Herniated Disk
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Herniated Disk What is a herniated disk? Disks are small, circular cushions between vertebrae (the bones of the spine). Normally, disks act as shock absorbers to cushion your vertebrae from each other as you move. A herniated disk is a disk that has bulged out from its proper place. It may press on nearby nerves and cause severe pain. How does it occur? A herniated disk occurs when the disk is damaged by: - a fall or accident - repeated straining of your back - a sudden strenuous action such as lifting a heavy weight or twisting violently - growing older. When the disk is damaged, the soft jellylike center of the disk squeezes out through a weak point in the hard outer layer, causing a bulge that often presses on nearby nerves. What are the symptoms? Symptoms of a herniated disk in your neck may begin suddenly or gradually. You may wake up and feel a sudden aching or a twisted neck that you cannot straighten without extreme pain. Also, you may have numbness, tingling, or weakness in one or both arms. If your herniated disk is below your neck, your symptoms may develop gradually or begin suddenly. Symptoms include: - back pain - pain down one or both legs - numbness, tingling, or weakness in one or both legs - changes in bladder and bowel habits. How is it diagnosed? Your doctor will review your symptoms and ask about the history of your pain. Then your doctor will examine your spine and test the movement and reflexes in your arms and legs. Finally, your doctor may want you to undergo one or more of the following tests: - x-rays of your spine - CT scan (computerized x-ray images of your spine) - magnetic resonance imaging (MRI) (an image of your spine and herniated disk generated by sound waves) - electromyography (tests of electrical activity in your muscles) - myelography (injection of dye into the fluid around the spinal cord that can be seen on x-rays) - diskography (injection of dye into a disk and x-rays taken). What is the treatment? In most cases, treatment without surgery will relieve your pain. For a disk in your back this may include: - several days or more of lying flat on your back on a firm mattress or on an ordinary bed with a stiff board under the mattress - muscle relaxants - anti-inflammatory drugs - painkillers such as aspirin or aspirin with codeine - hot or cold packs, depending on your doctor's preference - traction, which is the process of putting bones or muscles under tension with a system of weights and pulleys to keep them from moving or to relieve pressure on them - back massage or physical therapy - steroid injections into the space near the herniated disk to control pain and inflammation. As your pain lessens, your doctor will want you to begin a physical therapy program in which you will do exercises to strengthen your back muscles and joints. Recently, stabilizing exercises have been used successfully to treat herniated disks. This therapy involves learning how to control the movement of your spine in all recreation and work activities. If you continue to have symptoms, you may need to have surgery. If the weakness and numbness in your legs continue or if you lose control of your bowel or bladder function, contact your doctor immediately. Treatment for a herniated disk in your neck may include: - hot or cold packs - anti-inflammatory drugs - muscle relaxants - painkillers such as aspirin or aspirin with codeine - a neck collar or neck brace to relieve muscle spasms - neck and shoulder massage - traction - surgery, if weakness or numbness in your arms and hands gets worse or doesn't improve. How long will the effects of a herniated disk last? The initial intense pain should go away within a few weeks, but some pain may remain for a few months. You may be prone to backaches throughout your life and therefore must remember to protect your spine when lifting or being physically active. How can I take care of myself? Practice correct posture when you are walking, sitting, standing, lying down, or working. - When lifting heavy objects, don't bend over from your waist. Kneel or squat down by the object, while keeping your back as straight as possible. Use your thigh muscles to do the lifting, and avoid twisting. - When you stand, always stand up straight with your shoulders back, abdomen in, and the small of the back flat. When standing for long periods, move around frequently and shift your weight from one foot to another, while standing as straight as possible. - When you sit, have your feet flat on the floor or elevated. Get up every 20 minutes or so and stretch. Sit in a chair that has good back support. - Sleep on a firm mattress or one with a bed board under it. Lie on your side (never on your stomach) with your knees bent or on your back with a small pillow under your head and another pillow under your knees. What can be done to help prevent a herniated disk? Herniated disks can often be prevented by keeping your weight down, eating a proper diet, and exercising to keep your muscles firm. Strong, flexible muscles can stabilize your spine and protect it from injury. It is important to keep your stomach muscles strong. Walking and swimming are two good exercises for strengthening and protecting your spine. Developed by Clinical Reference Systems. ©1998 Wake Forest University Baptist Medical Center All rights reserved.