Definition
A herniated (slipped) disk occurs when all or part of a spinal disk is forced through a weakened part of the disk. This places pressure on nearby nerves.
See also: Low back pain
Alternative Names
Lumbar radiculopathy; Cervical radiculopathy; Herniated intervertebral disk; Prolapsed intervertebral disk; Slipped disk; Ruptured disk; Herniated nucleus pulposus
Causes, incidence, and risk factors
The bones (vertebrae) of the spinal column run down the back, connecting the skull to the pelvis. These bones protect nerves that come out of the brain and travel down your back, forming the spinal cord. Nerve roots are large nerves that branch out from the spinal cord and leave your spinal column between each vertebrae.
- The spinal vertebrae are separated by disks filled with a soft, gelatinous substance. These disks cushion the spinal column and space between your vertebrae.
- These disks may herniate (move out of place) or rupture from trauma or strain. When this happens, the spinal nerves may become compressed, resulting in pain, numbness, or weakness.
- The lower back (lumbar area) of the spine is the most common area for a slipped disk. The cervical (neck) disks are affected 8% of the time. The upper-to-mid-back (thoracic) disks are rarely involved.
Radiculopathy refers to any disease that affects the spinal nerve roots. A herniated disk is one cause of radiculopathy (sciatica).
Disk herniation occurs more frequently in middle-aged and older men, especially those involved in strenuous physical activity. Other risk factors include any conditions present at birth (congenital) that affect the size of the lumbar spinal canal.
Symptoms
Low back or neck pain can vary widely. It may feel like a mild tingling, dull ache, or a burning or pulsating sensation. In some cases, the pain is severe enough that you are unable to move. You may also have numbness.
The pain most often occurs on one side of the body.
- With a lumbar (lower back) herniated disk, you may have sharp pain in one part of the leg, hip, or buttocks and numbness in other parts. You may also feel the sensations on the back of the calf or sole of the foot. The affected leg may feel weak.
- With a cervical (neck) disk herniation, you may have pain when moving your neck, deep pain near or over the shoulder blade, or pain that radiates to the upper arm, forearm, or (rarely) fingers.
The pain often starts slowly. It may get worse:
- After standing or sitting
- At night
- When sneezing, coughing, or laughing
- When bending backwards or walking more than a few yards, especially if it is caused by spinal stenosis
You may also have weakness in certain muscles. Sometimes, you may not notice it until your doctor examines you. In other cases, you will notice that you have a hard time lifting your leg or arm, standing on your toes on one side, squeezing tightly with one of your hands, or other problems.
The pain, numbness, or weakness often will go away or improve a lot over a period of weeks to months.
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