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The spine, or backbone, is made up of a series of individual bones called vertebrae that are stacked to form the spinal column. Between the vertebrae are flat, round cushioning pads called intervertebral discs, which act as shock absorbers. Each disc has a soft, gel-like center ” called the nucleus pulposus ” surrounded by a tough, fibrous outer layer called the annulus.
A herniated disc ” also called a slipped disc or ruptured disc ” occurs when pressure from the vertebrae above and below force some or all of the nucleus pulposus through a weakened or torn part of the annulus. The herniated nucleus pulposus can press on the nerves near the disc, resulting in pain.
Herniated discs most frequently occur in the lower part of the spine; however they can also occur in the cervical and thoracic spine. A herniated disc is one of the most common causes of neck, back and/or leg pain (sciatica) and neckache.
Herniated discs often produce no symptoms at all. Symptoms of a herniated disc in the low back include:
Symptoms of a herniated disc in the neck include:
Symptoms of a herniated disc in the mid-back tend to be vague. There might be pain in the upper back, lower back, abdomen, or legs, as well as weakness or numbness in one or both legs.
A herniation occurs when the outer part of the disc, the annulus, becomes weak and tears. Several factors can contribute to disc-weakening, including:
Herniated discs are very common. They occur more often in people aged 35 to 55 years. They are more common in men than in women.
Your health care provider will begin an evaluation with a complete physical examination and medical history, including a review of your symptoms. He or she might perform a neurological exam to test your muscle reflexes, sensation, and muscle strength.
The health care provider might use certain other diagnostic tests to confirm the diagnosis and to better evaluate the site and extent of the herniation. These tests might include:
Most herniated discs resolve on their own or with conservative treatment, which includes rest, anti-inflammatories, and physical therapy. Some people find that ice packs or moist heat applied to the affected area provides some symptomatic relief of the pain and muscle spasms in the back. In cases that do not improve with conservative treatment, spinal injections or surgery might be needed.
Common over-the-counter NSAIDs include aspirin, ibuprofen (Motrin®, Advil® and naproxen (Naprosyn®, Aleve®). You may take medicines with food to avoid stomach irritation.
Muscle relaxants and various analgesics might be prescribed to relieve the discomfort associated with severe pain or muscle spasms in the initial treatment periods.
The exercises prescribed by your physical therapist can also help relieve pressure on your nerves, reducing the symptoms of pain and weakness. The exercise program often includes stretching exercises to improve flexibility of tight muscles and aerobic exercise ” such as walking or using a stationary bike ” to build endurance and improve circulation.
Other exercises might help to strengthen the muscles of your back, abdomen, and legs.
Chronic (ongoing) back or leg pain and loss of control or sensation in the legs or feet are some complications of an untreated disc herniation.
Most back and leg pain will get better gradually ” usually within six weeks ” by taking simple measures. In fact, most people with herniated discs respond to conservative treatment within six weeks and are able to return to their normal activities. Some will continue to have back pain even after treatment.
It is not always possible to prevent a herniated disc, but there are steps you can take to reduce your risk:
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This information is provided by Cleveland Clinic Abu Dhabi, part of Mubadala Healthcare, and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.
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