What Happens When A Herniated Disc Occurs?

A herniated disc refers to an issue with one of the rubbery cushions (discs)that sit between your bones (vertebrae)that stack to form your spine. The spinal disc is composed of a soft, jellylike core (nucleus), and a harder, more rubbery outer (annulus). A herniated disc is also known as a slipped or ruptured disc. This happens when the nucleus pushes through the annulus. The lower back is the most common place to find a herniated disc. It can cause pain, numbness or weakness in one arm or leg depending on the location of the herniated disc. A herniated disc can cause no symptoms in many people. Those who have symptoms will usually experience improvement over time. The problem is rarely treated with surgery.

A jelly donut is a great way to visualize a herniated disc. (Yes, it is strange. But bear with us. There are 24 discs in your spine. They range from the top (called cervical spine), to the bottom (called lumbar spine). Your spine’s discs act as shock absorbers by absorbing your movements. These discs support your spine and allow it to bend and move. “Imagine a jelly donut if you have a herniated disc.” The annulus fibrosus is the outside of the disc. It is similar to the dough in a donut. The nucleus pulposus is the jelly inside the donut. Imagine that the donut is hollowed out. Now press down. It will squirt from it, just as the nucleus pulposus would out of your actual disc. The pain of a herniated disc occurs when the nucleus pulposus touches a nerve and pushes out from the annulus fibrosus.

Signs

The majority of herniated discs are located in the lower back. However, they can also be found in the neck. The location of the disc and the nerve it is pressing on will determine the symptoms. Most herniated discs affect only one side of the body.

• Leg or arm pain. You might feel pain in your legs, buttocks, and thigh if your herniated disc is in your lower spine. There might be pain in one side of your foot.
• The most severe pain from a herniated disc in your neck is usually felt in your arm and shoulder. When you cough, sneeze, or move into certain positions, this pain can radiate into your arm and leg. This pain is sometimes described as burning or sharp.
• Tingling or numbness. Radiating tingling or numbness in the affected nerves is common for people with a herniated disc.
• Weakness. The affected nerves can cause weakness in the muscles that serve them. This can lead to stumbling or impair your ability to lift and hold objects.

A herniated disc can occur without any symptoms. It is possible to not be aware that you have a herniated disc until it appears on a spine image.

Risk factors

The following factors can increase the likelihood of a herniated disc:

• Weight. Extra weight can cause extra strain on the discs at the lower back.
• Occupation. Back problems are more common in those who work in physically demanding occupations. A herniated disc can also be caused by repetitive lifting, pulling, pushing and twisting.
• Genetics. Some people inherit the predisposition to develop a herniated disc.
• Smoking. Smoking is thought to reduce the oxygen supply to discs and cause them to fail more quickly.
• Frequent driving. The vibrations from the motor vehicle engine and prolonged sitting can cause pressure to the spine.
• Being sedentary. Regular exercise can prevent a herniated disc.

Complications

Your spinal cord is located just above your waist. The spinal canal ends at the end of a series of long nerve roots, which resemble a horse’s tail (cauda Equina). Disc herniation can sometimes compress the entire spine canal, as well as all nerves in the cauda-equina. Sometimes, emergency surgery may be necessary to prevent permanent weakness or paralysis.

If you are ill, seek emergency medical attention.

• Worsening symptoms. You may experience numbness, pain, or weakness that can make it difficult to do your daily tasks.
• Bladder dysfunction or bowel dysfunction. Cauda Equina Syndrome can lead to incontinence and difficulty urinating, even with a full bladder.
• Saddle anesthesia. The areas that touch a saddle are the inner thighs, back and rectum.

Prevention

These steps will help to prevent a herniated disc:

• Exercise. Stabilizing and supporting the spine by strengthening the trunk muscles is a great way to strengthen them.
• Good posture is important. This will reduce pressure on your spine, and discs. When sitting for long periods, keep your back straight and aligned. Properly lift heavy objects, allowing your legs to do the bulk of the lifting.
• Keep your weight under control. An excess weight can put more pressure on the spine, discs, and make them more vulnerable to herniation.
• Stop smoking. Do not smoke.

As shown in this illustration, there are four stages that lead to a herniated disc.

Disc Degeneration: The first stage is when the nucleus pulposus begins to weaken due to the chemical changes that occur in the disc with the passage of time. This stage does not see bulging or herniation. The disc becomes less capable of absorbing the shocks from your movements and starts to dry out.

Prolapse is when the disc’s shape or position changes. Depending on the location of the bulge, a slight bulge or protrusion may form. This could cause the spinal cord and spinal nerves to become crowded.

Extrusion: The gel-like nucleus of the nucleus pulposus is pushed through the tire-like annulus fibrosus wall during extrusion but remains in the disc.

Sequestration: The nucleus pulposus is released from the annulus fibrosus during the final stage and can even move outside of the spinal canal.