Sometimes simply resting can provide relief to a herniated disc.
A herniated disc, also called a ruptured or slipped disc, can cause pain in the lower back, neck, arms, legs or buttocks. Discs in the spine are composed of thick rings of hard cartilage (annulus) with soft gel-like material (nucleus) inside. The soft gel can rupture, or herniate, in the lower back, also known as the lumbar region between the bottom of the ribs and the hips. This rupture can penetrate the cartilage of the annulus through a tear and protrude or cause a bulge, thus producing a herniated disc. The irritated nerves of a herniated disc result in pain, numbness or weakness in the back, legs or arms.
The gel or nucleus in the discs can rupture due to age and gradual wear and tear on the spine. Over time, the spine loses some of its water content, making it less flexible. According to the Mayo Clinic, herniated discs commonly occur in people ages 35 to 45 due to degeneration of the discs. Trauma to the back, such as a fall or a blow to the back, can cause a rupture. Simple twisting or straining the back can also cause a herniated disc. People in physically demanding occupations that require a lot of lifting, pulling, pushing or bending, as well as prolonged sitting or standing, are at risk.
Other factors that make people at risk for herniated discs are an active lifestyle that puts pressure on the back; smoking, which decreases oxygen levels in the blood and nutrients in the tissues; obesity; and being tall.
Some simple positions and precautions can alleviate the pain of a herniated disc. Rest and a sedentary lifestyle for a few weeks help. Those who have to sit for long periods of time may want to change positions, shift their weight and stand and walk around. Another tip to alleviate pain is to hold the body up with the hands while sitting.
Chiropractic stretching of the spine helps minimize pain. Physical therapy exercises and positions help to strengthen and stabilize back muscles. A physical therapist may also apply heat, ice, traction, ultrasound and electrical stimulation to reduce pain.
Herniated discs can often get better without the need for surgery. Cold packs, compresses and ice can relieve pain and inflammation. After cold treatment has reduced spasms, gentle heat applications can provide additional comfort.
Over-the-counter pain relievers, such as aspirin, ibuprofen (Advil, Motrin), acetaminophen (Tylenol) and naproxen (Aleve), can ease mild to moderate pain. Physicians may prescribe muscle relaxers (Valium) or cyclobenzaprine (Flexeril) to relieve spasms in the back or legs. Side effects of prescriptions may include dizziness and sedation. Non-steroid anti-inflammatory medication (NSAID) are effective pain killers but may also cause gastrointestinal disorders.
Bed rest for up to two days can help with pain, but may hinder recovery due to loss of muscle tone. Most herniated discs simply need time, from four to six weeks, to improve.
Surgery may be necessary when physical therapy or pain medications are not successful, or when a disc fragment lodges in the spinal canal and presses on a nerve causing loss of function in the legs or back. When a patient loses quality of life, loses normal bowel and bladder functions, cannot perform normal daily activities or has weakness or numbness in the legs, he is a good candidate for spinal surgery. According a Johns Hopkins White Paper reported by the American Spinal Decompression Association, less than 5 percent of people with back pain are good candidates for surgery.
A common surgery for herniated discs is microdiscectomy, in which small incisions are made in the skin, muscles, tissues and bones around the herniated disc to reduce pressure on the nerves.
Other surgical options include a full discectomy, which removes the disc entirely and sometimes replaces it with a manufactured disc; laminectomy, which removes the lamina, or bony arch, of a vertebra; laminotomy, in which an opening is made in the lamina to relieve pressure on the spinal cord and nerves; and spinal fusion, in which bone is grafted onto the spine to provide support.
Common sense with daily activities can help prevent herniated discs. The American Association of Neurological Surgeons recommends doing crunches and abdominal strengthening exercises to improve spine stability; squatting with the legs, not bending with the back, while picking up heavy objects; maintaining good posture when sitting for long periods of time; avoiding stress; quitting smoking; and maintaining a healthy weight.