What is a disc herniation?

/ Embody Health Centre/

The bones (vertebral bodies) that form our spine, are cushioned by intervertebral discs between each segment of bone. A herniated disc occurs when the nucleus pulposus (gel-like center of the intervertebral disc) is displaced from the intervertebral space (the space between 2 vertebral bodies).

Imagine biting into a jelly donut, and the jelly in the center pushes out the back. With a herniated disc, generally patients will remember a specific motion that caused their pain, such as bending forward to grab an item off the ground, or twisting. Typically a herniated disc is preceded by an episode of low back pain, or a chronic history of pain.

Herniated disc pain can be often described as sharp, burning or stinging, and may radiate into the leg. In severe cases, it can be associated with weakness or sensation changes due to compression on the nerve or spinal cord.

Disc herniations are most common in people between 30-50, and commonly affects the lower lumbar spine (L4/5, L5/S1 discs). Herniated discs are diagnosed on an MRI.

Risk factors for developing a disc herniation are:

  • Repetitive mechanical activities, such as twisting, bending (especially without taking breaks)

  • Sedentary lifestyle

  • Obesity

  • Tobacco use

  • Poor posture

Signs and symptoms of a herniated disc:

  • Intense low back pain, can be described as sharp, burning or stinging

  • Pain may radiate into the leg

  • Pain with coughing, sneezing and/or straining

  • Tingling sensation, weakness or muscle atrophy may occur

  • Pain may increase with sitting, standing, or walking

  • Generally one side (left or right) is affected

Disc herniation should be treated conservatively first, usually with an interprofessional team such as Physiotherapy, Massage Therapy, Chiropractic and/or Osteopathy. If there is severe neurological involvement, it is important to see a Doctor.

Physiotherapy plays a vital role in recovery from a herniated disc, focusing on pain control modalities such as TENs or IFC, heat, acupuncture, traction, soft tissue work, education and exercises. Exercises will focus on stretching, aerobic activity, and strengthening exercises, especially focusing on core stabilization, gluteal, pelvic floor, and paraspinal strengthening. Manual therapy techniques can also help to aid in pain relief, and improve mobility.

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