What is a herniated disc, and what symptoms do you notice?
A herniated disc is a common condition of the spine, especially in the lower back. In this condition, an intervertebral disc becomes damaged. Interestingly, not everyone with a herniated disc experiences pain. In about 50% of cases there are actual symptoms.
When a herniated disc is recognised and treated in time, symptoms can often be limited or even prevented.
How is an intervertebral disc structured?
The structure of an intervertebral disc can be compared to an onion.
On the outside are strong rings (the anulus fibrosus) and in the middle is a soft, gel-like core (the nucleus pulposus).
With a herniated disc, a tear develops in the outer ring, allowing the soft core to bulge outward. When this bulge moves toward nerve tissue, symptoms can occur.
What causes herniated disc symptoms?
In most cases, a herniated disc does not develop suddenly, but due to long-term improper functioning of the spine. Pain occurs when the bulge puts pressure on a nerve or nerve root.
There are different stages:
Bulging disc (early stage)
Before there is a true herniated disc, we often first see a bulging disc. In this case, there is not yet a tear, but the intervertebral disc has weakened.
Due to small injuries (microtearing) in the outer layer, the disc loses its firmness and, as it were, starts to “loosen up”. You can compare this to a tyre with a weak spot under pressure, causing a bulge to form. At this stage, symptoms are often still mild or may come and go.
Protrusion
At an early stage, the outer layers of the intervertebral disc bulge slightly. This is called a protrusion . The pain often comes on suddenly, for example after a bending or twisting movement.
Prolapse
At a later stage, the soft core can push outward through small tears in the outer layer. This is called a prolapse . Symptoms may then be more severe, but can also develop gradually and fluctuate in intensity.
What symptoms can occur with a herniated disc?
Symptoms vary from person to person and depend on which nerve becomes irritated.
Common symptoms include:
- lower back pain radiating into the buttock or leg
- tingling or numbness
- loss of strength in the leg
- in severe cases: neurological deficits such as foot drop
Herniated discs most commonly occur in the lower back, but can also develop in the neck or upper back.
It’s good to know that leg pain does not automatically mean there is a herniated disc. In practice, only about 10% of people with leg symptoms actually have a herniated disc. In most cases, there is another cause.
How is a herniated disc diagnosed?
A herniated disc is not visible on a standard X-ray. To clearly visualize the herniation itself, an MRI scan is used. This shows exactly where the herniation is and whether it is putting pressure on a nerve root.
However, an MRI is not always immediately necessary. In many cases, the diagnosis can already be made reliably based on a physical examination, including neurological and orthopedic tests.
An X-ray can also provide valuable additional information. Although the herniation itself cannot be seen, it can be used to assess:
- the height of the intervertebral spaces
- the alignment of the vertebrae
- signs of wear and tear or a longer-standing problem
That’s why an X-ray is often a first step in imaging, with an MRI only used when there is a reason to do so.
Treating a herniated disc: what are the options?
The word ‘herniated disc’ often causes a lot of anxiety, especially in people with back complaints. Fortunately, most herniated disc symptoms can be treated well conservatively (non-surgically).
Many people with a herniated disc benefit from treatment by a chiropractor. This looks at how the spine functions as a whole, with the aim of reducing pressure on the nerve and supporting recovery.
At the same time, it’s important to realize that this is not sufficient in all cases. Sometimes a herniated disc cannot be resolved conservatively and further medical evaluation is needed, for example by a neurologist or neurosurgeon.
During the examination, it is often possible to make a good assessment of whether conservative treatment is appropriate, or whether referral is advisable. In some cases, this only becomes clear as recovery progresses.
Surgery is usually only considered when there is:
- worsening nerve damage
- severe, unbearable pain
Make an appointment for herniated disc symptoms
Do you have symptoms that may indicate a herniated disc, or would you like an assessment to find out what’s going on?
You can book an appointment for a thorough examination and honest advice.
Questions? Feel free to get in touch via the contact form or call 0182 – 570124.
