The bones that form the spine, called the vertebrae, are cushioned by small, spongy discs that act as shock absorbers and keep the spine flexible. When a disc is damaged, it may bulge or break open into the spinal canal, this is called a herniated, slipped, or ruptured disc. Normally there is space between the vertebrae and the spinal cord and nerve roots. A herniated disc can bulge into this space and press on the spinal nerves causing pain, numbness, and weakness along the entire nerve. A herniated disc in the lower back can cause pain and numbness along the leg called sciatica. Most herniated discs occur in the lower back (lumbar) but the can occur anywhere along the spine in the cervical and thoracic areas. Weakness or numbness in both legs accompanied by a loss of bladder or bowel control can be a sign of a rare but serious condition called cauda equina syndrome. If these symptoms occur, medical treatment should be sought immediately. A herniated disc in the cervical spine will cause symptoms in the neck and arms.

A herniated disc can be caused by normal wear and tear on the spine because as they age, the discs become less flexible and more prone to tears. Injuries to the spine are another leading cause of herniated discs. Injury can cause tiny cracks or tears in the harder outer layer of the disc allowing the gel inside the disc to be forced out into the spinal space. Diagnosis is made from a description of the symptoms, physical examination and patient history. X-rays, MRI and CT scans are also sometimes used to help in the diagnosis.

Sometimes symptoms resolve in a few weeks or months without treatment. Rest during times of severe pain and light activity such as walking when pain is less can help recovery. Alternating cold and hot packs for 10 to 15 minutes each can relieve symptoms. Exercise and physical therapy can help strengthen supporting muscles and may help relieve the pressure on the area of the spine involved and help relieve symptoms. Anti-inflammatory medications and pain relievers can help control pain and reduce inflammation that may be causing the pain.

About 10% of herniated disc cases will require surgery to get relief from the pain. Surgery is only indicated when there is a history of pain not resolved by other treatments, the condition is affecting your daily activities, and when diagnostic testing indicates that your condition can be treated surgically. Open discectomy is the surgical removal of herniated disc material that is pressing on the nerve. Laminectomy is the removal of the thin layer of the vertebrae that forms a protective arch over the spinal cord. It is removed to create more space for the spinal cord. These two procedures are done separately or together depending on the situation. Percutaneous discectomy is the surgical removal of disc material using special tools inserted through small incisions in the skin rather than in open surgery. Tools used include small surgical instruments or lasers. These procedures are considered less effective than open discectomy by some practitioners.

Preventative measures include maintaining a healthy body weight, exercising regularly, not smoking, maintaining good posture when sitting, standing or walking, and using proper lifting technique. A healthy body weight relieves unnecessary pressure on the spine, exercising regularly helps maintain strength and flexibility in tissues that support the spine, and smoking reduces the absorption of nutrients and the accumulation of toxins in the discs causing them to become dry and brittle. Good posture involves keeping the shoulders back and down, chin back, abdomen in and the lower back supported especially when sitting.

Reference: Reference: http://www.webmd.com/back-pain/tc/herniated-disc-topic-overview.

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