The spine is composed of a series of vertebrae that are separated by thick, gel-filled discs. These discs are responsible for connecting the vertebrae as well as for providing cushioning between them. As the spine moves (extends and flexes), the gel inside each of these discs moves to provide fluid motion and support. A herniated disc occurs when a disc bulges (extreme displacement of the gel) or ruptures (a tear in the outer layer of the disc causing protrusion of the gel). This can be caused by degeneration of the disc (a result of aging or repetitive trauma) and/or as the result of a single traumatic event.
This type of back injury may result in a variety of symptoms depending on the location and severity of the injury. If the herniated disc is not pressing upon a nerve, the injured person may experience a mild backache or no symptoms at all. If the herniation is in fact compressing a nerve (as pictured above), there may be pain or numbness in the area to which the nerve travels. For example, if the herniation occurs in the cervical spine (around the neck) the injured person may experience pain or numbness in the arms or shoulders. If the herniation occurs in the lumbar spine (lower back), the individual may feel pain or numbness in the legs.
A diagnosis of a herniated disc occurs through the combination of a review of an individual’s medical history and a physical assessment including an examination of gait, nerve innervation, range of motion, pain, numbness, and ligament tenderness. This method is most often all that is required to diagnose a herniated disc. However, if the prescribed treatment appears to be ineffective, an MRI (magnetic resonance imaging) may be suggested. Approximately 80% of all patients diagnosed with a herniated disc are able to recover without surgery. The primary non-surgical treatment option is exercise therapy focusing on core strength. Aquatic therapy can ease movements with buoyancy and allow for ideal posture when developing spinal stability strength. A massage therapist may be able to alleviate symptoms through stretching, exercise, manual therapy, and modalities such as heat, and ice.