Disc herniations can lead to a variety of symptoms, depending on their location. They are most common in individuals between the ages of 30 and 50 years old. 1 In this guide, we will discuss the basics of herniated discs, including symptoms, causes, diagnostics, physical therapy treatment, and prevention.
Table of ContentsDisc herniation is only a concern when it compresses a local nerve, causing symptoms. In fact, MRIs will often show asymptomatic disc herniations. 2 Conservative treatment is the recommended first step when any symptoms occur.
The discs in our spine act as cushions between the vertebrae. They are filled with a jelly-like substance called the nucleus pulposus.
A herniated disc occurs when the outer layer of the disc, called the annulus fibrosus, becomes compromised and causes the nucleus pulposus to be displaced. This can occur anywhere in the spine — there are 23 discs between the vertebrae. The most common site of disc herniation is the lumbar spine (low back), followed by the cervical spine (neck). 2
There are four stages of disc herniation: bulging, protrusion, extrusion, and sequestration. A disc herniation can gradually progress from one stage to the next or hit one stage suddenly due to trauma or sudden tissue give.
A herniated disc is a blanket term for the degeneration of the disc that causes the jelly-like center to change shape. A bulging disc specifically refers to the first stage, or mildest version of disc herniation — when the center bulges out, but the outer layer is still intact.
Why is disc herniation most common between 30 and 50 years of age? This is because the discs naturally lose moisture and extensibility with each decade after 30. However, once there has been significant water loss in the discs past the age of 50, then the risk of herniation drops since there is no longer substantial disc to bulge or leak.
Beyond the age of 65, the bigger concerns in the spine now involve issues like bone spurs, narrowing of the nerve root and spinal canal space, and other age-related degenerative changes that can potentially lead to pain. 1
Symptoms of a Herniated DiscThe symptoms of a herniated disc will vary depending on the location of the injury and the severity of the disc damage. Most often, herniated discs do no produce any symptoms and will heal on their own. 1
When symptoms are present, the most common symptom is pain, which can range from sharp to dull and achy. The pain may be localized to the area of the herniation or radiate down an arm or leg.
Other symptoms may include:
If you experience any of these symptoms, it is important to see a physician or spine specialist to rule out other potential causes of your pain .
In particular, if you experience "red flag" symptoms like sudden changes in bowel or bladder control, new numbness in the saddle area (where you'd sit on a bike seat), or sudden sexual dysfunction, these are all signs of cauda equina and you should seek medical care immediately.
Causes of Disc HerniationThere are a variety of causes of disc herniation. Most often, it is due to initial degenerative changes that occur around age 40. 2 Other potential causes include:
If you are experiencing any of the symptoms listed above, your doctor might order an MRI to confirm the diagnosis — particularly if symptoms are severe and other spine conditions need to be ruled out. While this information can be helpful and guide treatment, an MRI can also show changes in the spine that are not causing any pain or other symptoms, thus leading to unnecessary concern.
What's most important with recovery from a herniated disc is diagnosing your current functional deficits. This is why a CityPT physical therapy examination is most beneficial. First, we will discuss your medical history, symptoms, lifestyle, and biggest concerns. Then, during a telemedicine or in-person consultation, will look at factors like strength, flexibility, coordination, mobility, and more.
What to Expect from Physical Therapy for the SpineThe goal of physical therapy is to help you decrease pain, improve function, and prevent re-injury for long term results. Depending on your symptoms, this might look different for everyone.
Common treatments might include:
Most people with a herniated disc recover without surgery within a few weeks to months, especially with the initiation of motor control training. 3 However, if you have severe neurological symptoms (such as weakness, tingling, and radiating pain) and do not respond to conservative care, you might be a candidate for surgery. You can discuss options with your physical therapist and surgeon.
How to Prevent Disc HerniationThere are a few things you can do to help prevent disc herniation:
If you are currently dealing with a herniated disc, or think you might have one, don't hesitate to seek professional help. A CityPT physical therapist will be your best asset to get you on a path to recovery. Many people are afraid of a disc herniation diagnosis, but there's no need to feel hopeless — we understand your pain and condition, and we can help.
Get in touch with one of our CityPT spine experts to start your recovery process.
This guide is intended for informational purposes only. We are not providing legal or medical advice and this guide does not create a provider-patient relationship. Do not rely upon this guide (or any guide) for medical information. Always seek the help of a qualified medical professional who has assessed you and understands your condition.
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