What is a herniated disc?

In general, disk herniations represent a spilling away, if you will, of the innermost contents of the spinal disk, the term called the nucleus pulposus. The spinal disk or the disk that are located between the vertebrae, both from the cervical spine through the lumbar spine are made up of an inner nucleus pulposus which is a gelatinous material surrounded by a membrane which is further encompassed by the annulus fibrosus which is a fibrinous network of tissue meant to contain the nucleus pulposus and the combination of those two structures are determined to be the spinal disk. Secondary to trauma in general or repetitive injury to the disk injuring the nucleus fibrosis can cause a leaking of the nucleus pulposus which in those cases can impact the spinal nerve or the entire orientation of vertebrae to vertebrae causing significant back pain and debility.

Discs are small cushions that separate the bony spinal vertebrae. You might think of your discs as being like small shock absorbers for the spine. Wear and tear on a disc can cause it to become ruptured (or herniated), resulting in a gradual or sudden break in the supportive ligaments surrounding one of discs in the neck or lower spine, especially between the fourth and fifth lumbar vertebrae. A disc might become herniated because of a sudden injury or constant stress, such as obesity or improper lifting. The risk of having a ruptured disc increases with constantly lifting heavy objects or having poor fitness. Once the disc ruptures or herniates, the disc material causes inflammation, pressure on the spinal nerves and can result in tremendous pain.

A herniated disc is a condition where one of the rubbery cushions that act as shock absorbers in between the individual bones (vertebrae) in your spine fails. These discs are like a jelly donut, where the center of the disc is filled of a gelatinous/jelly like substance with a tough exterior composed of numerous little rings. Sometimes called a slipped disc or a ruptured disc, a herniated disc occurs when some of the softer "jelly" pushes out through a crack in the tougher exterior rings.

Symptoms of a herniated disc include pain, tingling and numbness, weakness in the arm or leg, and even no symptoms in some individuals. Most people that have a herniated disc do not require surgery. Most herniated discs occur in the neck (cervical spine) and the low back (lumbar spine). 

Chiropractic treatment has been shown effective and successful in treating herniated disc problems and symptoms. It is hard to pinpoint the exact cause of a herniated disc, usually from repetitive trauma i.e. improper bending, improper lifting techniques, traumatic events, twisting and turning while lifting, etc.

Your Chiropractor should educate you on your spinal health and how to help protect your spine while lifting, bending over, getting in and out of a car properly, etc. This will help protect your spine and the chances of a herniated disc from improper biomechanics that you are doing every day. 

Your spine is made up of 24 bony vertebrae, and in between each of them is a disc. The discs perform 3 functions:

1. They act as ligaments, by holding the vertebrae and spine together.
2. They act as shock-absorbers, by carrying the downward weight (axial load) of your body while you're upright.
3. They act as pivot points, allowing the spine to bend, flex and rotate.

The disc itself is designed like a jelly danish. The outer rim (annulus) is tough and fibrous, while the   "jelly" center (nucleus pulposis) is about the consistency of toothpaste. It's when the nucleus starts to protrude through the layers of the annulus that problems start.

When a damaged disc bulges outward, the "bubble" can compress or irritate spinal nerve roots, which can cause the numbness, radiation pain, weakness and tingling associated with disc injury. This most commonly happens in the cervical or lumbar spine.

Disc injuries are quite common, and may be caused by attempting to lift a heavy object, spending time in a bent-forward position or from traumatic events. They may also occur during seemingly benign activities like sneezing or tying one's shoes. Injuries that occur during these "harmless" activities are usually the result of a gradual weakening of the disc over time.

The good news is, many disc injuries (even severe ones) can be dramatically improved without surgery. While a damaged disc may never actually return to its original, healthy state, a good rehab program can often get you back to your normal, everyday activities without pain.

A physical rehab program works by rebuilding the muscular support system around the damaged joint, training it to take over the job of the disc. Functional rehabilitation, McKenzie exercises, core stabilization, joint mobilization and flexibility training can all help make your disc injury a non-issue. And once the acute pain is gone, a regular program of core conditioning can help minimize recurrences.

For those disc herniations that don't respond to conservative care like PT and chiropractic, a series of epidural steroid injections or even surgery may be the best option. And even if you do end up requiring surgery, maintaining a regular spinal exercise program will be crucial for helping you maintain a healthy back.

A herniated disk is also called a slipped or bulging disk or a pinched nerve. The disks are oval-shaped structures that sit between the vertebrae. They have a gel-like center and three tougher outer layers. Some people think of the disks like jelly doughnuts, where the center is the jelly and outer part is the dough. In this injury, some of the disk center pushes into the outer layers. It may even push all the way out of these layers. When this happens, the center gel can press on the nerves that branch off the spinal cord.

(This answer provided for NATA by the University of Alabama Athletic Training Education Program.)

The bones that form your spine are cushioned by small discs that act as shock absorbers and keep the spine flexible. When a disc is damaged, it may bulge or break open. This is called a herniated disc, slipped disc, or ruptured disc. It may push on the nerves and cause pain, numbness, or weakness in the area where that nerve travels. Most herniated discs happen in the lower back.