Part One, What Is Disc Herniation And How Does It Happen?
Disc herniation, often referred to as a slipped or ruptured disc, is a condition affecting the spine, which can cause significant pain and discomfort. To understand disc herniation, it’s important to grasp the basic structure of the spine and the role of the intervertebral discs. This might sound a little intimidating, but we will keep things simple so you can be informed on what is causing your pain.
The Structure of the Spine
The human spine, or backbone, is a complex structure composed of 33 individual vertebrae stacked one on top of the other; vertebrae is just a fancy name for the small bones that make up your back. These vertebrae are categorized into five regions:
- Cervical spine (neck): 7 vertebrae (C1-C7)
- Thoracic spine (upper and mid-back): 12 vertebrae (T1-T12)
- Lumbar spine (lower back): 5 vertebrae (L1-L5)
- Sacrum: 5 fused vertebrae
- Coccyx (tailbone): 4 fused vertebrae
Intervertebral Discs
Between each vertebra lies an intervertebral disc, which acts as a cushion or shock absorber. These discs are crucial for maintaining spine flexibility and allowing a range of movements such as bending and twisting.
Each intervertebral disc is made up of two main components:
- Annulus Fibrosus: The tough, outer layer of the disc, composed of several layers of fibrocartilage.
- Nucleus Pulposus: The soft, jelly-like center of the disc, which provides the disc with its cushioning properties.
Don’t worry, there won’t be a quiz at the end! It’s just important to understand the basic structure of the spine: it is made up of a bunch of small bones that all have cushions in between them.
What Is Disc Herniation?
Disc herniation occurs when the nucleus pulposus, the soft inner material of the disc, pushes through a tear in the annulus fibrosus, the tougher outer layer. This can lead to the displaced disc material pressing on the nearby spinal nerves or spinal cord, causing pain and other symptoms.
Essentially, disc herniation is when the cushions in between your bones in your spine jut out of where they should be. This can put pressure on nearby nerves and muscles, which then causes the pain you feel with a herniated disc.
A herniated disc can occur at any point along your spine including high up in your neck or even low down in your back. Your injury will depend on a bunch of factors from what activities you do on a daily basis, how you like to workout, and even what you do for work. As an Austin physical therapist can explain, disc herniation is very simple: the cushion in your spine slips out of place, but what led up to that occurring is actually very complicated.
How Does Disc Herniation Happen?
Several factors can contribute to the development of a herniated disc, including:
- Natural Aging: As we age, the intervertebral discs lose water content, becoming less flexible and more prone to tearing or rupturing even with minor strain or twist. This is a natural aging process that you cannot stop. That is why it is important to protect your spine as you age.
- Wear and Tear: Daily activities and minor injuries over time can lead to the degeneration of the discs. This natural wear and tear is a primary cause of disc herniation in older adults. If you do lots of heavy lifting, for example, this causes constant wear and tear on your spine.
- Accidents: Sudden trauma from falls, car accidents, or sports injuries can cause a disc to herniate. In fact, you may have an injury when you are young. However, this may not cause disc herniation right away — instead, it makes your back more susceptible to injuries, and you may find herniated discs to become more of an issue as you age.
- Heavy Lifting: Incorrectly lifting heavy objects can put excessive strain on the lower back, leading to disc herniation. Proper lifting techniques, such as lifting with the legs and keeping the back straight, are crucial to prevent injury. This is not the same as repetitive wear and tear; it is possible to herniate a disc just once by improperly lifting something.
- Occupational Hazards: Jobs that require repetitive bending, twisting, or lifting can increase the risk of disc herniation. For example, construction workers, nurses, and warehouse employees are often at higher risk. Even those that focus on health such as yoga class teachers can be more susceptible to herniated discs as part of their occupation if they are not careful.
- Sports: Certain sports that involve repetitive stress on the spine, like weightlifting, gymnastics, or football, can also contribute to disc herniation.
- Family History: Genetics can play a role in predisposing individuals to disc herniation. If close family members have had disc problems, there may be an increased risk for other family members.
- Sedentary Lifestyle: Lack of regular physical activity can weaken the muscles that support the spine, increasing the risk of disc herniation. For those of you that work at a desk daily, this can affect your spinal health. Be sure to take breaks and do some stretches regularly throughout the day to support your back.
- Obesity: Excess body weight, especially around the abdomen, puts additional stress on the lower back and can contribute to disc degeneration and herniation.
- Smoking: Smoking is known to reduce blood flow to the spine, which can speed up disc degeneration.
Symptoms Of Disc Herniation
The symptoms of a herniated disc can vary depending on the location of the herniation and whether it is pressing on a nerve. Common symptoms include:
- Localized Pain: Pain may be felt in the area of the herniated disc. For example, a herniated disc in the lumbar spine can cause lower back pain.
- Radiating Pain: If the herniated disc presses on a spinal nerve, pain can radiate to other parts of the body. For example, a herniated disc in the lower back can cause pain to radiate down the leg (sciatica). Even after a disc is fixed, you still may experience sciatic pain for a period of time as your body heals.
- Numbness and Tingling: A herniated disc can cause numbness or tingling sensations in the body part served by the affected nerve. This is common in the arms and legs.
- Weakness: Muscles served by the affected nerve may weaken, which can affect the ability to perform certain movements. For example, a herniated disc in the neck can cause arm weakness.
- Loss of Reflexes: Reflexes can be diminished in the area affected by the nerve compression.
If you notice these symptoms sticking around, go to a doctor to see what is wrong. Once you have a herniated disc diagnosis, you can then seek treatment with a physical therapist to work on overcoming your pain without heavy use of pain medication.
Diagnosis Of Disc Herniation
If a healthcare provider suspects a disc herniation, they may use several methods to diagnose the condition:
- Physical Examination: The provider will check for muscle strength, reflexes, and sensations in the affected area. They may ask the patient to move in specific ways to see what causes pain or other symptoms. They should also gently feel along your spine for any issues; a herniated disc does not always jut out in a very apparent manner, but it does happen.
- MRI (Magnetic Resonance Imaging): This is the most common test used to diagnose disc herniation. It provides detailed images of the spine and can show the location and severity of the herniation. There are two types normally available, open and closed. If you are claustrophobic, open is the best way to go.
- CT Scan (Computed Tomography): A CT scan can also provide detailed images of the spine, often used if an MRI is not available or suitable. Your healthcare provider will be able to determine which test is best based on your circumstances.
- X-rays: While X-rays cannot show herniated discs, they can help rule out other causes of back pain, such as fractures or tumors.
- EMG (Electromyography): This test measures the electrical activity of muscles and can help determine if a nerve is functioning properly.
- Nerve Conduction Studies: These tests measure the speed and strength of electrical signals traveling along a nerve and can help pinpoint nerve damage.
Disc herniation is a common condition that can cause significant pain and discomfort. Understanding the structure of the spine and how disc herniation occurs is essential for recognizing the symptoms and seeking appropriate medical care. Whether caused by age-related degeneration, injury, repetitive motions, genetic factors, or lifestyle choices, disc herniation requires careful diagnosis and management to alleviate pain and prevent further complications. If you experience symptoms of a herniated disc, it is important to consult with a healthcare provider for a thorough evaluation and appropriate treatment plan.
If you have been diagnosed with a herniated disc, then it’s time to seek out a physical therapist in Austin, Texas. After determining where exactly your herniated disc is located and your related symptoms of pain and discomfort are radiating, your physical therapist will create a customized plan just for you. Work with a physical therapist from Move Empower Concierge Physical Therapy to get back to being pain free.
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