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Most (80-90%) patients with a new or recent acute disc herniation will improve with surgery.
*Source: North American Spine Society

Ruptured Disc Overview

Ruptured disk is also known as herniated disk, slipped disk, bulging disk, or prolapsed disk. The spine is made up vertebrae, which are separated by soft spinal disks that cushion the vertebrae, permit flexibility and absorb shocks to the spine. The disks have a hard casing and a gel-like center. The front area of each vertebra is known as the vertebral body.


In the case of ruptured disk, one of the disks is bulging beyond the edges of the vertebral bodies above and below it. The gel material leaks, irritating nearby nerves. This can cause intermittent or continuous low back pain or sciatica, in which pain typically radiates into the leg and down to the foot. Although the lower back (lumbar area) is typically involved, ruptured disk can sometimes affect the cervical disks of the neck


Slipped disks are often the result of age and wear and tear on the body. The spinal disks become less elastic over the years and can become brittle and cracked.


There are three types of disk ruptures.


  • Prolapse—the disk is bulging out between the vertebrae, but its outer layer is still in tact.
  • Extrusion—there is a tear in the outer layer of the spinal disk, causing disk tissue to leak. The leaking tissue remains connected to the disk.
  • Sequestration—leaked spinal disk tissue has entered the spinal canal and is no longer directly attached to the disk.

WellStar neurologists and neurosurgeons are experts at diagnosing and treatment ruptured disks. Because many conditions can cause back pain, it’s important to visit your physician so that he or she can analyze your specific symptoms and determine whether you have a herniated disk or disks.


Most patients experience a significant improvement after several weeks. During that time nonsurgical treatment can help relieve symptoms.


Symptoms

Once the nucleus of the disk breaks (herniates) through the outer ring, lower back pain may improve. But sciatic leg pain is likely to increase. That’s because the leaking gel inflames the spinal nerves and may put pressure on them.


In addition to back and leg pain, other symptoms of a ruptured disk can include:


  • Numbness or tingling sensation in the leg and/or foot
  • Weakness in the leg and/or foot
  • Spasm of the lower back muscles
  • Decrease in knee or ankle reflexes
  • Pain may worsen after standing or sitting; at night; when sneezing, coughing or laughing; and when bending backward or walking more than a few yards

In rare cases patients will experience a loss of bladder or bowel control. This may indicate a more serious condition known as cauda equina syndrome, which requires immediate medical attention. It occurs when the spinal nerve roots are compressed.


In some cases a herniated disk is not pressing on a nerve, it may cause only low level of back pain, or no pain at all. May not need medical attention or evaluation, just the patient’s vigilance.


Risk Factors

One of the primary risk factors for herniated disk is aging—the effects of wear and tear on the spine over time. There are other more controllable risk factors that influence your chance of having this condition.


  • Being a man. Men between age 30 and 50 are most likely to experience a disk rupture.
  • Improper lifting. It is possible to rupture a disk by using the back muscles to lift heavy objects rather than the legs.
  • Other occupational tasks. Heavy exertion, twisting and turning, lifting or pulling heavy objects or repetitive activities that strain the spine can contribute to disk rupture.
  • Weight. Being overweight puts extra stress on the disks of the lower back.
  • Nutrition. Inadequate nutrition can contribute to poor disk health.
  • Frequent or excessive driving. Sitting for long periods of time is hard on the spine and disks. Drivers have the additional hazard of vibration from the vehicle engine.
  • Sedentary habits. Living a sedentary lifestyle weakens the muscles and increases body weight and reduces circulation. All these factors can contribute to disk degeneration.
  • Poor posture. Poor posture and bad body mechanics can put additional stress on the spine.
  • Smoking. Tobacco use can reduce the ability of the disks to absorb needed nutrients and may increase sensitivity to pain.