*Always consult a doctor for
pain that spreads down your leg or is accompanied by tingling, numbness
Symptoms: When a disc is ruptured some of the
inner substance protrudes and may irritate the spinal nerves. If
this occurs in the lower back, it may cause sciatica
- pain and/or numbness that radiates from the lower back, through
the buttocks, back of the leg, and sometimes to the foot. The pain
can vary, from a burning sensation or a dull ache. It may be intermittent
or chronic. The severity of the pain can range from mild to severe.
In some cases, there may not be any symptoms.
*When a nerve is compressed it is often referred to as a "pinched
While a herniated disc is the most common cause of a "pinched
nerve" in the lower spine, other conditions such as spinal
stenosis, swelling of surrounding tissues due to muscle
injury, and bone spurs that may occur in osteoarthritis
of the spine may compress spinal nerve roots.
The lower back (lumbar spine) is the most common location for a
herniated disc as the lower back is subject to the most mechanical
stress and supports most of the weight of the body. If a herniated
disc occurs in the neck area (cervical spine), pain, tingling and
weakness may occur in the arm or hand.
Is there a difference between a herniated disc and a bulging disc?
These terms are often used interchangeably – both are often
used as catchall descriptions for an abnormality of a disc. The
term bulging disc is usually used to describe a
disc that bulges slightly and does not produce symptoms. A herniated
disc is usually used to describe a disc that protrudes
against a spinal root nerve and causes pain. However, some bulging
discs bulge enough to cause problems and some herniated discs do
not cause any problems.
Definition of a bulging disc:
Sometimes the disc does not actually rupture but protrudes due to
a weakening of the outer part that lets the inner fluid to push
against the weakened wall and cause a bulge – this is called
a bulging disc
Definition of a herniated disc:
A herniated disc is a rupture of the outer casing of the disc. The
inner substance of the disc then protrudes.
A Herniated Disc Can Develop Gradually or Suddenly
A herniated disc is often the result of gradual degenerative changes
in the discs that occur over a long period of time that make the
discs susceptible to injury.
A herniated disc may also occur suddenly, e.g. by excessive compression
of the disc, as in a fall or car accident or even lifting a heavy
object. Click here for proper lifting techniques.
Disc damage often occurs gradually and sets the stage for a herniated
disc. Even when a herniated disc has developed gradually, the back
pain caused by a herniated disc can occur suddenly.
Aging and herniated disc:
Aging increases the risk of a herniated disc. With aging, the discs
lose some flexibility and water content, and may develop cracks and
fissures These changes leave the discs less able to handle compression
and more likely to bulge or rupture.
Bulging discs are considered a normal part of aging. Bulging discs
often cause no problems, but if a bulging disc protrudes against
a spinal root nerve, back pain can result. A bulging disc is more
susceptible tearing, and becoming a herniated disc.
Lack of Exercise and herniated disc:
Muscles support the spine and help maintain proper posture. Weak
muscles can’t adequately support the spine and discs become
more compressed and subject to damage. A damaged disc is more likely
to become a herniated disc. Strengthening exercises are essential
to counteract the gradual loss of muscle mass that comes with aging.
Being overweight also causes extra compression of the discs, increasing
the risk of a herniated disc. Even small reduction in body weight
can make a difference.
Posture and herniated disc:
Poor Posture contributes to gradual disc damage and herniated
disc. The pressure on the discs from poor posture is uneven, causing
uneven wear on the discs. When the natural curve of the lower
back is increased (sway back) or decreased (flattened back) the
discs are more compressed. This increases the risk of herniated
Activities and herniated disc:
When bending forward at the waist, extra weight is placed on the
front of the discs causing compression to the front of the discs.
Exercises like toe-touching and bending forward to stretch the legs
cause excess compression of the discs in the lower back and can
cause gradual damage.
*See a physician immediately if pain radiates down your leg, or
is accompanied by tingling, numbness or weakness to rule out serious
conditions that may require immediate surgery.
Since most herniated discs improve without surgery (the protruding
part of the disc may gradually shrink), the focus is on treating
the pain and any inflammation. NSAIDs (anti-inflammatory medications)
such as aspirin and ibuprofen are often helpful. Stronger prescription
pain medications may be needed for severe pain.
Muscles often spasm around the site of pain. Stretching
exercises and/or massage
can help release muscle spasms and pain. Muscle relaxants are sometimes
prescribed. Calcium and magnesium supplements can also help reduce
The use of heat and cold often relieves pain. See back
pain treatment for more information. Click
here for information on complementary
Stretching exercises for the back increase spaces between the
vertebrae, relieving pressure on the discs and allowing more room
for the spinal nerves. Low-impact aerobic exercise such as walking
and swimming increase blood flow to the discs and promote healing.
Strong muscles are necessary for keeping
the spine in proper alignment. Strengthening exercises should be
eased into very gradually to avoid straining the back. Avoid exercises
that place pressure on the lower back until the pain has subsided
or as recommended by a physician or physical therapist. Click
here for more on back exercises.
A firm mattress will help keep the spine in proper alignment.
Avoid sleeping on the stomach as this shortens back muscles, increases
the curve in the lower spine and increases pressure on the discs
and spinal nerves.
Any movement or activity that increase symptoms of pain or numbness
should be avoided. Avoid activities that strain the back such as
heavy lifting and maintain proper posture.
Poor posture decreases the space between the vertebrae and increases
pressure on the discs. Sitting places more pressure on the discs
in the lower back than standing. Avoid sitting for long periods
of time. A chair that reclines slightly shifts the body weight to
the backrest of the chair and takes some stress off of the discs
in the lower spine. Click here for more on
posture. High heels also throw the spine out of alignment and
increases pressure on the discs in the lower back.
Surgery does not guarantee pain relief. In the time it takes to
recover from surgery, most herniated discs will have improved without
any treatment. Though surgery is usually a last
resort, if there are signs of progressive nerve damage (e.g. progressive
weakness), waiting too long to have surgery may result in permanent
*If nerves that affect bladder or bowel
control are affected, immediate surgery is necessary to prevent
permanent nerve damage.
Fortunately, the vast majority of herniated discs improve without
A herniated disc is not nearly
as common a cause of back pain as muscle or ligament strain.
to Other Back Conditions