A Herniated disk. You heard someone talk about it. Do you have it? What is it? How serious is it? Each year, around 2% of the population will get a herniated disk. Herniated disks are one of the leading causes of back and/or leg pain also known as sciatica.
What Is A Herniated Disk?
The term ‘herniated disk’ refers to a problem with one of the rubbery cushions (disks) that are between the vertebrae (bones) that make up your spine. A herniated disk can happen anywhere along the spine, but typically they occur in the lower back or neck - rarely do they occur in the middle of the back.
Our spines consist of 24 bones (vertebrae) that have little shock absorbers between them called disks which allow us to move and bend. These disks are made up of a soft, jelly-like middle, called a nucleus which is covered by a tougher outside, called the annulus. A herniated disk (often referred to as a ‘slipped disk’) happens when the annulus gets torn and some of that jelly nucleus starts to squeeze out. While most people don’t experience any symptoms, the herniated disk can irritate the spinal nerves causing pain, weakness, or numbness.
Signs Of A Herniated Disk
Although herniated disks can happen anywhere along your spine they tend to be concentrated in the lower part of the spine, just above your hips. This is what can cause people to experience lower back pain but the pain can also spread from your back to your buttocks, thighs, and even calves. It usually affects one side of the body and not both.
Some Signs Of A Herniated Disk
When the nerves of affected muscles are interfered with, those muscles can experience some weakness. This weakness can cause problems with your ability to walk properly, lift certain things, or hold heavier items.
People with herniated disks often report a tingling or numbness that radiates throughout the muscles of their legs and/or backs.
Lower back herniated disks often cause pain in the glutes, thighs, and calf muscles. It might even extend as far as your feet. People often talk about feeling a burning, shooting pain that gets worse when they are active or when they cough or sneeze. Sitting can also make the pain feel worse because certain positions can put extra pressure on that pinched nerve.
What Causes A Herniated Disk?
Like most low back pain issues, finding the cause of a herniated disk can be very challenging. Quite often disk herniation can be caused by the gradual wear and tear of our disks over time. This is known as disk degeneration. As our disks get worn down they lose some of their flexibility making them more prone to injury with even simple movements like a twist here or a strain there. Occasionally it is easy to pinpoint the cause if there has been a traumatic event like a big fall, but sometimes just using the wrong muscles to pick up something heavy can do it.
How Is A Herniated Disk Diagnosed?
When it comes to low back pain, most people immediately think of having an x-ray or an MRI to see what is wrong and how to fix it. Unfortunately imaging is generally fairly useless when it comes to diagnosing herniated disks, or any low back pain issue for that matter. The best way to tell if you have a herniated disk is to make an appointment with your primary care doctor. Your healthcare provider can do a physical exam, checking for areas that are painful.
If you lie on your back and do certain leg lifts it can be quite easy for a doctor to tell if you have a herniated disk or not, depending on where, and how intensely you experience pain. They will be looking at your reflexes, muscle strength and the sensations you are experiencing. This physical exam is really the only test you need to confirm a diagnosis.
Effectiveness of MRIs In Diagnosing Herniated Disks
Many people still feel like it is important to get an MRI to confirm a diagnosis of a herniated disk. Interestingly enough research seems to show that MRIs are often not very helpful in making this diagnosis. In 2018 a study was published in the Journal Of Chiropractic And Manual Therapies that looked at the accuracy of diagnostic imaging for herniated disks and sciatica.
The researchers looked at 14 clinical studies on almost 1000 patients and found “moderate diagnostic accuracy for all CT, myelography and MRI, indicating a large proportion of false positives and negatives”. All but one study was conducted after 1995 but the authors did note that they could find “no studies evaluating today’s more advanced imaging techniques”.
Risk Factors For Developing A Herniated Disk
While it can be hard to know how to avoid having a herniated disk when the causes are not super clear there are certain risk factors that can increase your risk of getting one. Some of the risk factors associated with a herniated disk are:
Age (age can cause wear and tear on your disks)
Weight (Excess weight can cause stress on your disks)
Occupation (Physically demanding jobs are more likely to result in back issues)
Smoking (Smoking decreases the supply of oxygen to the disks causing them to break down faster)
Genetics (Some people have a family history of disk degeneration)
Home Remedies For Herniated Disks
Like with most low back pain issues, herniated disks will often go away by themselves over time. There are some things that you can do at home to help speed up your recovery process:
Avoid Bed Rest
Taking things easy is definitely recommended but prolonged bed rest is not. International guidelines for managing low back pain suggest that gentle and moderate exercise is important for maintaining mobility and helping to reduce stiffness.
Heat And Ice Packs
Heat and ice packs can help reduce swelling and inflammation and relieve pain.
Over The Counter Medications
Medications like ibuprofen and acetaminophen can be helpful in the initial stages as they have anti-inflammatory properties as well as help to relieve pain. These medications do not help with recovery though and should be taken sparingly as they have their own set of contra-indications and side effects.
Finding a cause for low back pain can be about as difficult as getting season tickets for your favorite sports team. Everyone thinks they can help you but in the end you find yourself watching the games from the comfort of your own couch. There are so many opinions on how to treat low back pain. So many terms that people sometimes use incorrectly.
At the end of the day, listening to the international guidelines on the best treatments to follow, getting checked out by your primary care doctor, and giving your body time to heal are the best ways to manage low back pain and herniated disks. A herniated disk still sounds super scary, but the management is pretty much the same as with most low back conditions.