What is a Herniated Disc?
Spinal Discs
Let’s start with what a spinal disc is in the first place. A spinal disc is a piece of soft tissue that sits between the vertebrae in your spine. A lot of people compare spinal discs to jelly doughnuts. They have a firm outer layer and a softer inner filling. They act as shock absorbers when you do things like walk or run, and they aid in spinal mobility, similar to what cartilage does in other joints. Given the importance of things like walking and running, these discs play a pretty important part in helping us get around, though most people may not even know this until they injure or damage one.
Spinal Disc Herniation
A herniated disc, also known as a bulging disc, occurs when the soft inner part of a spinal disc starts pushing through the outside wall of the disc, distending it or even rupturing the disc wall in severe cases. Since the spine is a focus point for nerves running throughout the body, a disc that extends too far can come into contact with these nerves, causing pain, numbness and tingling around the spine as well as in proximity to where the nerves run. For instance, if a disc comes into contact with a nerve that runs to the leg, the individual with such an injury may feel discomfort in the leg as well, a phenomenon known as referred pain.
Typically people herniate their discs with some sort of physical activity. For me, it was while performing bent over rows in the gym. I felt a small pop in my back with minor discomfort, but otherwise didn’t notice anything out of the ordinary. I continued my workout that day, but the next day I was in a considerable amount of pain. In my case, bending over made my spine vulnerable and the added weight was the exacerbating factor that caused my disc to bulge. Any time you are bent over, or your back is twisted, your spine is vulnerable to injury. When you are in such a physical position, you should avoid adding weight or pressure to your back. Picking up heavy objects is the obvious example, but people have also herniated their discs from sneezing as well!
What Causes a Disc Herniation?
There are a few things that can contribute to a herniated disc.
Age
Typically as we get older, our soft tissue begins to deteriorate. Creaky or aching joints become more common. The wear and tear our bodies experience begins to offset the natural healing process. Over time, our spinal discs may affected in a similar way. They can begin to dehydrate, shrinking them and making them weaker and more prone to injury. Although aging is a natural part of life, suffering from a herniated disc doesn’t have to be. Staying active and healthy can slow down the worst effects of the aging process and help prevent a herniated disc in the first place. If you do experience a disc herniation and age might be a contributing factor, then it is doubly important to keep yourself in shape.
Weight
Those who are overweight are also more prone to disc herniations. The excess body weight adds torque to our natural movements. Oftentimes, disc herniations occur when we bend forward, since this can put pressure on our discs and ‘squeeze’ them out the back of our spines. If you compare someone with a normal body weight vs someone with an extra 10 kgs/ 20 lbs around the midsection, then the person with some extra weight in the torso will be adding that weight to the pressure on their spinal discs when they bend over. If 20 lbs doesn’t seem like much, go pick up a 20 lb barbell the next time you go to the gym. Now imagine that amount of weight compressing or pressuring a piece of soft tissue that is around the same diameter as a golf ball with the thickness of four stacked quarters. A healthy lifestyle will not only alleviate the symptoms of a herniated disc but it can also help you reduce excess body weight. Those who are overweight will very much benefit from the advice and articles on this blog.
Work/Physical Activities
Those with jobs that are physically demanding are at high risk for spinal disc injuries. If you work a job where you are picking up and moving heavy items day in and day out, then the wear and tear on your spinal discs in conjunction with the kinds of movements you perform can easily cause you to injure yourself and your back. For example, it is common knowledge that when lifting heavy objects, you should lift with your legs rather than your back. However, if you are performing heavy lifting during the day, you may tire yourself out and start using your back muscles when picking something up. If you are carrying this object around while also navigating a construction site or going up and down stairs, then you may also end up having to move awkwardly, turning or twisting to avoid objects and obstacles. Bending over while having your back twisted is a very common way for people to herniate discs. While you may be in shape from working a physically demanding job, there may be other things that you can do to avoid lower back pain or manage it if you already have it. There are a variety of stretching and mobility exercises that can help you tune your body. Likewise, you might benefit from some time in the pool or inversion therapy. However, the most important thing will be undertaking lifestyle changes to avoid or manage herniated discs or lower back pain. Start thinking about climbing the job ladder to the point where other people are doing the heavy lifting, or transitioning to an occupation where you can do less physically demanding tasks.
Genetics
Some people just draw the short straw when it comes to inheriting traits from their parents. This was the case for myself, though the physical activities I undertook also contributed. I was born with a small defect in my lower back where the vertebrate did not completely fuse together. This in conjunction with my weight lifting caused me to herniate my L5S1 spinal disc. If you happen to suffer from the genetic factors that contribute to lower back pain or spinal disc herniation, don’t get too down on yourself. Just know that you have an extra factor to consider when working, working out or going about your day to day activities. Focus on building a strong core to help keep your spine strong and stable, and work on flexibility and mobility to keep yourself out of pain.
Symptoms of a Herniated Disc
First signs
Herniating a disc in my back was less painful than I expected. At first. When I herniated my L5S1 spinal disc, I was in the middle of a lifting workout. Performing bent over rows, I felt a small pop in my back followed by some mild discomfort. I felt reasonably well, but decided to continue my workout another day. I carried on with my day as normal. However, the next morning, I could hardly get out of bed from the pain. I also felt something off in my back, like the bones in my spine were grinding against each other. The following day though, the pain was largely gone. I decided to take a few months off of weight lifting. I had an upcoming cross country season anyways, and gaining too much weight from muscle would be counterproductive. I ended up running a full season of college cross country, always with some minor pain and discomfort in my back. Actually, the running usually made my back feel better, it was other things like sitting for long periods, that would aggravate it. Eventually, I went to the doctor for a diagnosis. He ordered an MRI whereupon the herniation was discovered.
For many people, these symptoms will some familiar. Little pain the day of the injury, followed by severe pain in the following days. People suffering a herniated disc will report feeling a ‘pop’ in their backs, followed by some discomfort. However, the following days will be painful, with patients having difficulty with any position besides lying flat on their backs. Afterwards, there will be a number of symptoms that will manifest that are good indicators of a disc herniation.
Back pain
This is the most obvious symptom of a disc herniation. Usually the back pain is located close to the area of the disc herniation. This is a general symptom, and may also be caused by muscle strain. In fact, a disc herniation and muscle strain may occur at the same time. In other situations, a bad back strain can be painful in its own right. For this reason, back pain is not the sole indicator that you may have herniated a disc in your back.
Nerve pain/ Sciatica
Sciatica is the shooting, stinging, painful sensation you feel when your nerves are being pinched or squeezed. If you have herniated a spinal disc, the disc may come into contact with the nerves in your spine. When that occurs, the nerve may feel pain and that pain will manifest along the entire length of the nerve. Many of the nerves that run into your legs and lower body converge in your lower back, meaning that if a lower back spinal disc comes into contact with that nerve, you may feel a shooting sensation all the way down into your legs. This kind of pain is also a reasonable indicator that you have a herniated disc. As always though, consult a doctor for an actual diagnosis.
Limb pain
If you herniate a disc in your lower back, you may also feel pain in your butt, legs and even your feet! If the herniation occurs in your upper back, then you may feel pain in your shoulders, arms or hands. This may be accompanied by sciatica as described above, but it can also feel like standard muscular pain. This is known as referred pain, and though it may feel like a different injury, the root cause is the damaged spinal disc.
Numbness, tingling, weakness, loss of motor control and/or incontinence
If you ever injure your back, and any of the following symptoms include numbness or tingling, seek medical attention immediately. This is an indicator that your herniated disc is severely impinging on your spinal nerves and immediate action is necessary to preserve your health and future mobility. Your brain controls all of your movements, and it routes its messages through your spine. Any of the aforementioned symptoms means that your brain is unable to send those signals, and the responses from that part of your body are likewise not being sent properly, If you injure your lower back, some of the nerves that control your lower digestive and waste management processes such as bowel movements or urination may be impacted. Take care of yourself and make sure you report any difficulties or changes here to your physician ASAP!
Diagnosis
The diagnosis of a herniated disc can be a frightening experience. Your back is an important part of your body and damaging it can have lasting repercussions on your future health and well-being. However, if properly managed, a herniated disc may be overcome! So what do you do if a doctor gives you the news that you have a bulging disc in your back? My post about the steps you should take following a back injury is a great place to start! If you have already gone through that post though, let me add some additional points to keep in mind!
Don’t panic!
The diagnosis of a medical condition can be scary for anyone. But do not panic! Most people overcome disc herniations and lower back pain, and go on to live healthy and physically active lives! Just know that if you stay calm, positive and focused on a better outcome, you will overcome this and end up even healthier than before!
Develop a plan
Figure out what factors led to your lower back pain and disc herniation, then use those to inform how you move forward. Write it down; it will help you remember what to do on a day to day basis as well as keep you committed. For instance, when I injured my back, I decided that I would start stretching 5-10 minutes per day, that I would swim 3 times a week and that I would try to stand instead of sitting while working or studying. Use this website as a resource and get some ideas for new physical activities or lifestyle changes you can make to help yourself recover.
Follow through
Often times, lower back pain from a herniated disc will resolve after a few weeks. Don’t let the absence of pain let you slip into old habits though. Remember that you more than others without a herniated disc need to take action to ensure health and well-being as you continue with your physical activities.
