A disc is a structure positioned between the bony vertebrae of the spine. The disc is a cartilage-type material that allows for movement between segments of the spine and also provides shock absorption between the rigid bones of the spine.
With age and usage, the disc can undergo changes that lend to a tear in its outer structure. The disc may bulge if this occurs and produce a “herniation.” A herniation, which is a bulging or protrusion of a disk that normally is flat. If the disk herniates, it can compress a nerve and produce dysfunction of the nerve called “radiculopathy" (see radiculopathy definition in the Cervical and Lumbar Disc Disease section). The symptoms of a disk herniation may be characterized by low back pain with associated buttock, thigh, or leg pain if the herniation is situated in the lumbar spine. If the disc herniation is situated in the neck, it may produce neck pain with associated shoulder blade or arm pain.
The diagnosis of a disc herniation is usually made by listening to a patient’s symptoms, examining the patient, and correlating the symptoms and exam findings to imaging. The most common imaging modality for demonstrating a disc herniation is an MRI, which allows for visualization of soft tissues including discs and nerves, structures that an x-ray does not demonstrate.
Most disc herniations can be managed non-surgically, as the resultant pain is self-limited, which means it will usually resolve with observation and antiinflammatory medication. In some cases, however, further treatments are required including physical therapy, anti-inflammatory injections (epidural steroid injections), or even surgery in the case of relentless pain, weakness or clumsiness.
If the disc herniation ultimately requires surgery, the outcomes are good, in the 80 to 90 percent efficacy range for relief of nerve-related symptoms.
(Also see Cervical and Lumbar Disease)