One of the common causes of neck or back pain is due to a herniated disc . Sometimes called a “displaced” or “ruptured” disc, this condition occurs most often in the lower back, as well as the smaller discs in the neck. A herniated disc can sometimes cause a lot of pain, however, most sufferers do feel an improvement with a few months of simple treatments that do not involve surgery.

How is a herniated disc born?

Hernia = a part of the body that protrudes through an abnormal opening; Disc = the disc-shaped cushions between the bones of the spine.

The spine is made up of 33 bones known as a vertebra (plural, vertebra). Each vertebra is separated from the adjacent vertebrae by intervertebral discs, a spongy but strong connective tissue. Intervertebral discs, along with ligaments and facet joints, connect individual vertebrae to help maintain normal alignment and curvature of the spine while allowing movement.

The image above shows the entire spine from the side and from the front. The bones of the spinal column are gray, and the intervertebral discs are black.

In the center of the spine is an open canal called the spinal canal. The spinal cord and spinal nerves meet in the spinal canal, where they are surrounded by spinal fluid and protected by the strong spinal column.

On each side of the spine, small openings between adjacent vertebrae called foramina (singular, foramen) allow nerve roots to enter and exit the spinal canal.

The spine is divided into the following distinct regions

Cervical spine : consists of seven vertebrae in the neck. These vertebrae are small and allow for the mobile nature of the neck.

Thoracic spine: consists of 12 vertebrae in the upper and middle part of the back. These are larger and stronger than the cervical vertebrae. Each thoracic vertebra is attached to a rib on each side. This provides significant stiffness and strength to the thoracic part of the spine.

Lumbar Spine : Usually consists of five vertebrae in the lower back, but it can vary between four and six. These vertebrae are the largest because they resist the greatest amount of force on the spine. The lumbar spine is also more mobile than the thoracic spine. Due to these factors, the lumbar spine is most affected by degenerative conditions, spinal stenosis, and herniated discs.

Sacrococccygeal: the lowest portion of the spine. The sacrococcygeal region consists of a single bone, made of vertebrae fused into the sacrum (five vertebrae) and coccyx (four vertebrae). Attaches to the pelvis on both sides. In a small number of people, there may be a disc between the first and second sacral vertebrae. Alternatively, the fifth vertebra in the lumbar (lower) spine may occasionally fuse with the sacrum, leaving only 4 lumbar vertebrae.

When does a herniated disc occur

A herniated disc occurs when the fibrous outer portion of the disc ruptures or tears, and the jelly-like nucleus is squeezed out. When the herniated disc compresses a nearby nerve, as in the image below, the result can be a pinched nerve.

A pinched nerve can cause pain, numbness, tingling, or weakness in the arms or legs. The substance that makes up the gelatinous nucleus of the disc can also inflame and irritate the nerve, causing additional pain.

Symptoms of herniated disc

Herniated disc generally produces a sensation of pain in the lower back, but in addition to this symptom, the pain can spread to other areas of the body, with the following symptoms appearing:

  • Neck pain, especially in the back or side.
  • Deep pain near or on the affected side of the shoulder.
  • Pain radiating to the shoulder, upper arm, forearm, and sometimes to the hand, fingers, or chest.
  • Worsening pain when coughing, straining, or laughing.
  • Increased pain when bending the neck or turning the head to the side.
  • Spasm of the cervical muscles.
  • Arm muscle weakness.

Tips to avoid herniated disc

To determine if you have a herniated disc, your doctor will ask for a complete medical history and perform a physical exam. A physical exam will help determine which nerve roots are affected.

To help confirm a herniated disc diagnosis, your doctor may recommend a magnetic resonance imaging (MRI) scan. This test can create clear images of soft tissues such as intervertebral discs.

However, if you have not yet received a diagnosis, here are some tips that will help you stay at bay from this painful condition such as herniated disc.

Avoid overexertion and bad posture

Be very careful both at work and in games, not to make excessive efforts lifting heavy objects in an incorrect posture, putting the spinal discs at risk of injury.

Control obesity

Being overweight adds stress to your lower back and weakens the muscles. It is important to balance your weight through diet and exercise. If you are pregnant you should try not to gain excess weight.

Do exercises to reduce the risk of a herniated disc

Find a routine of exercises and stretches that strengthen the muscles of your abdomen and back. These exercises are ideal for maintaining proper posture and preventing herniated discs .

Avoid cigarette

Cigarettes are made up of a large number of chemicals that decrease your body’s ability to absorb nutrients. In the absence of nutrients, the discs become brittle and more prone to hernias.

Maintain a healthy diet

Diet plays a very important role in the absorption of nutrients that strengthen the discs and prevent hernias . We must include foods rich in fiber, vitamins and minerals, such as cereals, fruits and vegetables. In addition, we must start the good habit of drinking water.

Treatments and tips for herniated discs

  1. People who suffer from herniated discs should undergo physical therapy to treat this problem. Professionals will tell you the correct posture to take, how to properly lift objects, walk, dress, and perform other activities.
  2. When sitting for long periods, it is recommended to use lumbar support.
    Sleep with a pillow under your knees if you sleep on your back, between your knees if you sleep on your side, and under your belly if you sleep on your stomach.
  3. As the problem lessens, you can resume your normal activities, but slowly.
  4. When the pain starts, avoid lifting heavy things or twisting your back for at least 6 weeks.
  5. Stop exercising and only resume 2 to 3 weeks after pain. At this point, it is only recommended to do those recommended by the physiotherapist.

By Dr. Eric Jackson

Dr. Eric Jackson provides primary Internal Medicine care for men and women and treats patients with bone and mineral diseases, diabetes, heart conditions, and other chronic illnesses.He is a Washington University Bone Health Program physician and is a certified Bone Densitometrist. Dr. Avery is consistently recognized in "The Best Doctors in America" list.

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