A herniated disk is a disk that has
bulged out from its proper place in your back. Disks
are small, circular cushions between the bones of the
spine (vertebrae). Normally, disks act as shock absorbers
to cushion your vertebrae from each other as you move.
A herniated disk may press on nearby nerves and cause
severe pain.
How does it occur?
When a disk is damaged, the soft rubbery center of the
disk squeezes out through a weak point in the hard outer
layer. A disk may be damaged by:
a fall or accident
repeated straining of your back
a sudden strenuous action such as lifting a heavy weight
or twisting violently.
What are the symptoms?
If your herniated disk is in your back, your
symptoms may develop gradually or begin suddenly. Symptoms
include:
back pain
numbness, tingling, pain, or weakness in one or both
legs (this is called sciatica)
changes in bladder and bowel habits.
Symptoms of a herniated disk in your neck may also begin
suddenly or gradually. You may wake up and feel a sudden
aching. Or you may have a twisted neck that you cannot
straighten without extreme pain. You may also have numbness,
tingling, or weakness in one or both arms.
How is it diagnosed?
Your health care provider will review your symptoms
and ask about the history of your pain. Then he or she
will examine your spine and test the movement and reflexes
in your arms and legs. Finally, your provider may want
you to have one or more of the following tests:
x-rays of your spine
magnetic resonance imaging, also called MRI (an image
of your spine and herniated disk
generated by sound waves)
CT scan (computerized x-ray images of your spine)
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).
How is it treated?
In most cases, treatment without surgery will relieve
your pain.
For a herniated disk in your back, your health care
provider may recommend:
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, or lying on your belly
with a pillow under your chest,
whichever is more comfortable
anti-inflammatory drugs
prescription pain relievers
muscle relaxants
hot or cold packs
traction
back massage
physical therapy
steroid injections into the space near the herniated
disk to control pain and
inflammation.
Treatment for a herniated disk in your neck may include:
hot or cold packs
anti-inflammatory drugs
muscle relaxants
prescription pain relievers
a neck collar or neck brace to relieve muscle spasms
neck and shoulder massage
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.
As your pain lessens, your health care provider will
want you to begin a physical therapy program in which
you will do exercises to strengthen your back muscles
and joints. Stabilization exercises are 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. However, most people who have herniated disks
do not need surgery.
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.
If the weakness and numbness in your legs continue or
if you lose control of your bowel or bladder function,
contact your health care provider immediately.
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. 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. This
includes keeping your stomach muscles strong. Walking
and swimming are two good exercises for strengthening
and protecting your spine.
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