A herniated disc occurs when a tear in the outer ring of an intervertebral disc allows the soft, central portion to bulge out. It is most often caused by trauma, lifting injuries or general wear and tear. The tear in the ring may also cause inflammatory chemical mediators to be released, causing severe pain.
Symptoms of a herniated disc can range widely, from little or no pain (if only the disc is injured) to severe, relentless pain in the neck and arms for cervical discs or lower back and leg pain for lumbar herniation causing nerves that become irritated or pinched by the herniated tissue. Other symptoms may include pain in the thighs, knees or feet; numbness or tingling; muscular weakness and even paralysis.
Treatment In most cases, a herniated or ruptured disc does not require surgery. Initial treatment usually involves non-steroidal anti-inflammatory pain drugs (NSAIDs), which are not recommended for long-term use. Another option is injecting cortisone into the spine near the suspected source of pain. In addition to these anti-inflammatory approaches, physical therapy, anti-depressants and graduated exercise programs can also be useful.
Surgery is typically considered as a last resort, or if the patient has a significant neurological loss.