Medical Library: Back & Spine – Herniated Disk

Herniated disks are one potential cause of back and neck pain, and is also sometimes referred to as a bulging disc.

The spine is made up of vertebrae that are stacked on top of one another with a rubbery piece of cartilage called an intervertebral disk in between each one. When we’re young the disk is made mostly of gelatin, but as we age, and sometimes with injury or excessive wear and tear, we start to lose some of that gelatin, and the volume of the disk decreases, resulting in less space between the vertebrae. The disk becomes flatter and less flexible, leaving less space between each set of vertebrae. In some cases, the gelatin can push out through a crack in the rubbery exterior and lead to a herniation (bulge) or rupture (tear).

Herniated disks are most common in the neck (cervical spine) and low back (lumbar spine). In the low back, disks may become damaged by excessive wear and tear or an injury.

Your risk for developing a herniated disk increases due to:

• Age – most herniated disks occur in people who are 30 to 50 years of age as a result of age-related disk degeneration. Herniated disks are less common after the age of 50, however, because with aging there is less fluid to push out of the disk
• Obesity – increased weight results in increased pressure on the disks
• Occupation – jobs that are physically demanding and involve repetitive tasks such as lifting, pushing, pulling, and twisting place additional stress on the disks
• Low levels of physical activity – people who are not physically active are less able to handle physical demands

You might have mild to intense neck or back pain—or no pain at all. Herniated disks sometimes show up on the diagnostic images of people who have no symptoms.

When the disk ruptures and a portion of the disk pushes outside its normal boundaries, it can “pinch” or press on spinal nerves or the spinal cord. This condition is called “radiculopathy.” The pressure can lead to back pain or to pain, numbness, or weakness in the legs.

The type and location of your symptoms depends on the location and the amount of pressure on the nerves:

• If you have a herniated disk in the cervical spine, you may have pain, tingling, numbness, weakness, or any combination of these symptoms in the arm, shoulder, or neck.
• If you have a herniated disk in the lumbar spine, you may have pain, tingling, numbness, weakness, or any combination of these symptoms in the back, buttocks, or legs; most likely, your symptoms will be on only one side of your body.

Often, symptoms from herniated disks are made worse by certain activities or positions. If you have a herniated disk in the lumbar spine:

• Pain may get worse with sitting, bending, and reaching.
• Pain may be worst first thing in the morning and after staying in one position for a long time.
• You may need to switch positions frequently.
• You may prefer to stand rather than sit.

If you have a herniated disk in the neck, symptoms are often worse with prolonged sitting and when lying down.