What is a herniated disk?

Your spine (backbone) is made up of vertebrae (bones) and disks. Disks are like soft cushions between the bones of the spine. The disks in the spine let you move your backbone.

When a disk between two bones in the spine presses on the nerves around the backbone, it's called a herniated disk. The word "herniate" (say: her-nee-ate) means to bulge or to stick out. Sometimes this is called a ruptured or slipped disk. Herniated disks are most common in the lumbar spine -- the lower part of your backbone, between the bottom of your ribs and your hips.

What are the signs of a herniated disk?

When part of a disk presses on a nerve, it can cause pain in the back and the legs. The location of the pain depends on which disk is weak. How bad the pain is depends on how much of the disk is pressing on the nerve. In most people with herniated disks, the pain spreads over the buttocks and goes down the back of one thigh and into the calf. This is known as sciatica because the pain travels along the path of the sciatic nerve. Some people have pain in both legs. In some people, the legs or feet feel numb or tingly.

The pain from a herniated disk is usually worse when you're active and gets better when you're resting. Coughing, sneezing, sitting, driving and bending forward may make the pain worse. The pain gets worse because these movements put more pressure on the nerve.

People who have painful herniated disks often try to change positions to reduce the pain. You may have found that holding yourself up with your hands while you are sitting helps the pain. Shifting your weight to one side may also help.

How does a disk become herniated?

As you grow older, the disks in your spine weaken and become flatter -- less cushiony. If a disk becomes too weak, the outer part may tear. The inside part of the disk then pushes through the tear and presses on the nerves beside it. The drawing to the right shows how a disk looks when it gets pushed through the tear and presses on a nerve. Herniated disks are most common in people in their 30s and 40s.

How does my doctor know I have a herniated disk?

After asking you questions and giving you an exam, your doctor may take X-rays and other pictures to see whether you have a herniated disk.

What can be done for the pain of a herniated disk?

Your doctor may suggest medicine for the pain. You can probably be more active after taking the pain medicine for 2 days. Becoming active will help you get better faster. If your pain is severe, your doctor may suggest that you rest in bed for 1 or 2 days.

If the pain medicine doesn't help, your doctor may give you a shot in your backbone. This might stop your pain. You may need more than 1 shot.

Sometimes stretching of the spine by your doctor or a chiropractor can help the pain.

Will exercises help the pain?

Yes, exercises can be helpful. Begin by stretching. Bend over forward and bend to the sides. Start these exercises after your back is a little stronger and doesn't hurt as much. The goal of exercise is to make your back and stomach muscles stronger. This will ease the pressure on your disk and make you hurt less. Ask your doctor about exercises for your back. Your doctor may want you to see a physical therapist to learn about safe back exercises.

What about my posture?

Good posture (standing up straight, sitting straight, lifting with your back straight) can help your back by reducing the pressure on your disk

1. Bend your knees and hips when you lift something, and keep your back straight.
2. Hold an object close to your body when you carry it.
3. If you stand for a long time, put one foot on a small stool or box for a while.
4. If you sit for a long time, put your feet on a small stool so your knees are higher than your hips.
5. Don't wear high-heeled shoes.
6. Don't sleep on your stomach.

The pictures on this page show good posture in standing and lifting.

 What are my chances of getting better?

Your chances are good. Most people who have a herniated disk are better in about 4 weeks. Sometimes it takes longer. If you still have pain or numbness after 4 to 6 weeks, or if your signs get worse, talk with your doctor. Sometimes it takes surgery to relieve pain.

If you have trouble going to the bathroom or have weight loss, pain at night or more pain or weakness than usual in your backbone, tell your doctor right away. These might be the signs of a more serious problem.

• Will I always have a herniated disk?
• Am I at risk of another herniated disk?
• How can I prevent getting another herniated disk?
• What can I do to treat a herniated disk?
• What can I do about the pain?
• What types of medicines are used to treat herniated disks? Are there side effects?