Learn more from Mohamad Bydon, M.D.
Hello. I'm Dr. Mohamad Bydon, a neurosurgeon at Mayo Clinic. In this video, we'll cover the basics of disk herniation. What is it? Who gets it? The symptoms, diagnosis, and treatment. Whether you're looking for answers for yourself or someone you love, we're here to give you the best information available. Your spine is a stack of bones known as vertebrae, and between these bones are small rubbery disks that act as cushions. They have a soft jelly-like center or nucleus that is encased by a tougher rubbery exterior. Sometimes the exterior of these rubbery disks can tear, and the soft inside slips out. This results in a herniated disk, also known as a slipped disk or ruptured disk. This disk injury can irritate nearby nerves causing pain, numbness, or weakness in an arm or a leg. Many people with a slipped disk never experience symptoms and surgery is rarely required to fix the problem. Nonetheless, there are a range of treatments available to help those who suffer pain or discomfort from a herniated disk.
In most cases, a slipped disk happens because of wear and tear, something known as disk degeneration as you age. Your disks become less flexible and are more prone to tears and ruptures. Most people cannot identify the cause of their herniated disk. It can happen from using your back muscles instead of your leg and thigh muscles to lift heavy a object. Or from awkwardly twisting and turning. That said, there are other factors outside of your age that can increase your risk of slipping a disk. Being overweight increases the strain on the disks in your lower back. Some people may be genetically predisposed to rupturing a disk. Working a physically demanding job, and smoking can decrease the oxygen supply to your disk, causing it to degenerate more rapidly.
It's possible to have a herniated disk without having any symptoms. This happens to a lot of people. They may first learn about a herniated disk while undergoing tests for a different issue. Slip disks can trigger a few classic symptoms. Arm or leg pain often described as a sharp or shooting pain. Pain in your buttocks, thighs, calf, even your foot, numbness or tingling. Your exact symptoms depend on where the herniated disk is located, whether it's pressing on a nerve. Talking to a doctor about the pain that you're experiencing is always a smart move.
Your doctor will usually be able to tell if you have a herniated disk by conducting a physical exam, asking about your medical history. They may ask you to lie flat, move your legs into various positions. They may also check your reflexes, muscle strength, walking ability, see if you can feel light touch, pinprick vibration. If your doctor thinks another condition is causing the pain or needs to see which nerves are being affected by the slipped disk, they may order one or more of the following; an X-ray, a CT scan, an MRI, rarely a myelogram. Your medical team may perform a nerve test like a nerve conduction study or an EMG to help pinpoint the location of the nerve damage.
More often than not, watching your movement, and taking pain medication relieves symptoms for most people. Over-the-counter pain relievers like acetaminophen, ibuprofen, naproxen are great options for mild-to-moderate pain. If your pain is severe, your doctor might recommend a cortisone injection or muscle relaxers. In rare cases, opioids may be prescribed for a short period of time when other treatments have not worked. Physical therapy can also help manage pain with positions, stretches, and exercises designed to minimize the discomfort caused by a herniated disk. Few people with a slipped disk ever need surgery, but when it's necessary, surgeons may perform what's known as a diskectomy. This may be done in an open manner or in a minimally invasive manner. The protruding portion of the disk is removed. Sometimes in cases of spinal instability, a bone graft is needed where the vertebrae are fused together with metal hardware. In rare circumstances, a surgeon may implant an artificial disk to replace the herniated one.
If you think you have a herniated disk, talk to your doctor, come prepared, try to figure out when your symptoms started, how you may have injured it, and what, if anything, helps improve your symptoms. Back injuries are incredibly common. Thankfully, most people find a way to manage their pain and are able to return to normal activity in no time. If you'd like to learn more about disk herniation, watch our other related videos or visit mayoclinic.org. We wish you well.