Herniated Disc ("Slipped Disc")
What Is It?
A herniated disc, sometimes referred to as a "slipped disc", is a bulging or rupture of an intervertebral disc due to degenerative spine disease
or trauma. It can cause nerve compression which leads to neurological symptoms.
The intervertebral disc is a cartilaginous and fibrous structure that sits between vertebral bones of the spine at each level. Their normal function can be thought of as shock absorbers for the spine, helping to support the weight of the person and adapt to changes in posture and weight. Normally, the outer rim of the disc is smooth. With age and degenerative changes in the spine with wear and tear, some discs can become weak. Their outer rim becomes lax, leading to bulging of the disc, and can even rupture or tear, leading to extrusion of the interior contents of the disc.
When a disc herniates, it can press on neurological structures, most notably the spinal nerves that are passing in and out of the spine at that level. This compression of the nerves can lead to neurological symptoms.
A herniated disc can occur slowly over time due to aging and degenerative changes of the spine. However, occasionally they can occur suddenly with trauma to the spine which ruptures the disc. The most common locations for a herniated disc are in the cervical spine and in the lumbar spine. thoracic disc herniations are much less common.
What Types of Symptoms Are Typical?
Symptoms vary from patient to patient depending on the severity of herniation, the timeframe and the exact location of the disc herniation.
For one, disc herniation often causes pain. Pain in the neck or back in the area of the herniation can be accompanied by pain that radiates into the arm or leg on the side of the herniation.
Other neurological symptoms can occur as the disc compresses spinal nerves. Symptoms include numbness and tingling and muscle weakness in the distribution of that nerve. Typically these symptoms are one-sided in one limb, correlating with the side and level of the herniation.
Cervical herniations: For more information about symptoms specifically related to cervical disc herniation, see the Cervical Disc page.
Lumbar herniations: For more information about symptoms specifically related to lumbar disc herniation, see the Lumbar Disc page.
Thoracic herniations: For more information about symptoms specifically related to thoracic disc herniation, see the Thoracic Disc page.
How Is The Diagnosis Typically Made?
If a patient presents with pain and/or neurological symptoms which are consistent with a herniated disc on physical examination, an imaging study of the spine is often ordered. Most commonly, an MRI scan
of the spine will reveal the herniated disc clearly and allow identification of its location on the spine. In some patients, to confirm that their symptoms are related to disc disease, other studies such as a discogram or nerve conduction studies
can be performed as well.
What Are Some Common Treatments?
For most patients, a period of conservative treatment will be suggested first. This entails rest, anti-inflammatory drugs and physical therapy. Spinal injections are also sometimes effective to decrease inflammation and the pair associated with a herniated disc.
If these conservative measures fail, or if their symptoms are very severe, some patients will require a surgical procedure to remove the disc herniation. Generally, a procedure called a discectomy is performed. In the lumbar spine this can be done through a small microdiscectomy or through a tube with endoscopic spine surgery. In the cervical spine it is usually performed from the front of the neck as an anterior cervical discectomy and fusion. In either case, the goal is to remove the part of herniated disc which is compressing nerves and causing symptoms.
Each case is different so each patient should discuss their diagnosis and treatment options with their own physician.
Return to the Spinal Disease page from the Herniated Disc page.
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This site is not intended to offer medical advice. Every patient is different, and only your personal physician can help to counsel you about what is best for your situation. What we offer is general reference information about various disorders and treatments for your education.