lumbar disc prolapse

A herniated disk is a condition that can occur anywhere along the spine, but most often occurs in the lower back. It is sometimes called a bulging, protruding, or ruptured disk. It is one of the most common causes of lower back pain, as well as leg pain or “sciatica.”

Between 60% and 80% of people will experience low back pain at some point their lives. Some of these people will have low back pain and leg pain caused by a herniated disk.Although a herniated disk can be very painful, most people feel much better with just a few weeks or months of nonsurgical treatment. 

Anatomy

Your spine is made up of 24 bones, called vertebrae, that are stacked on top of one another. These bones connect to create a canal that protects the spinal cord.

Five vertebrae make up the lower back. This area is called your lumbar spine.

Other parts of your spine include:

Spinal cord and nerves. These “electrical cables” travel through the spinal canal carrying messages between your brain and muscles. Nerve roots branch out from the spinal cord through openings in the vertebrae.

Intervertebral disks. In between your vertebrae are flexible intervertebral disks. These disks are flat and round, and about a half inch thick.

Intervertebral disks act as shock absorbers when you walk or run. They are made up of two components:

  • Annulus fibrosus. This is the tough, flexible outer ring of the disk.
  • Nucleus pulposus. This is the soft, jelly-like center of the disk.

Description

A disk begins to herniate when its jelly-like nucleus pushes against its outer ring due to wear and tear or a sudden injury. This pressure against the outer ring may cause lower back pain. 

If the pressure continues, the jelly-like nucleus may push all the way through disk’s outer ring or cause the ring to bulge. This puts pressure on the spinal cord and nearby nerve roots. In addition, the disk material releases chemical irritants that contribute to nerve inflammation. When a nerve root is irritated, there may be pain, numbness, and weakness in one or both of your legs, a condition called “sciatica.”

Cause

A herniated disk is most often the result of natural, age-related wear and tear on the spine. This process is called disk degeneration. In children and young adults, disks have high water content. As people age, the water content in the disks decreases and the disks become less flexible. The disks begin to shrink and the spaces between the vertebrae get narrower. This normal aging process makes the disks more prone to herniation.

A traumatic event, such as a fall, can also cause a herniated disk.

Risk Factors

Certain factors may increase your risk of a herniated disk. These include:

Gender. Men between the ages of 20 and 50 are most likely to have a herniated disk.

Improper lifting. Using your back muscles instead of your legs to lift heavy objects can cause a herniated disk. Twisting while you lift can also make your back vulnerable. Lifting with your legs, not your back, may protect your spine.

Weight. Being overweight puts added stress on the disks in your lower back.

Repetitive activities that strain your spine. Many jobs are physically demanding. Some require constant lifting, pulling, bending, or twisting. Using safe lifting and movement techniques can help protect your back.

Frequent driving. Staying seated for long periods, plus the vibration from the car engine, can put pressure on your spine and disks.

Sedentary lifestyle. Regular exercise is important in preventing many medical conditions, including a herniated disk.

Smoking. It is believed that smoking lessens the oxygen supply to the disk and causes more rapid degeneration.

Symptoms

In most cases, low back pain is the first symptom of a herniated disk. This pain may last for a few days, then improve. Other symptoms may include:

  • Sciatica. This is a sharp, often shooting pain that extends from the buttock down the back of one leg. It is caused by pressure on the spinal nerve.
  • Numbness or a tingling sensation in the leg and/or foot
  • Weakness in the leg and/or foot
  • Loss of bladder or bowel control. This is extremely rare and may indicate a more serious problem called cauda equina syndrome. This condition is caused by the spinal nerve roots being compressed. It  requires immediate medical attention.
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