What is a Herniated disc?
Commonly referred to as a slipped disc, ruptured disc or pinched nerve, a herniated disc
will cause severe pain in the lower back and in approximately 80 percent of patients, disc surgery
is usually not necessary.
Other common names for herniation of a disc are; ruptured disc, torn disc or bulging
Herniation of a disc occurs when the inner core (Nucleus Pulpous), gets squeezed out
through the ligaments in the outer layer of the disc (Annulus Fibrosus). The resulting tear
will cause back pain and if the bulging disc itself exerts pressure on a spinal nerve then pain may
be felt in any part of the body served by that nerve.
Equally, there's a pairs of spinal nerves in between each vertebrae of the spine which are
linked to different parts of the body (Nerve Root). Therefore, not only will a slipped disc cause
pain in the lower back but it can also affect other areas too.
Fig1. Diagram of an un-injured disc, vertebra and spinal
Fig2. A herniated disc. The necleus pulposus
pinching a nerve root.
Studies show that most people get a ruptured disc in the morning and although
this is not yet clearly understood it is likely due to changes that happen within the spine
throughout the day, and a regime of simple stretching before getting up may reduce the
likelihood of a slipped disc occurring.
Most people suffer a herniated disc in the same two discs of the lower
back. These are the discs between the fourth and fifth lumbar vertebra and those between the
fifth lumbar and the first sacral vertebra. Of course it
possible for a ruptured disc to occur anywhere within the spine, but these are the most painful and
Symptoms of a Herniated Disc
The pain from a slipped disc is normally felt as a sharp pain down the affected leg served
by the spinal nerve that is under pressure from the ruptured disc. Often the first sign is a
snapping or tearing sensation, along with sudden back pain, although the patient may have a history
of back or leg pain.
It is important to remember that a slipped disc is different from disc pain, where the
disc itself causes the back pain in a localised area. This is referred to as Degenerative disc
Treatment of back pain caused by a herniated
It is here that a diagnosis of the root cause of the back pain, neck pain or leg pain is
vital to correctly ascertain which course of action is required for the patient. This is
particularly important if disc surgery is being considered. For example the cause of the back pain
may have been triggered by a sports injury and may only be a soft tissue or muscle strain and not a
ruptured or slipped disc.
Procedures such as a CT Scan, MRI Scan or Discogram along with a physical examination of
nerve function in different areas of the arms or legs, muscle strength and pain in certain
positions, are all tools available to decide if disc surgery is
Surgery to the spine will only be considered if normal treatments such as chiropractic
care, pain medications, injections, physical therapy and exercise regimes have not provided
adequate pain relief. Spinal surgery will only provide relief of back pain if the herniated disc or
degenerative disc as shown by the MRI scan is the cause of the pain.
The most common surgical procedures are:
• Microdiscectomy – when
a portion of the herniated disc that is pressing on the nerve is removed.
• Spinal fusion – when the disc space in between two vertebrae is fused into one solid long