function to absorb shock and provide stability to your spinal column. But bad habits like poor posture, core weakness, and poor lifting form force the discs to lose their shock absorption characteristics and weaken, making them susceptible to injury. As a result, the discs can migrate forward, backward, or towards either side.
This is known as a herniated disc. There are different classifications of disc herniations, ranging from “a little out of a place” to “very out of place.”
Regardless of the type of herniation you have, it’s important to understand where the disc is sitting in relation to the nerves that make up the spinal column. When an intervertebral disc herniates, it is worrisome when it moves towards the spinal nerves. These nerves are highly sensitive to change, and a disc invading its space certainly counts as a drastic change in the environment. When this happens, the nerves will become inflamed and trigger pain responses.
Disc Herniation Symptoms
Some of the most common signs and symptoms of a disc herniation include:
- Pain with sitting
- Pain immediately upon waking in the morning
- Pain with coughing/sneezing
- Pain in the leg
- Numbness/tingling/burning down one leg
- Muscle weakness in certain areas of the body
When a disc herniation first occurs, the pain might feel worse when coughing, sneezing, or moving between positions. After a while, the pain may lessen and transition into numbness, tingling, or burning sensations.
This may come as a surprise to you, but it’s possible to have a herniated disc without any obvious signs of inflammation or pain. Other times, the pain can be so intense that you can barely stand.
How Is a Disc Herniation Diagnosed?
Sometimes disc herniation symptoms can masquerade as other types of low back conditions like spinal stenosis, muscle strain, or instability. That is why it’s important to be evaluated by a specialist who can perform a thorough examination and order imaging.
Imaging, like CT scans and MRIs, can be helpful when it comes to making a disc herniation diagnosis. But you should also be aware that imaging doesn’t always match your pain levels or problems, which is why it is only one piece of the puzzle.
Your specialist should also perform a direction-specific movement analysis to determine the direction of movement that causes the least amount of pain. To accomplish this, you will be asked to do a series of movements on an exercise mat, sitting, or standing. This type of examination has been linked with better outcomes, especially if the specialist finds the direction that your body prefers. Once this is established, it will become part of your treatment plan.
Recall our earlier explanation about the kinetic chain? It applies here, too. Imaging may reveal a disc herniation at a specific level in your back, but that doesn’t mean that your back pain is coming from the same area. Oftentimes, the herniated disc causes pain above or below the area that is affected, and part of that is due to the kinetic chain. Basically, this is another reason why you should see a specialist for a suspected disc herniation.
Treatment for Herniated Discs
Treatment for herniated discs will vary, depending on your pain, the amount of damage to the disc and surrounding areas, and your overall function. Once you have a confirmed diagnosis, your best treatment option is to see a physical therapist for specific exercises that may limit or prevent the disc from further herniation.
Avoid the temptation to head straight to the surgeon’s office. Instead, see an orthopedic specialist for a full examination so you can carefully weigh your treatment options. Like we learned above, imaging does not always tell the full story and should be considered along with an examination.
Most people will choose a non-surgical, or conservative, route for treatment. This usually includes modification of workouts, work-related duties, housework, and other physical tasks. Your specialist will most likely send you to physical therapy for strengthening, stabilization, and mobility exercises to reduce the pain and the size of the disc herniation. If successful, you will be able to avoid the costly route of surgery and the lengthy post-surgical recovery that follows.
One of the most crucial components of treatment is learning how to modify the activities that are causing pain. You may need to find alternative ways to sleep, bathe, or get in and out of a car. This also applies to when you are starting to feel better and want to get back to working out again.
Ultimately, the goal for most herniated disc treatments is to avoid surgery and prescription pain medications. Surgery for disc herniations is rare unless the herniation is so large that it’s crushing the spinal nerves and causing loss of sensation or muscle strength. While there was a point in time when surgery was more common, most surgeons now conclude that back surgery is not the best treatment for a majority of people with herniated discs.
How To Prevent Herniated Discs
Since herniated discs can occur without warning, it is difficult to prevent them entirely. However, there are a few things that you should be doing to maintain the health of your discs and spine.
- Stop smoking (smoking can increase the risk of herniated discs and degenerative disc disease)
- Lift with proper technique
- Avoid sitting for long periods of time
- Avoid wearing high heels
- Eat healthy, well-balanced meals
Almost everyone will experience a disc herniation in their lifetime. This does not necessarily mean that you will need surgery because, fortunately, most disc herniations can be managed conservatively through physical therapy.
Expectations for recovery from disc herniations can vary, depending on your pain, symptoms, and the size of the herniation. However, a complete recovery is possible as long as you begin treatment early. Although it’s nearly impossible to prevent herniated discs, following healthy lifestyle habits and proper lifting techniques is your best protection.
Recovering from a strain in your low back? Check with a specialist, especially if the pain has not lessened in a week or two. Remember, disc herniations can mimic other common back conditions so don’t delay seeking medical help.
Written for Fitness Blender by Kayla C, PT, DPT
Board-Certified Neurological Clinical Specialist