Have you ever heard of someone “throwing out” their back? If you or someone you know has experienced this, there can be several causes, but one common cause is a herniated disk.
What is a herniated disk?
The back and neck are composed of vertebrae (bones) that have a soft cushion between each of them. This is the intervertebral disk. The disk has tougher fibers around the outside, and the inside is softer and is called the nucleus. When the tough fibers of the annulus bread down or tear, the nucleus gets pushed out (kind of like jelly coming out of a jelly donut). This can happen due to an injury like lifting something, falling, or twisting. It can also happen as a result of repetitive injuries, such as repeated motions or even sitting or standing in certain postures over a long period of time.
The herniated disk itself may not be that painful. In fact, some people don’t have any pain with a herniated disk and may not realize that they have one. However, the disks are near the nerves of the spine and when they become herniated they often pinch the nerves. This is where most people get pain, and the symptoms can be fairly mild to quite severe.
Some symptoms include:
- Pain that may be radiating.
- Numbness and tingling.
Typically these symptoms only affect one side, though it occasionally affect both sides. If it is the neck disk that is involved, the symptoms are usually in the arms. If it is a disk in the back that is affected, the symptoms are in the legs.
One rare but serious symptom is if there is a change in bowel or bladder function. This is known as cauda equina syndrome and is a medical emergency. If this occurs, you need to see a physician immediately.
When someone finds out that they have a herniated disk, they are often afraid that it will mean that they have to have surgery. In fact, 9 out of 10 patients are treated successfully with conservative treatments like physical therapy, exercise and modified activity, along with pain medication as needed. Heat or cold are also often very helpful for pain relief.
When to Call a Healthcare Professional
Many times symptoms of a herniated disk resolve on their own in 1-2 weeks. A physical therapist can help you determine which exercises and positioning can help you the most, as well as which activities to avoid. If your symptoms are not improving after two weeks you should call your physical therapist* or your doctor. Any time that your symptoms are worsening, you should call a healthcare professional.
Call your doctor if:
You have significant pain, weakness, or numbness, or if any of those symptoms are getting worse.
Difficulty with bladder or bowel function, either loss of control and incontinence, or difficulty voiding, even with a full bladder (this is a medical emergency and you need to seek treatment immediately).
Loss of sensation in the inner thighs, back of legs and area around the rectum (this is also a medical emergency).
See here for more information about herniated disks.
*In the state of Colorado, as well as many other states, you have direct access. This means that you can see your physical therapist without first seeing a physician.