Herniated disc: causes, symptoms, diagnosis and treatment

By Cristiano Antonino On Jun 16, 2023

A herniated disc is a very common condition that occurs when the nucleus pulposus leaks from the intervertebral space and compresses the spinal nerves

It is one of the most common causes of pain in the neck, back, arms (brachialgia) and legs (sciatica).

Intervertebral discs are in fact present on all stretches of the spinal column, from the cervical to the lumbar segment.

These tend to degenerate with age and rupture during heavy physical exertion.

There are various types of herniated discs, with different treatment indications.

Herniated disc: symptoms

The term herniated disc encompasses various pathological conditions affecting the intervertebral disc, which can become thinner and bulge (bulging), like a flat, crushed tyre, or rupture, causing its softer, jelly-like contents, the nucleus pulposus, to leak out (herniated disc).

The resulting pain varies, therefore, depending on the type of hernia, its volume, location (in the neck or back) and even age.

The most common symptom is undoubtedly pain in the spine radiating down the arm (brachialgia) in the case of a cervical hernia, or in the leg in the case of a lumbar hernia, so-called sciatica or cruralgia.

The pain may appear suddenly after excessive exertion, or progressively after a few hours or days, with the intensity increasing over time.

This may be associated with weakness, lack of strength, numbness and tingling and other symptoms due to irritation of the nerve roots.

In special cases, there may be interference with the functioning of the bladder, with difficulty urinating, or of the intestines.

These are urgent conditions where prompt treatment is needed.

What are the causes of a herniated disc?

Herniated discs are caused by several factors.

Over time, intervertebral discs tend to lose their water content and their constituent fibres, resulting in less resistance and flexibility.

This degenerative process, combined with the wear and tear of the other elements of the spinal column and the absence of adequate paravertebral muscles, can lead to rupture of the fibrous ring (annulus) and thus to herniation, even with minimal strain.

It is also possible for a healthy, not yet worn disc to rupture/fissure as a result of incorrect movement or over-exertion (often common in those who perform heavy tasks or work) or trauma to the spinal column.

Traumatic or violent causes that can lead to a herniated disc can be

intense sports activity (lifting weights)
carrying heavy materials
sudden or abrupt movements such as flexion-extension or excessive twisting of the trunk
falls on the back

Treating herniated discs

Herniated discs in particular tend to reabsorb naturally and reduce in size over time.

Therefore, pharmacological treatment is preferred, pending spontaneous resolution, and only as a last resort, surgical treatment.

In the case of muscle weakness, however, in the arms or legs, as well as in the case of difficulty urinating (bladder function), surgical treatment is recommended instead.

Spontaneous healing of the hernia is in fact a process that takes several weeks and is therefore not always possible to wait, especially if there is a risk of permanent neurological damage.

Some hernias also remain painful for several months despite conservative treatment, and therefore require surgery.

The surgical procedure normally guarantees the immediate disappearance of symptoms and, with modern microsurgical and endoscopy techniques, presents minimal risks.

The convalescence period is a few days, and once it is over, the patient can return to common daily activities.

The most common conservative treatments are oral medication, targeted infiltration procedures, and postural physiotherapy.

Preventing the occurrence of herniated discs involves a balanced diet and regular physical activity.

Maintaining good paravertebral muscles prevents the onset of this condition.

Herniated Disc: Definition, Symptoms, Diagnosis And Treatment

Discopathy: Definition, Symptoms, Diagnosis And Treatment

What Is Low Back Pain? An Overview Of Low Back Pain

Back Pain, What Are The Different Types

Back Pain: The Importance Of Postural Rehabilitation

Cervicalgia: Why Do We Have Neck Pain?

Cervical Hernia: Definition, Causes, Symptoms, Diagnosis, Treatment

Osteochondrosis: Definition, Causes, Symptoms, Diagnosis And Treatment