Herniated Disc: Causes, Symptoms & Treatment

A herniated disc occurs when the soft, gel-like center (nucleus pulposus) of an intervertebral disc ruptures through the tough outer ring (annulus fibrosus) and protrudes into the spinal canal. This protrusion may compress nearby nerve roots, causing pain, numbness, or weakness. The lumbar spine is most commonly affected, followed by the cervical spine.

Most disc herniations occur gradually due to age-related degeneration, though they can result from acute injury.

Risk factors include:

• Age (degenerative changes)
• Repetitive heavy lifting
• Smoking
• Prolonged sitting
• Obesity
• Sedentary lifestyle
• Genetic predisposition
• Traumatic injury

Symptoms depend on location and severity:

• Localized back or neck pain
• Radicular pain (burning, sharp pain radiating down arm or leg)
• Numbness or tingling in legs or arms
• Muscle weakness
• Loss of reflexes
• Loss of bowel or bladder control (cauda equina syndrome)

Diagnosis involves:

• Patient history and physical examination
• Neurological testing
• MRI (gold standard imaging)
• CT scan with myelography
• Electromyography (EMG) for nerve function

Conservative treatment (first-line):

• Rest and activity modification
• NSAIDs for pain relief
• Physical therapy
• Epidural steroid injections
• Manual manipulation (cervical only)

Surgical intervention:

• Discectomy or microdiscectomy
• Laminectomy
• Fusion (severe cases)

Prevention strategies include:

• Proper lifting and body mechanics
• Regular exercise and stretching
• Core strengthening
• Maintain healthy weight
• Smoking cessation
• Ergonomic workspace

Seek care for radiating pain lasting more than 2 weeks, progressive weakness, or numbness in the groin/saddle area. Specialist consultation is recommended if conservative treatment fails after 6-12 weeks.