Herniated Discs
(bulging disc, blown disc)
The human back is a complex structure of 24 individual vertebrae (the bones of the spine), between the head and the pelvis. It is supported by 24 ribs, multiple muscles, nerves, ligaments, tendons, and fascia. There are also cartilage-like pads called discs between the bones of our spine that provide cushion. Injuries or imbalances with any of these can lead to back pain!
These discs are made of a tough outer layer of rings called the “annulus fibrosus” and a gel-like center called the “nucleus pulposus.” When the rings get weak, they will develop tears, and the gel inside of them bulges or ruptures, when this happens, the gel can press on the various nerve roots in your spine and can cause pain, numbness, or muscle weakness in the arms or legs.
The problem is that it doesn’t always cause any of these symptoms. Many surgeons will suggest surgery, even though the research suggests that between 20%-76% of people who have a herniated disc have no pain, numbness or muscle weakness.
What does this mean?
A herniated disc may cause back pain, but many times, even if you have one, it is not your bulging disc that is causing your back pain!
Back pain alone (especially without leg pain) can have many causes other than a herniated disc.
What puts me at risk of a Herniated Disc Injury?
A disc injury can happen to anyone, still there are a few factors that can increase your risk:
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Age – As time goes on, the disc may start to lose water content, making it less effective as a cushion for your vertebrae. People over 40 years old have more disc injuries.
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Smoking Habits – Smoking can constricts your arteries, which reduces the Oxygen supply to the spine, and makes your discs wear out faster.
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Weight – More weight = more stress on your spine, your muscles, tendons, ligaments, and fascia. More stress just means that you need to be stronger to handle normal day to day activities than those who are not as heavy need to be.
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Occupation – Different jobs wear down your body differently. Whether you are lifting heavy things, staying in awkward positions for long periods of time, or sitting for long periods of time at a computer, or driving, your job puts stress on you in similar ways, consistently, for a significant portion of your life. This wear and tear will eventually become worn and torn.
Neck Disc Herniation
There are 7 vertebrae in the neck portion of the spine. This allows the neck to move so much, and so well. If one of the discs in your neck is herniated, you may experience a few of these symptoms:
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Dull or sharp pain in the neck or upper back
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Pain, numbness, or tingling in the shoulder and upper arm
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Arm and hand weakness
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Pain may get worse when holding or moving your neck in certain positions
Types of Disc Injury:
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Disc Bulge/Protrusion – The rings of the disc begin to poke out from between the vertebrae. This bulging tissue can press on the spinal nerves.
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Disc Extrusion – The outer rings of the disc begins to tear, and the gel that should be in the middle of the disc begins to poke out from between the vertebrae. With this type of herniation, the extruded tissue is still attached to the disc.
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Disc Sequestration – The gel bursts, completely separating from the disc. This is a rare type of disc injury but it’s also the most severe.
What Does a Herniated Disc Feel Like?
The spine is very complicated, and your body is smart. What this means is that your body will try to take care of problems itself without making you aware of it. Again, you likely have a herniated disc and don’t know it, because it’s not causing any symptoms right now. But, when they show up, they are typically significant!
Mid Back Disc Herniation
There are 12 sets of ribs, and 12 vertebrae in your mid back that connect with them. If you have a mid back disc herniation you could feel it in your chest, abdomen, and mid back.
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Pain in the mid back, especially if the herniation is compressing a spinal nerve
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Chest pain
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Numbness or tingling that travels from the mid back, around the side, to the chest or upper abdomen
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Weakness or numbness in the leg
Low Back Disc Herniation
There are 5 vertebrae in the lower back. These vertebrae take the most force from activities like sitting, jumping, running, and lifting. They are the most common place to have a disc or spine injury.
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Burning, tingling, or pain in the buttocks, legs, and feet
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Lower back pain that worsens when standing, sitting, or walking
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Pain, numbness, or tingling in the legs
Traditional Disc Injury Treatment
If you’re having back pain, your doctor will perform an examination, and will check for decreased muscle strength, reflexes, or range of motion, and they may order imaging tests (X-ray or MRI) to rule out all of the big red flags: dislocation, fracture, infection, or a tumor.
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Conservative treatment is usually the first and the best option for a bulging disc. Your doctor will likely suggest some combination of bed rest, physical therapy, massage, and pain medications to treat your symptoms. For more severe and painful disc injuries, your doctor may prescribe steroid injections, ultrasound therapy, or even surgery.
Some research indicates that there is often no direct association between a herniated disc and low back pain. According to the research, up to 76% of people with a disc herniation have no back pain.
It’s a pretty common thought that everyone who has back pain has a ruptured disc, but it’s just not true.
Thankfully, a true herniated disc is not very common.
