Herniated disk

When people say they have a "slipped" or "ruptured" disk in their neck or lower back, what they are actually describing is a herniated disk a common source of pain in the neck, lower back, arms, or legs.


Disks are soft, rubbery pads found between the hard bones (vertebrae) that make up the spinal column. The spinal canal is a hollow space in the middle of the spinal column that contains the spinal cord and other nerve roots. The disks between the vertebrae allow the back to flex or bend. Disks also act as shock absorbers. Disks in the lumbar spine (low back) are composed of a thick outer ring of cartilage (annulus) and an inner gel like substance (nucleus). In the cervical spine (neck), the disks are similar but smaller in size.




Risk Factors/Prevention

  • Improper lifting
  • Smoking
  • Sudden pressure (which may be slight)
  • Repetitive strenuous activities


Lower Back


  • Weakness in one leg
  • Tingling (a "pins and needles" sensation) or numbness in one leg or buttock
  • Loss of bladder or bowel control (if you also have significant weakness in both legs, you could have a serious problem and should seek immediate attention)
  • A burning pain centered in the back


As with pain in the lower back, neck pain is also common. When pressure is placed on a nerve in the neck, it causes pain in the muscles between your neck and shoulder (Trapezius muscles). The pain may shoot down the arm. The pain may also cause headaches in the back of the head. Other symptoms include:

  • Weakness in one arm
  • Tingling (a "pins and needles" sensation) or numbness in one arm
  • Loss of bladder or bowel control (if you also have significant weakness in both arms or legs, you could have a serious problem and should seek immediate attention)
  • Burning pain in the shoulders, neck, or arm


To diagnose a herniated disk, your doctor will ask for your complete medical history. Tell him or her if you have neck/back pain with gradually increasing arm/leg pain. Tell the doctor if you were injured. A physical examination will help determine which nerve roots are affected (and how seriously). A simple X-ray may show evidence of disk or degenerative spine changes. MRI (magnetic resonance imaging) or CT (computed tomography) (imaging tests to confirm which disk is injured) or electromyography (a test that measures nerve impulses to the muscles) may be recommended if the pain continues.


Nonsurgical Treatment


  • Rest and over the counter pain relievers may be all that is needed.

Any physical activity should be slow and controlled, especially bending forward and lifting, taking short walks and avoiding sitting for long periods. This can help ensure that symptoms do not return.


If these nonsurgical treatment measures fail, epidural injections of a cortisone like drug may lessen nerve irritation and allow more effective participation in physical therapy. These injections are given on an outpatient basis over a period of weeks.

Surgical Treatment


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